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VA Disability Rating for Traumatic Brain Injury (TBI)

The Department of Veterans Affairs rates traumatic brain injuries, or TBI, based on how much function a veteran loses and the extent of disability caused by the injury. Obtaining a VA rating for TBI can help veterans pursue compensation for the losses they faced after their time in service. At Veterans Guide, we support veterans as they pursue their disability rating for TBI and determine how the VA can aid them.

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Content Reviewed by: Matt Coveney
Last Modified Date: December 9, 2024

 A traumatic brain injury, or TBI, is life-altering. Even minor brain injuries have symptoms that linger for a long time. Moderate to severe brain injury may last for a lifetime, causing a variety of serious issues that impact your daily life. If you have a brain injury, you may struggle with memory, focus, concentration, personality changes, increased risk of seizures and infections, and decreased life expectancy.

At Veterans Guide, we help veterans understand the VA rating for TBI and how you can pursue a disability rating that offers compensation for the struggles they face due to brain injuries sustained during service in the Armed Forces.

How Does the VA Rate Traumatic Brain Injury?

The VA rates TBI under 38 CFR § 4.124a, which covers neurological conditions and convulsive disorders. A TBI disability rating from the VA may depend on the symptoms you experience, including visual impairment, hearing loss, seizures, muscle weakness, concentration, judgment deficits, and memory impairment.

The VA looks at several subcategories impacting veterans with brain injuries and then assigns each one a rating of 0, 1, 2, 3, or Total. The VA then uses the combined rating to determine the total disability you have due to TBI. The subcategory ratings are assigned as follows:

  • 0: No impairment and a 0 percent rating
  • 1: Mild impairment and a 10 percent rating
  • 2: Moderate impairment and a 40 percent rating
  • 3: Severe impairment and a 70 percent rating
  • Total: Total impairment and a 100 percent rating

Each category has a specific rating system based on how those challenges impact veterans.

Memory, Attention, Concentration, and Executive Function

  • 1: Mild memory loss described by the veteran but without objective evidence
  • 2: Objective evidence of mild impairment of memory, executive function, or attention in an exam
  • 3: Objective evidence of moderate impairment in cognitive areas during an exam
  • Total: Objective evidence of severe impairment of memory, executive function, or attention, including severe functional impairment related to those conditions

Judgment

  • 1: Mildly impaired judgment, including difficulty understanding or making unfamiliar decisions
  • 2: Moderately impaired judgment, including trouble weighing alternatives or understanding potential consequences. in unfamiliar situations
  • 3: Moderately severe impaired judgment, including trouble with even familiar decisions and tasks
  • Total: Severely impaired judgment and inability to weigh the consequences of potential actions

Social Interaction

  • 1: Occasionally inappropriate social behavior
  • 2: Frequently inappropriate social behavior
  • 3: Inappropriate social behavior most or all the time

Social interaction does not have a “Total” rating on the VA scal

Orientation

  • 1: Occasional problems with one element of who a person is, what time it is, place, or situational orientation
  • 2: Occasional disorientation in at least two of the four aspects of orientation
  • 3: Often disoriented in at least of the four aspects of orientation
  • Total: Consistently disoriented in at least two of the four aspects of orientation

Motor Activity

  • 1: Usually normal motor activity, but with occasional slowness due to apraxia, or damage to the part of the brain that controls how your muscles move
  • 2: Mild to moderate slowing in normal motor activity
  • 3: Moderate decrease in normal motor activity
  • Total: Severely decreased motor activity due to apraxia related to TBI

Visual and Spatial Orientation

  • 1: Mild impairment, including occasionally getting lost in unfamiliar situations, but can use assistive devices like a GPS to get around
  • 2: Moderate impairment: Gets lost in unfamiliar surroundings and may have trouble using assistive devices, including GPS devices
  • 3: Moderate to severe impairment: Gets lost even in familiar surroundings and cannot follow directions or use a GPS device
  • Total: Severe impairment in visual and spatial orientation, including difficulty touching their own body parts when asked or difficulty navigating in any surroundings

Communication

  • 1: Only occasional impairment of either spoken or written language
  • 2: Difficulty with written or spoken language less than half the time, but more than occasionally
  • 3: Inability to communicate by written or spoken language at least half the time, but not all the time
  • Total: Complete inability to communicate via either written or spoken language or both

The VA also looks at subjective symptoms that can interfere with your normal daily living, work, or family. In addition, the VA looks at whether you suffer from any level of altered consciousness due to TBI.

