The Playbook › Condition guides
VA does not rate the head injury itself. It rates what the injury left behind: the memory problems, the headaches, the short fuse, the dizziness. The regulation calls these residuals, and a traumatic brain injury (TBI) can leave several of them, each rated in a different place.
That is why TBI claims are so often under-rated. A veteran files for “TBI,” gets one number, and never learns that the migraines, the ringing in the ears, or the depression could have been rated on their own.
The short version
- TBI residuals are rated under Diagnostic Code 8045 at 0%, 10%, 40%, 70%, or 100%. There is no 20%, 30%, 50% or 60%.
- VA scores 10 areas (the regulation calls them facets) from 0 to 3, or “total.” Your single highest score sets the rating. The scores are not added or averaged.
- A score of 1 is 10%, 2 is 40%, 3 is 70%, and “total” in any one area is 100%.
- Residuals with their own diagnosis, such as migraines, a mental health condition, hearing loss, or seizures, are rated separately and combined with the TBI rating.
- VA cannot pay twice for the same symptom, so each symptom counts in one place only.
- “Mild,” “moderate,” or “severe” TBI in your records describes the injury on the day it happened. It does not set your rating.
On this page
How VA looks at a TBI
The regulation splits the effects of a TBI into three groups:
- Cognitive. Memory, attention, concentration, and what the regulation calls executive functions: planning, organizing, problem solving, judgment, and making decisions.
- Emotional and behavioral. If you have a diagnosed mental health condition, VA rates it under the mental health schedule. If you do not, VA rates these symptoms in the TBI table below.
- Physical. Things like weakness or numbness, vision problems, hearing loss and tinnitus, loss of smell or taste, seizures, balance problems, speech problems, and bladder or bowel problems. Each is rated under its own diagnostic code.
Cognitive problems and general symptoms that do not have a diagnosis of their own are rated using one table with 10 areas.
The 10 areas and how the score becomes a rating
| Highest score in any one area | Rating |
|---|---|
| 0 | 0% |
| 1 | 10% |
| 2 | 40% |
| 3 | 70% |
| Total | 100% |
Only the highest score counts. A veteran who scores 1 in six areas and 3 in one area is rated 70%. A veteran who scores 2 in all ten is rated 40%.
Not every area goes all the way up. This matters, because it tells you which areas can carry a high rating.
| Area | What it covers | Highest score available |
|---|---|---|
| Memory, attention, concentration, executive functions | Thinking, remembering, planning | Total (100%) |
| Judgment | Weighing choices and making reasonable decisions | Total (100%) |
| Social interaction | Whether your behavior around others is appropriate | 3 (70%) |
| Orientation | Knowing who you are, where you are, the time and the situation | Total (100%) |
| Motor activity | Slowed or reduced movement from apraxia, with muscles and nerves intact | Total (100%) |
| Visual spatial orientation | Getting lost, reading maps, judging distance | Total (100%) |
| Subjective symptoms | Headaches, dizziness, fatigue, insomnia, light and sound sensitivity | 2 (40%) |
| Neurobehavioral effects | Irritability, impulsivity, aggression, apathy, lack of motivation | 3 (70%) |
| Communication | Speaking, writing, and understanding language | Total (100%) |
| Consciousness | Coma, vegetative or minimally responsive state | Total only (100%) |
The areas that decide most claims
Memory, attention, concentration, executive functions
| Score | What the regulation requires |
|---|---|
| 0 | No complaints |
| 1 | A complaint of mild loss, such as trouble following a conversation, recalling recent conversations, remembering new names, finding words, or often misplacing things, without objective evidence on testing |
| 2 | Objective evidence on testing of mild impairment causing mild functional impairment |
| 3 | Objective evidence on testing of moderate impairment causing moderate functional impairment |
| Total | Objective evidence on testing of severe impairment causing severe functional impairment |
Notice the jump from 1 to 2. Without testing that shows the problem, this area stops at a score of 1, which is 10%. With testing, the same memory problems can support 40% or more. This is the single biggest reason to ask your doctor about neuropsychological testing.
Subjective symptoms
| Score | What the regulation requires |
|---|---|
| 0 | Symptoms that do not interfere with work, daily living tasks, or close relationships. Examples: mild or occasional headaches, mild anxiety |
| 1 | Three or more symptoms that mildly interfere. Examples: intermittent dizziness, daily mild to moderate headaches, tinnitus, frequent insomnia, sensitivity to sound, sensitivity to light |
| 2 | Three or more symptoms that moderately interfere. Examples: marked fatigability, blurred or double vision, headaches requiring rest periods during most days |
This area tops out at 40%. If your main problem is headaches, a separate migraine rating may be worth more than counting them here.
