VA Disability for Traumatic Brain Injury (TBI)
A Traumatic Brain Injury (TBI) is a serious condition that affects many who have served our country. It is often called the “signature wound” of the post-9/11 conflicts, but TBI has impacted veterans from all service eras due to combat, training accidents, and other service-related events.
A TBI occurs when an outside force, such as a jolt, a blow to the head, or a blast, disrupts the brain’s normal functioning. The VA disability rating process for TBI is unique because the VA does not rate the initial injury itself. Instead, it rates the lasting effects (physical, mental, and emotional changes) that remain after the injury. Understanding these effects and having the proper documents is essential for getting your benefits.
What Are TBI Residuals (The Lingering Symptoms)?
TBI residuals are the chronic, persistent symptoms that continue after the initial brain injury. These can show up right away or develop months or even years later. The VA understands that a TBI can affect nearly every area of a veteran’s life.
These lingering symptoms are typically grouped into three main categories:
1. Cognitive (Thinking and Mental) Changes
This category often includes the most significant difficulties. Cognitive residuals affect how you think, focus, and remember.
- Memory: Trouble learning new things, recalling recent events, or remembering names and faces.
- Attention/Focus: Being easily distracted, struggling to stay focused, or having difficulty completing tasks.
- Executive Functions: Impairment in skills like planning, organizing, solving problems, and making good decisions.
- Orientation: Feeling confused about the time, where you are, or who people are.
2. Emotional and Behavioral Changes
A TBI can change a veteran’s personality and how they control their emotions.
- Mood Swings: Rapid or uncharacteristic shifts in your emotional state.
- Irritability and Aggression: Having trouble controlling your anger or experiencing frequent outbursts.
- Anxiety and Depression: Developing new mental health conditions or seeing existing ones get worse.
- Apathy: Losing interest or motivation in activities you used to enjoy.
3. Physical Changes
TBI can also cause a range of physical problems.
- Headaches: Dealing with chronic migraines or frequent tension headaches.
- Dizziness and Balance: Feeling off-balance or having vertigo.
- Sensory Issues: Problems with vision (like blurred or double vision), hearing (like ringing in the ears, or tinnitus), or a loss of smell or taste.
- Motor Control: Weakness, tremors, or issues with coordination.
- Speech: Difficulty speaking or understanding language (aphasia) or slurred speech (dysarthria).
It’s vital to know that a single TBI may lead to a combination of these residuals. The VA looks at the total impact of these symptoms when deciding on your rating.
Establishing Service Connection for Your TBI
To seek VA disability compensation for a TBI, you generally need to show three elements. Collecting medical evidence to support each of these is an essential step in your benefits pursuit.
- A Current Diagnosis: You need a current, confirmed diagnosis of TBI or its residuals from a qualified medical professional.
- An In-Service Event: You need proof of an event during your military service that caused or made your TBI worse (e.g., a blast, head trauma, or an accident). This can be shown through service treatment records or statements from you or a fellow service member (Lay Statements or Buddy Statements).
- A Medical Link (Nexus): There must be a medical opinion that connects the in-service event to your current TBI residuals.
The Domino Effect: Presumed Service Connection for TBI-Related Conditions
In some cases, the VA may presume a condition is service-connected if it develops after an already service-connected TBI. Think of this as a domino effect—the TBI is the first domino, and it knocks over others (the new conditions).
If you have a service-connected TBI, and one of the following conditions is diagnosed within a specific timeframe, the VA may assume a link, which can simplify your evaluation process:
- Parkinson’s disease (if the TBI was moderate or severe).
- Seizures (if no other clear cause is found).
- Depression (if diagnosed within three years of a moderate or severe TBI, or within one year of a mild TBI).
- Certain types of dementia (if diagnosed within 15 years of a moderate or severe TBI).
- Hormone deficiency diseases (if diagnosed within 12 months of a moderate or severe TBI).
How the VA Rates TBI: The 10-Facet System
The VA uses a unique method to rate TBI under Diagnostic Code 8045. They do not use the initial severity (mild, moderate, or severe) to assign a rating. Instead, they evaluate the most severe functional impairment found across 10 specific facets of TBI residuals.