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TDIU and Traumatic Brain Injury

Total Disability Individual Unemployability, or TDIU, benefits are available if you cannot work due to brain injury symptoms. To obtain a TDIU rating, you must receive at least a 60 percent disability rating for TBI or have multiple conditions with a combined rating of 70 percent, with one condition rated at least 40 percent disabling.

TDIU will provide the veteran with a stipend that helps make up financially for an inability to work.

How to Obtain VA Disability Compensation for Traumatic Brain Injury

Veterans who sustained TBI during their service can seek compensation through the VA by filing a claim online. VA disability benefits offer regular compensation for damages from a traumatic brain injury. To apply, complete the form and provide all relevant information, including copies of medical records from both military and non-military hospitals.

C&P Exams

A Compensation and Pension Exam, or C&P Exam, allows the VA to independently assess the extent of your brain injury and how those symptoms impact your daily life. You may have to undergo a C&P exam to show the full extent of your injuries.

Furthermore, if you suffer worsening symptoms of brain injury or a change in your symptoms, you may need another exam.

Nexus Letters

A Nexus Letter establishes the connection between your TBI and your time in service. A medical professional can put together the connection between any head trauma you suffered in service, including repeated head trauma, and how it connects to your current disability.

If you have questions about how to receive a VA rating for TBI, Veterans Guide can help. Contact us to learn more.

Secondary to Traumatic Brain Injury

Traumatic brain injuries can connect to several possible mental health conditions, including depression and anxiety. Brain injuries often also coexist with post-traumatic stress disorder. Furthermore, you may develop other conditions related to your TBI, including:

If you have a condition with a presumptive connection to TBI, you can apply for a secondary disability rating for that condition. A secondary disability rating adds to the compensation you receive from the VA each month.

However, it is important to note that the same symptoms cannot be used to rate two different disorders. The VA will not apply multiple diagnostic codes to a single symptom. So if a symptom is used to establish traumatic brain injury, you cannot use it to also support a claim for another condition.

Special Monthly Compensation If You Have a VA Rating for TBI

Special Monthly Compensation, or SMC(t), is a benefit specifically for veterans with severe TBI. It offers additional monthly payments if you need regular in-home aid and attendance to handle activities of daily living, including bathing and dressing.

You may qualify SMC(t) if you would otherwise need institutional care at a hospital, nursing home, or another facility if you didn’t receive in-home aid and attendance.

Veterans and Traumatic Brain Injuries

A traumatic brain injury can occur any time you suffer a blow, bump, or jolt to the head. Service members have a high risk of suffering brain injury due to the physical challenges they face as part of their daily job duties. Service members are at risk for such injuries given the following:

  • They work in highly physical jobs.
  • They deal with risky environments.
  • They are exposed to explosives that can cause concussive force trauma.

Traumatic brain injuries cause a host of symptoms. The following are some of the more common symptoms:

  • Loss of consciousness
  • Headache
  • Dizziness
  • Sensitivity to light or sound
  • Blurred vision
  • Nausea
  • Vomiting
  • Drowsiness
  • Disorientation
  • Confusion
  • Loss of sensation in the fingers and toes
  • Loss of coordination
  • Memory loss
  • Speech problems
  • Balance problems
  • Ringing in the ears
  • Changes in sleep patterns
  • Dilation of one or both pupils
  • Clear fluid drainage from the nose or ears
  • Changes in your emotions or cognitive abilities
  • Agitation, combativeness, or other unusual behavior

According to the Centers for Disease Control, veterans with brain injuries also have a greater risk of seizures, drug poisoning, infections, or pneumonia.

Fifty-seven percent of people with moderate to severe traumatic brain injury are moderately or severely disabled, while 55 percent cannot hold a job. The CDC reports 33 percent of them rely on others for help with everyday activities.

Proving a disability related to traumatic brain injuries can be difficult. Brain injury symptoms vary dramatically from person to person, depending on where the injury occurred and the individual in question. You must provide hard medical records and evidence of the disability to get a disability rating.

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Matt is a VA-accredited attorney who co-founded NAVDA in 2023. Matt has helped veterans with the VA disability appeals process since he became accredited in 2021.