How the VA rates TBI
The VA rates residuals of traumatic brain injury under Diagnostic Code 8045 in 38 CFR Part 4. Rather than a single symptom list, TBI is evaluated across three main areas: cognitive impairment, emotional and behavioral effects, and physical (neurological) effects.
The cognitive piece is scored using ten facets. For each facet, the examiner assigns a level of impairment, and the highest single facet level determines your overall TBI evaluation.
- Level 0 = 0 percent
- Level 1 = 10 percent
- Level 2 = 40 percent
- Level 3 = 70 percent
- Total = 100 percent
Because the single highest facet controls the rating, one severely affected area, such as memory or judgment, can drive a high evaluation even if other areas are mildly affected.
Note: This is general information about VA disability, not legal advice. Only the VA can rate your specific claim based on your evidence and examination.
The ten cognitive facets
The cognitive impairment portion of the TBI rating scale evaluates ten facets, each scored from 0 to 3 (with some allowing a "total" level):
- Memory, attention, concentration, and executive functions
- Judgment
- Social interaction
- Orientation
- Motor activity
- Visual spatial orientation
- Subjective symptoms (such as headaches or dizziness)
- Neurobehavioral effects
- Communication
- Consciousness
The examiner assigns each facet a level based on how severely it affects your daily functioning. The facet with the highest level sets your overall percentage. This is why a thorough, accurate examination is so important. If a facet is under-scored, your entire rating can be too low.
Mild, moderate, and severe TBI
TBI is often classified at the time of injury as mild, moderate, or severe. This initial classification describes the injury itself, but it does not directly set your VA rating. The rating is based on your current residuals, meaning the lasting effects you live with now.
- Mild TBI (concussion). May involve brief loss of consciousness and lingering headaches, memory trouble, or mood changes. Even "mild" TBI can leave significant residuals.
- Moderate TBI. Longer loss of consciousness and more pronounced cognitive or physical effects.
- Severe TBI. Extended unconsciousness and serious, often permanent, impairment.
A veteran with a "mild" TBI at the time of injury can still have serious ongoing residuals years later. What matters for your rating is how the condition affects you today.
Residuals and overlap with PTSD
TBI residuals frequently overlap with mental health conditions, especially PTSD. Symptoms like irritability, sleep problems, difficulty concentrating, and depression can stem from either condition. The VA has specific rules for how it handles this overlap.
When symptoms cannot be clearly separated between TBI and a mental health condition, the VA generally assigns a single evaluation under whichever diagnostic code produces the higher rating, to avoid rating the same symptom twice (pyramiding). When symptoms can be distinguished, the conditions may be rated separately.
This makes coordination between your TBI and mental health claims critical. A poorly documented exam may lump everything together and undercut your total rating. Learn more about PTSD claims and mental health disability ratings.
If TBI and PTSD together prevent you from maintaining substantially gainful employment, you may qualify for Total Disability based on Individual Unemployability (TDIU), which pays at the 100 percent rate even if your combined schedular rating is lower.
The C&P exam for TBI
Your Compensation and Pension (C&P) examination is often the single most important step in a TBI claim. VA guidelines direct that TBI examinations be conducted by one of four specialists when possible: a neurologist, neurosurgeon, physiatrist, or psychiatrist.
To prepare:
- Be honest and specific about how symptoms affect your daily life, work, and relationships. Do not minimize on a "good day."
- Bring examples: missed appointments, mistakes at work, family conflict, or safety issues.
- Consider lay statements from family or coworkers who see your struggles firsthand.
If the exam is inadequate or performed by an unqualified examiner, that can be grounds to challenge the resulting decision. You can estimate how a TBI rating combines with your other conditions using our VA disability calculator, or contact us to discuss your claim.
Frequently Asked Questions
How does the VA decide my TBI percentage?
For cognitive impairment, the VA scores ten facets from level 0 to 3 (or total). The single highest facet level sets your overall rating: level 1 equals 10 percent, level 2 equals 40 percent, level 3 equals 70 percent, and total equals 100 percent. Emotional and physical residuals may be rated separately.
Can I be rated for both TBI and PTSD?
Sometimes. If the symptoms of TBI and PTSD can be clearly separated, they may be rated separately. When symptoms overlap and cannot be distinguished, the VA generally uses the single code producing the higher rating to avoid rating the same symptom twice. This is general information, not legal advice.
My TBI was called mild. Can I still get a high rating?
Yes. The mild, moderate, or severe label describes the injury at the time it happened, not your current rating. Your VA rating is based on your lasting residuals today. A mild TBI can still leave significant, ratable effects years later.
Who should perform my TBI C&P exam?
VA guidance directs that initial TBI examinations be performed, when feasible, by a neurologist, neurosurgeon, physiatrist, or psychiatrist. If your exam was inadequate or done by an unqualified examiner, that may be a basis to challenge the decision on appeal.
What if my TBI keeps me from working?
If your TBI, alone or combined with other service-connected conditions, prevents you from maintaining substantially gainful employment, you may qualify for TDIU, which pays at the 100 percent rate even when your combined schedular rating is lower.
Struggling to get the right TBI rating?
TBI claims are complex, and inadequate exams often lead to low ratings. Our team helps veterans document residuals and challenge unfair decisions. Contact us for a free case review.