TBI VA Disability Rating: Criteria, Evidence & Pay

What is TBI and how does it affect veterans?

Traumatic Brain Injury (TBI) is one of the signature injuries of recent military conflicts, though it affects veterans of all eras. TBI occurs when a sudden trauma — blast exposure from IEDs, concussions from vehicle accidents, falls, combat impacts, or training injuries — causes damage to the brain. TBI ranges from mild (concussion) to severe (penetrating injury or prolonged loss of consciousness), and the effects can be temporary or permanent.

Veterans with TBI may experience a wide range of symptoms across cognitive, physical, emotional, and behavioral domains. Cognitive effects include memory problems, difficulty concentrating, slowed thinking, and impaired judgment. Physical symptoms can include chronic headaches, dizziness, balance problems, and sensitivity to light and noise. Emotional and behavioral changes often include irritability, mood swings, depression, anxiety, and impulsivity. Many of these symptoms overlap with PTSD, making accurate diagnosis essential.

Unlike other mental health conditions, TBI is rated under a completely different system. While PTSD, depression, and anxiety use the General Rating Formula for Mental Disorders under 38 CFR § 4.130, TBI is evaluated under DC 8045 per 38 CFR § 4.124a using a facet-based rating system. This distinction is critical because TBI can be rated separately from mental health conditions, and the secondary conditions caused by TBI often result in significant additional compensation.

VA diagnostic code for TBI

TBI is rated under Diagnostic Code (DC) 8045 per 38 CFR § 4.124a, Schedule of Ratings — Neurological Conditions and Convulsive Disorders.

The TBI rating system is unique within the VA disability framework. Rather than using the General Rating Formula for Mental Disorders, DC 8045 evaluates TBI across 10 facets of brain function. Each facet is assigned a severity level, and the overall rating is determined by the highest facet level. Physical, emotional, and cognitive residuals of TBI that can be evaluated separately under other diagnostic codes (such as migraines or depression) are often rated individually as secondary conditions.

Rating criteria for TBI

The VA rates TBI using a facet-based system that is fundamentally different from other conditions. Here are the 10 facets evaluated:

1. Memory, attention, concentration, executive functions
2. Judgment
3. Social interaction
4. Orientation
5. Motor activity (with intact motor and sensory system)
6. Visual-spatial orientation
7. Subjective symptoms
8. Neurobehavioral effects
9. Communication
10. Consciousness

Each facet is assigned a level from 0 to 3 (some facets have additional levels). The highest facet level determines the overall TBI rating as follows:

0% rating

Criteria: All 10 facets are rated at level 0, indicating no impairment or symptoms.

Monthly payment: $0 (but establishes service connection, which matters for future increases and secondary claims)

What the facets look like at level 0:

• Memory and concentration are normal
• Judgment is normal
• Social interaction is routinely appropriate
• Orientation is always intact
• Motor activity and visual-spatial orientation are normal
• No subjective symptoms or neurobehavioral effects
• Communication is normal
• Consciousness is normal

10% rating — $180.42/month

Criteria: The highest facet level among all 10 facets is level 1.

What the facets look like at level 1:

• Memory: Mild memory loss (forgetting names, directions, recent events), attention and concentration mildly impaired — able to complete most tasks but may need more time
• Judgment: Mildly impaired — occasionally fails to identify, plan, or weigh alternatives for routine problems
• Social interaction: Occasionally inappropriate behavior
• Orientation: Occasionally disoriented in one or more aspects (person, time, place, situation)
• Motor activity: Mildly decreased — movement slowed but mostly normal
• Visual-spatial: Mildly impaired — gets lost in unfamiliar surroundings, has difficulty reading maps
• Subjective symptoms: Present but do not interfere with work or daily activities (mild headaches, mild anxiety)
• Neurobehavioral effects: One or more neurobehavioral effects that occasionally interfere with social interaction
• Communication: Comprehension or expression (or both) mildly impaired — can generally communicate but may need more time

40% rating — $795.84/month

Criteria: The highest facet level among all 10 facets is level 2.

What the facets look like at level 2:

• Memory: Moderate memory impairment — difficulty recalling recent events, retaining new information, or completing complex tasks without prompting
• Judgment: Moderately impaired — routinely fails to identify, plan, or weigh alternatives for problems
• Social interaction: Frequently inappropriate behavior
• Orientation: Frequently disoriented in two or more aspects
• Motor activity: Moderately decreased — movement slow, limited, or uncoordinated
• Visual-spatial: Moderately impaired — occasionally gets lost in familiar surroundings
• Subjective symptoms: Present and interfere with work or daily activities, requiring medication or behavioral management
• Neurobehavioral effects: Frequently interfere with workplace interaction, social interaction, or both
• Communication: Moderately impaired — can communicate basic needs but has difficulty with complex or abstract information

70% rating — $1,808.45/month

Criteria: The highest facet level among all 10 facets is level 3.

What the facets look like at level 3:

• Memory: Severely impaired — difficulty retaining any new information, frequently unable to recall basic personal information or complete simple tasks without prompting
• Judgment: Severely impaired — unable to identify, plan, or weigh alternatives even for basic decisions
• Social interaction: Inappropriate most or all of the time
• Orientation: Consistently disoriented in two or more aspects
• Motor activity: Severely decreased — assistance required for most motor activities
• Visual-spatial: Severely impaired — may not be able to find way around own home
• Subjective symptoms: Present and severely interfere with ability to perform activities of daily living
• Neurobehavioral effects: Interfere with or preclude workplace interaction, social interaction, or both on most days
• Communication: Severely impaired — unable to communicate basic needs without assistance

100% rating — $3,938.58/month

Criteria: Total occupational and social impairment. Under DC 8045, a total rating is assigned when there is total disability due to TBI. This may manifest as:

• A level of impairment beyond level 3 in one or more critical facets
• A state of severely altered consciousness (such as persistent vegetative state or minimally conscious state)
• Complete inability to perform activities of daily living
• Total disorientation requiring constant supervision

What this looks like: You cannot work in any capacity and require substantial assistance with daily living. You may have severe cognitive deficits that prevent independent functioning, persistent consciousness impairment, or profound deficits across multiple facets that collectively result in total disability.

