VA rating guide · Neurological
TBI VA Rating: Facets & Residuals Explained
A traumatic brain injury is rated differently from almost any other condition. The VA looks at ten areas of cognitive function, then rates physical and emotional residuals separately.
- How the 10 facets work
- Separate residual ratings
- Presumptive conditions
- TBI severity levels
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How the VA Rates TBI
Residuals of traumatic brain injury (diagnostic code 8045) fall into three areas, and each may be rated:
- Cognitive: memory, concentration, attention and executive functions, rated with the TBI facet table below.
- Emotional and behavioral: rated under the mental health formula if you have a mental health diagnosis, or under the facet table if you don’t.
- Physical: problems with a distinct diagnosis, such as migraines, tinnitus, hearing loss, vision problems, seizures, or balance problems, are each rated separately under their own diagnostic codes.
The VA can’t use the same symptoms to support two ratings, but every distinct residual should be identified and rated.
How the Facet Table Becomes a Rating
The VA rates 10 facets of TBI: memory, attention, concentration and executive functions; judgment; social interaction; orientation; motor activity; visual spatial orientation; subjective symptoms; neurobehavioral effects; communication; and consciousness. Each is scored 0 to 3, or “total.” Your rating comes from the single highest facet.
Conditions Presumed Linked to a Service-Connected TBI
Under 38 CFR 3.310(d), if your TBI is service-connected, the VA presumes these conditions are caused by it, without needing a medical opinion, unless there’s clear evidence otherwise:
- Parkinsonism, including Parkinson’s disease, following moderate or severe TBI
- Unprovoked seizures following moderate or severe TBI
- Certain dementias (presenile dementia of the Alzheimer type, frontotemporal dementia, and dementia with Lewy bodies) if they appear within 15 years of a moderate or severe TBI
- Depression within 3 years of a moderate or severe TBI, or within 12 months of a mild TBI
- Hormone deficiency diseases from hypothalamo-pituitary changes within 12 months of a moderate or severe TBI
Outside those time limits or severity levels, the conditions can still be service-connected with medical evidence.
How the VA classifies TBI severity
Severity is based on symptoms at the time of injury, not how you function today. For example, a mild TBI involves loss of consciousness of 30 minutes or less and post-traumatic amnesia of up to a day; moderate involves loss of consciousness over 30 minutes but under 24 hours; severe involves loss of consciousness over 24 hours. Meeting any one criterion of a higher level puts the TBI at that level.
Proving a TBI From Service
- Blast exposure from IEDs, mortars or breaching, even without a recorded diagnosis at the time
- Vehicle accidents, falls, parachuting and training injuries
- Service records of concussion screenings, “bell rung” incidents, or medical visits after an event
- Statements from people who saw the incident or noticed changes in you afterward
Many TBIs were never documented, especially before routine screening began. Lay statements and later medical evaluations can fill that gap.
TBI VA Rating: Common Questions
Can I be rated for TBI and PTSD at the same time?
Yes, but the VA can’t use the same symptoms twice. If you have a mental health diagnosis, emotional and behavioral symptoms are rated under the mental health formula, while cognitive impairment is rated under the TBI facets. An examiner may need to separate which symptoms come from which condition.
Are migraines from a TBI rated separately?
Yes. Residuals with their own diagnosis, like migraines, tinnitus or seizures, are rated under their own diagnostic codes in addition to the TBI facet rating.
I was never diagnosed with a TBI in service. Can I still claim it?
Yes. Many service TBIs, especially from blasts, were never documented. Statements about the event and your symptoms afterward, plus a current medical evaluation, can support the claim.
Does depression after a TBI count?
If your TBI is service-connected, depression is presumed linked if it appears within 3 years of a moderate or severe TBI, or within 12 months of a mild TBI. Outside those windows, it can still be connected with medical evidence.
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