How does the VA rate Traumatic Brain Injury (TBI) for disability?
The VA assigns ratings for traumatic brain injury (TBI) based on the lasting residual effects, or persistent symptoms, rather than the initial severity of the injury.
They assess ten specific areas of impairment, including memory, judgment, and emotional regulation. A disability rating (0%, 10%, 40%, 70%, or 100%) is determined based on the single area that exhibits the highest level of impairment.
The 09 Facets of TBI Residuals
The VA examiner will look at how the TBI affects your daily life in these ten areas:
- Memory, Attention, Concentration, and Executive Functions: Problems with focus, recall, planning, and decision-making.
- Judgment: Your ability to make sound decisions and understand what might happen as a result.
- Social Interaction: How appropriately you behave and interact with others.
- Orientation: Your awareness of where you are, the time, and who people are.
- Motor Activity: The speed and coordination of your movement.
- Visual-Spatial Orientation: Difficulty with things like navigating, reading a map, or judging distances.
- Neurobehavioral Effects: Issues like irritability, aggression, apathy, or acting without thinking (impulsivity).
- Communication: Your ability to understand or express language (spoken or written).
- Consciousness: Includes rare conditions like a persistent vegetative state.
Subjective Symptoms: Symptoms like chronic headaches, dizziness, or fatigue that consistently get in the way of your work or social life.
For each of these 10 facets, a severity level is assigned. Your overall TBI rating is determined by the highest single rating from any of the 10 facets:
| Severity Level | Disability Rating |
| No impairment | 0% Rating |
| Mild impairment | 10% Rating |
| Moderate impairment | 40% Rating |
| Severe impairment | 70% Rating |
| Total impairment | 100% Rating |
For example, if the evaluation finds a Total impairment in Judgment (100%), but only a Mild impairment in Memory (10%), your overall TBI rating would be 100%.
A Note on Overlapping Symptoms: The VA’s rules (called the anti-pyramiding rule) prevent the same symptoms from being used to rate two different conditions. For instance, if your depression symptoms are rated under the TBI criteria, those same symptoms generally cannot also be used to rate a separate mental health condition.
What kind of medical evidence may I need for a TBI evaluation?
Essential medical evidence includes a confirmed diagnosis of TBI and its residuals, detailed medical records of symptoms and treatments, neuropsychological testing results, and a strong medical nexus letter. Statements from the veteran and witnesses (Lay Statements) are also vital to describe the functional impact of the TBI.
Essential Evidence for Your Evaluation
Proving a connection to service and the severity of TBI residuals requires detailed, consistent documentation.
- Service Treatment Records (STRs): Documentation of any head trauma, concussions, or blast exposures you experienced while in service.
- Current Medical Diagnosis: A confirmed diagnosis of TBI and its current residuals from a neurologist, psychiatrist, or other qualified medical professional.
- Neuropsychological Testing: These tests are often necessary for objectively showing how your cognitive abilities (like memory, attention, and executive functions) are impaired.
- A Medical Nexus Letter (Highly Recommended): This is a strong medical opinion from a doctor that specifically links your TBI and its current symptoms to the in-service event or exposure.
- Lay Statements (Buddy and Personal Statements): These are extremely important for TBI. Many TBI residuals—like changes in personality, memory issues, or social difficulties—are best captured by the people who live with you or served with you.
- Your Personal Statement: Describe the TBI event (if you remember it), when symptoms began, and, most importantly and how your TBI residuals affect every part of your daily life.
- Buddy Statements: Statements from family, friends, or fellow service members who saw the injury happen or witnessed the changes in your behavior and abilities during or after service.
Discover the importance of medical evidence
Clear and concise medical documentation is crucial for the success of any disability claim. If you’re unsure about your documentation, talk to one of our licensed medical experts for FREE.
And know that at the heart of everything we do at Trajector Medical are the stories of our clients. We are proud to say that we have surpassed 1,000 recorded testimonial videos on our YouTube Channel. Real people that we have helped by building supporting medical evidence that they used to pursue the disability benefits they choose.