Neurobehavioral effects
The regulation’s examples are irritability, impulsivity, unpredictability, lack of motivation, verbal aggression, physical aggression, belligerence, apathy, lack of empathy, moodiness, lack of cooperation, inflexibility, and not being aware of your own disability.
| Score | What the regulation requires |
|---|---|
| 0 | Effects that do not interfere with workplace or social interaction |
| 1 | Effects that occasionally interfere with workplace interaction, social interaction, or both, but do not prevent them |
| 2 | Effects that frequently interfere, but do not prevent them |
| 3 | Effects that interfere with or prevent workplace or social interaction, or both, on most days, or that occasionally require supervision for your safety or the safety of others |
Judgment
| Score | What the regulation requires |
|---|---|
| 0 | Normal |
| 1 | Mildly impaired. For complex or unfamiliar decisions, occasionally unable to weigh the options, understand the consequences, and make a reasonable decision |
| 2 | Moderately impaired. For complex or unfamiliar decisions, usually unable to do so, though simple decisions cause little difficulty |
| 3 | Moderately severely impaired. For even routine and familiar decisions, occasionally unable to do so |
| Total | Severely impaired. For even routine and familiar decisions, usually unable to do so. Example: cannot pick appropriate clothing for the weather or judge when to avoid dangerous situations |
The other areas, briefly
- Social interaction. Occasionally inappropriate is 1, frequently inappropriate is 2, inappropriate most or all of the time is 3.
- Orientation. Occasionally disoriented to one of the four aspects (person, time, place, situation) is 1. Occasionally disoriented to two, or often to one, is 2. Often disoriented to two or more is 3. Consistently disoriented to two or more is total.
- Visual spatial orientation. Occasionally getting lost in unfamiliar places but able to use GPS is 1. Usually getting lost in unfamiliar places and having difficulty with GPS is 2. Getting lost even in familiar places and unable to use GPS is 3.
- Communication. Only occasionally impaired is 1. Unable to communicate or understand more than occasionally but less than half the time is 2. At least half the time, but still able to communicate basic needs, is 3. Complete inability is total.
- Motor activity. Mildly slowed at times is 1, mildly decreased or moderately slowed is 2, moderately decreased is 3, severely decreased is total.
The symptoms listed in the table are examples. The regulation says they do not all have to be present for you to get that score.
What gets rated separately
This is where most of the money in a TBI claim is found. The regulation tells VA to rate any residual that has its own diagnosis under its own diagnostic code, then combine it with the TBI rating.
| Residual | Where it is rated |
|---|---|
| Migraine or post-traumatic headaches | Migraines |
| PTSD, depression, anxiety, or another diagnosed mental health condition | PTSD or depression and anxiety |
| Hearing loss and tinnitus | Hearing loss and tinnitus |
| Seizures | Epilepsy codes |
| Vision problems | Eye codes |
| Balance problems, Meniere’s disease | Ear codes |
| Loss of smell or taste | Their own codes |
| Weakness, numbness or pain in the arms, legs or face | Nerve codes |
| Bladder or bowel problems, hormone problems | Their own codes |
The separate ratings are combined using VA math, so they do not simply add up.
The no double-counting rule
VA cannot use the same symptom to support two ratings. If your headaches are rated as migraines, they cannot also be counted as a subjective symptom in the TBI table.
Where the symptoms of two conditions cannot be clearly separated, the regulation tells VA to give one rating under whichever set of criteria better captures the overall impairment. This comes up constantly with TBI and PTSD, because memory problems, irritability, and poor sleep can come from either one. When the symptoms can be separated, you get a rating for each.
What this means for you: ask your doctors to say, where they can, which symptoms come from which condition. If they cannot separate them, that is fine. VA should then rate the whole picture under the criteria that work out better.
“Mild TBI” does not mean a low rating
Records often label a TBI as mild, moderate, or severe. That label is based on what happened at the time of injury, such as how long you were unconscious. The regulation says plainly that this classification does not affect the rating under Diagnostic Code 8045. A “mild” TBI with serious lasting effects can be rated high, and a “severe” TBI with a good recovery can be rated low.
The label does matter for one thing: the secondary conditions below.
Conditions VA treats as caused by your TBI
If your TBI is already service connected, VA accepts that these conditions were caused by it unless there is clear evidence otherwise. You do not need a separate medical opinion linking them.
| Condition | Requirement |
|---|---|
| Parkinsonism, including Parkinson’s disease | After a moderate or severe TBI |
| Unprovoked seizures | After a moderate or severe TBI |
| Certain dementias (presenile dementia of the Alzheimer type, frontotemporal dementia, dementia with Lewy bodies) | Appearing within 15 years of a moderate or severe TBI |
| Depression | Appearing within 3 years of a moderate or severe TBI, or within 12 months of a mild TBI |
| Hormone deficiency diseases from changes to the hypothalamus or pituitary gland | Appearing within 12 months of a moderate or severe TBI |
If you miss a time limit or your TBI was classed lower, you can still claim the condition as secondary. You would then need a nexus opinion like any other secondary claim.