What evidence do you need?

Building a strong TBI claim requires several types of evidence:

Service records

• Service treatment records documenting the traumatic brain injury event (blast exposure, concussion, vehicle accident, fall)
• Incident reports, combat action records, or line-of-duty investigations
• Post-deployment health assessments that screen for TBI
• Any in-service neurological evaluations or brain imaging (CT, MRI)

Medical evidence

• Current diagnosis of TBI residuals from a qualified neurologist, neuropsychologist, or other specialist
• Neuropsychological testing results documenting cognitive deficits across the 10 facets
• Brain imaging (MRI, CT, PET scans) showing structural or functional changes if available
• Treatment records showing ongoing symptoms and their progression over time
• Documentation of all medications prescribed for TBI-related symptoms

Nexus letter

A medical opinion letter connecting your current TBI residuals to the in-service traumatic event. A strong nexus letter should explain the mechanism of injury, the expected progression of symptoms, and how current deficits are consistent with the documented TBI. For blast-related TBI, the letter should address how blast wave physics can cause brain injury even without direct head impact.

Buddy statements

Statements from fellow service members, family, or friends who can describe:

• The traumatic event that caused the brain injury, if they witnessed it
• Changes in your cognitive abilities, personality, and behavior before and after the injury
• Specific examples of memory problems, judgment issues, or behavioral changes
• How TBI residuals affect your daily life and ability to work

Personal statement

Your own detailed account of the injury event and how TBI affects your current daily functioning. Describe specific problems across the 10 facets: “I get lost driving to the grocery store I’ve been going to for five years. Last month I left the stove on three times. I can’t remember my children’s phone numbers anymore. I’ve had four car accidents since my TBI because I misjudge distances.”

C&P exam tips for TBI

The Compensation & Pension (C&P) exam for TBI is different from mental health exams. Here’s how to prepare:

What the examiner evaluates

The examiner uses the TBI-specific evaluation protocol and assesses each of the 10 facets of brain function individually. The exam typically includes:

• A detailed history of the traumatic event(s)
• Cognitive testing and screening
• Evaluation of motor function and coordination
• Assessment of communication abilities
• Review of neurobehavioral symptoms
• Determination of the highest facet impairment level

How to prepare

1. Document the injury event clearly. Know the dates, circumstances, and immediate symptoms (loss of consciousness, confusion, amnesia) of your TBI. If you had multiple TBIs, document each one.
2. Don’t downplay cognitive deficits. If you struggle with memory, concentration, or finding words, say so honestly. Don’t try to appear sharper than you typically are.
3. Bring someone who knows you well. A spouse or family member can describe cognitive and behavioral changes that you may not be aware of — people with TBI often lack full insight into their own deficits.
4. Describe your worst days. If you have good days and bad days, make sure the examiner knows what your worst days look like. Describe specific examples of each facet that causes problems.
5. Mention all secondary conditions. Tell the examiner about headaches, sleep problems, depression, dizziness, tinnitus, and any other symptoms that developed after the TBI.

Common mistakes

• Minimizing cognitive deficits because you’ve developed compensating strategies (using phone reminders, relying on your spouse for navigation)
• Not connecting current symptoms back to the in-service TBI event
• Failing to report all TBI events — many veterans had multiple concussions during service
• Not mentioning secondary conditions that the VA should evaluate separately

Common secondary conditions linked to TBI

TBI frequently causes or aggravates other conditions. These can — and should — be claimed as secondary service-connected disabilities, as they are often rated separately from the TBI itself:

• Migraines — Post-traumatic headaches are one of the most common residuals of TBI. Chronic migraines following a TBI are well-documented in medical literature and can qualify for a separate rating of up to 50%.
• Depression — TBI causes structural and chemical changes in the brain that frequently lead to Major Depressive Disorder. Depression is one of the most common psychiatric conditions secondary to TBI.
• Sleep apnea — TBI can disrupt the brain’s control of breathing during sleep, and the association between TBI and obstructive sleep apnea is well-established in research.
• Tinnitus — Blast exposure and head trauma commonly damage the auditory system, causing persistent ringing in the ears. Tinnitus is rated separately at up to 10%.
• Hearing loss — The same blast exposure or head trauma that causes TBI frequently damages hearing. Sensorineural hearing loss is commonly service-connected secondary to TBI.

How to calculate your monthly payment

Your total VA disability payment depends on your combined rating across all service-connected conditions, not just TBI alone. Because TBI generates many separately-rated secondary conditions, your combined rating is often significantly higher than the TBI rating itself. Use our VA disability calculator to:

• Calculate your combined rating with multiple conditions
• See how VA math combines ratings differently than simple addition
• Estimate your monthly payment including dependents

For the full breakdown of payment amounts at every rating level, see our 2026 VA disability pay rates page.

Disclaimer: This content is for informational purposes only and does not constitute legal or medical advice. For personalized guidance on your VA disability claim, consult a VA-accredited Veterans Service Organization (VSO), attorney, or claims agent. You can find accredited representatives at VA.gov.