Rating guide · Neurological
Brain Injury Claims: More Than One Rating
A traumatic brain injury can affect memory, mood, headaches, hearing and balance at the same time. The VA rates it in pieces, and getting every piece identified is how veterans avoid being underrated.
- How facets are scored
- Residuals rated separately
- Presumed secondary conditions
- Unrecorded injuries
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The Facet Table, Simplified
Cognitive and subjective effects are scored across ten facets: memory, attention, concentration and executive functions; judgment; social interaction; orientation; motor activity; visual spatial orientation; subjective symptoms; neurobehavioral effects; communication; and consciousness. The single highest facet decides this part of the rating.
Residuals That Earn Their Own Ratings
Anything with its own diagnosis is rated under its own code, on top of the facet rating:
- Headaches and migraines
- Tinnitus and hearing loss
- Vision problems, seizures, balance and coordination issues
- Mood and behavior changes. With a mental health diagnosis, these are rated under the mental health formula instead of the facet table.
The VA won’t count the same symptom twice, so the exam needs to sort out what comes from where.
Conditions Presumed to Follow a TBI
With a service-connected TBI, the VA presumes these are caused by it, absent clear evidence otherwise:
- Parkinsonism, and unprovoked seizures, after a moderate or severe TBI
- Presenile Alzheimer-type, frontotemporal, or Lewy body dementia within 15 years of a moderate or severe TBI
- Depression within 3 years of a moderate or severe TBI, or 12 months of a mild one
- Hormone deficiency diseases from hypothalamo-pituitary changes within 12 months of a moderate or severe TBI
TBI severity is based on what happened at the time of injury, such as how long you lost consciousness, not on your current functioning.
No record of the injury?
Blast exposures and vehicle accidents often went undocumented. Statements from people who were there, records of symptoms that followed, and a current neurological evaluation can establish it.
TBI VA Rating: Common Questions
Can a TBI and PTSD both be rated?
Yes, as long as different symptoms support each rating. An examiner may need to separate symptoms between the two.
Are my post-injury headaches part of the TBI rating?
No. Headaches with their own diagnosis, like migraines, are rated separately in addition to the facet rating.
How does the VA decide TBI severity?
By the signs at the time of injury, including length of unconsciousness, post-traumatic amnesia, and Glasgow Coma Scale score, not by how you function now.
I was near a blast but never got checked. Can I still file?
Yes. Lay statements describing the event and your symptoms afterward, along with a current evaluation, can support a TBI claim.
Nebraska Veterans: Get the Rating You Earned
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