Other conditions commonly claimed as secondary to TBI, with a medical opinion, include migraines, sleep problems, tinnitus, and mental health conditions.
Getting service connected
You need three things: a diagnosis of TBI, an event in service, and a medical link between the two.
The event. Common ones are blast exposure, vehicle accidents, falls, training accidents, parachute landings, combatives and boxing, and assaults. Many were never written up. If yours was not, use:
- Service treatment records showing headaches, dizziness, or confusion afterward
- Post-deployment health assessments where you reported a blast or head injury
- Awards, incident reports, or unit records placing you at the event
- Buddy statements from people who saw it or saw you afterward
- Your own personal statement describing what happened and what changed
The diagnosis. See the next section. Who makes the first TBI diagnosis matters.
The C&P exam
TBI exams work differently from most.
- The TBI questionnaires are not public. VA’s list of public DBQs states that the initial and review TBI forms are not available for public use, so your private doctor cannot fill one out for you the way they can for most conditions.
- VA policy has required the first diagnosis of TBI to come from one of four kinds of specialist: a physiatrist, psychiatrist, neurosurgeon, or neurologist.
- You will often get a separate mental health exam as well, so the examiners can sort out which symptoms belong to which condition.
How to prepare:
- Go through all 10 areas beforehand and write down a real example for each one that applies. “I got lost driving to my daughter’s school, a route I drive every week” is far more useful than “my memory is bad.”
- Count your symptoms. The subjective symptoms area needs three or more. List every one: headaches, dizziness, fatigue, sleep trouble, light sensitivity, sound sensitivity, blurred vision.
- Describe your bad days, and how often they happen. The regulation recognizes that symptoms go up and down from day to day.
- Bring someone who lives with you if you can, or a written statement from them. People with a TBI often do not notice their own changes, and the regulation lists that lack of awareness as a symptom.
- Bring test results. Neuropsychological testing, brain imaging, and any treatment records from a TBI or polytrauma clinic.
See the C&P exam guide for more.
Evidence that helps
- Neuropsychological testing. The memory area needs objective evidence on testing for anything above 10%.
- Statements from family, friends and coworkers. They can describe the irritability, the forgetting, and the personality change, with dates and examples.
- Work records. Write-ups, lost jobs, accommodations, or a supervisor’s statement about conflicts or mistakes. These speak directly to the “workplace interaction” wording in the table.
- A symptom log. A month or two of headaches, dizzy spells, sleep, and incidents.
- Treatment records from neurology, speech therapy, occupational therapy, vision clinics, and mental health.
If you were rated before October 23, 2008
The TBI criteria were rewritten on that date. If your rating was set under the old version, you can ask VA to review it under the current criteria even if your condition has not worsened. VA treats the request as a claim for increase, and any increase cannot be effective earlier than October 23, 2008. See filing for an increase.
If the rating does not reflect how disabled you are
- TDIU. If TBI residuals keep you from holding a job, you may be paid at the 100% rate without a 100% rating. See TDIU.
- Special monthly compensation. The regulation tells VA to consider extra pay for things like loss of use of a limb, certain sensory losses, erectile dysfunction, being housebound, or needing another person’s help, including help staying safe because of cognitive problems. There is also a special level, SMC-T, for veterans who need daily in-home care because of TBI residuals and would otherwise need to be in a hospital or nursing home. See special monthly compensation.
Common mistakes
- Filing only for “TBI” and never claiming the headaches, tinnitus, or depression separately
- No neuropsychological testing, which holds the memory area at 10%
- Describing only one or two symptoms when the subjective symptoms area needs three
- Assuming “mild TBI” in the records means a low rating
- Going to the exam alone and saying “I’m doing okay”
- Not asking doctors to say which symptoms come from TBI and which from PTSD
- Leaving a pre-2008 rating in place without asking for a review
Free printable checklist. Everything to gather before you file, what to bring to your C&P exam, and what to check in your decision, on two pages.
Sources
- 38 CFR 4.124a, Diagnostic Code 8045, residuals of traumatic brain injury
- 38 CFR 3.310(d), conditions VA treats as caused by a service-connected TBI
- 38 CFR 3.350(j) and 3.352, special aid and attendance for TBI
- VA Benefits: Public Disability Benefits Questionnaires
- VA Public Health: Traumatic Brain Injury
Last reviewed October 2026. This guide is general educational information, not legal or medical advice, and this site is not affiliated with the Department of Veterans Affairs. Rules and rates change. Confirm details on VA.gov or with an accredited representative. See our disclaimer and editorial policy.
