Neurological
TBI & Head Injuries
The ten facets of §4.124a and overlap with mental health ratings
Traumatic brain injury is rated across ten cognitive facets under a specialized formula. Its residuals overlap with — but are rated separately from — mental health conditions.
What TBI & Head Injuries Really Is
A blast, a rollover, a fall, a boxing match in basic. You got up, you kept working, and nobody wrote it down. Years later you cannot hold a thought, you snap at people you love, the lights are too bright, and the headaches never fully leave. Traumatic brain injury is the condition the VA is worst at capturing, because the damage is in the wiring and the wiring does not show on a routine scan.
What it actually means
A blast, a rollover, a fall, a boxing match in basic. You got up, you kept working, and nobody wrote it down. Years later you cannot hold a thought, you snap at people you love, the lights are too bright, and the headaches never fully leave. Traumatic brain injury is the condition the VA is worst at capturing, because the damage is in the wiring and the wiring does not show on a routine scan.
What the VA measures
The VA rates residuals of TBI using ten facets of cognitive impairment: memory and attention, judgment, social interaction, orientation, motor activity, visual spatial orientation, subjective symptoms, neurobehavioral effects, communication, and consciousness. Each facet is assigned a level of impairment from zero to three or total, and the single highest facet level drives the overall rating.
Why claims get missed
The highest facet controls the rating, so one honestly documented severe facet is worth more than ten mild ones. Veterans, and often examiners, average the facets instead. And when the same symptom could belong to TBI or to PTSD, the VA is required to rate it once but not to shortchange you: if the symptom cannot be cleanly separated, it must be attributed in the way most favorable to you.
What in Your Service Causes TBI & Head Injuries
Service connection is not a feeling, it is a chain of evidence. These are the pathways the VA already recognises. Find yours, then make sure your file says it out loud.
Blast overpressure
IEDs, breaching charges, mortars, and repeated firing of crew-served weapons or shoulder-fired rockets produce cumulative overpressure injury even without a documented concussion.
Vehicle accidents and falls
Rollovers, aircraft mishaps, parachute landings, and falls from height are common undocumented mechanisms. A line-of-duty report, a sick call slip, or a buddy statement can establish the event.
Combatives, boxing, and sports injuries
Required unit training produced real head impacts. Repetitive subconcussive impacts are now medically recognized as harmful.
Artillery and range work
Cannon crews, mortarmen, and instructors absorbed thousands of pressure waves as a routine part of the job.
Rated Across Ten Facets
TBI residuals are evaluated under Diagnostic Code 8045 across ten facets of cognitive impairment — memory, judgment, social interaction, orientation, motor activity, visual spatial orientation, subjective symptoms, neurobehavioral effects, communication, and consciousness. The highest facet level generally sets the rating, and the assessment requires a properly trained examiner.
The Mental Health Overlap Problem
TBI and conditions like PTSD or depression share symptoms. The VA must avoid pyramiding but also must not lump a separately diagnosable mental disorder into the TBI rating when it should be rated on its own under §4.130. Getting this boundary right is technical and frequently done wrong.
Building a Complete TBI Claim
Documentation of the head injury event in service
Neuropsychological testing across the ten facets
Separate development of secondary headaches
Careful separation of TBI and psychiatric residuals
Establishing Service Connection
To establish service connection for a neurological condition, veterans must meet three criteria. First, there must be a current diagnosis. Second, there must be evidence of an in-service injury, event, or exposure that could have caused or aggravated it — including head trauma, blast exposure, or an underlying service-connected condition. Third, a nexus — a medical link — must connect the in-service event to the current condition.
Current diagnosis of the neurological condition
In-service injury, event, or exposure (or a service-connected primary condition)
Medical nexus linking the condition to service ("at least as likely as not")
Records documenting frequency and severity of neurological symptoms
Imaging or specialist evaluation where available
Why Work With an Accredited Advocate
Veterans should seek the assistance of an Accredited VA Disability Advocate because we guide you through the complex claims process and ensure all necessary evidence is gathered and presented effectively. Our advocates are trained to identify and link service-related conditions, increasing the likelihood of a successful claim. We also provide personalized representation, helping veterans navigate appeals and secure the benefits they deserve. As a VA-Accredited Claims Agent, our fees are regulated under 38 CFR §14.636 — and there are no fees unless we win your appeal.
The Rating Schedule, Spelled Out
Residuals of traumatic brain injury are rated under 38 CFR §4.124a, Diagnostic Code 8045. The VA evaluates ten facets of cognitive impairment — memory, judgment, social interaction, orientation, motor activity, visual-spatial orientation, subjective symptoms, neurobehavioral effects, communication, and consciousness. The single highest facet level sets the overall rating. Physical and emotional residuals are rated separately under their own codes.
Highest facet level of “0” — no complaints of impairment, and normal objective findings.
Highest facet level of “1” — a mild loss such as mild memory impairment or occasional mildly inappropriate social interaction.
Highest facet level of “2” — for example, objective evidence of moderate impairment of memory, attention or executive function.
Highest facet level of “3” — for example, frequently inappropriate social interaction or often being disoriented to two of the four aspects of orientation.
Highest facet level of “total” — for example, a persistently altered state of consciousness such as vegetative state, or total impairment of an evaluated facet.
Key Points to Remember
Rated under 38 CFR §4.124a, Diagnostic Code 8045, across ten facets of cognitive impairment
The highest facet level generally sets the overall rating (0, 10, 40, 70, or 100)
Residuals — headaches, mental health conditions — can be separately rated
Neuropsychological testing strengthens the record for cognitive impairment
What to Expect at Your TBI C&P Examination
A traumatic brain injury exam is unlike any other in the schedule. Under 38 CFR §4.124a Diagnostic Code 8045 the examiner scores you across ten facets of cognitive impairment, each on a scale from 0 to 3 with an additional "total" level, and your evaluation is driven by the HIGHEST facet level, not by an average. The regulation also requires that the exam be conducted by a physiatrist, psychiatrist, neurologist or neurosurgeon. Anyone else performing the initial TBI examination is grounds to challenge it.
Verification that the examiner holds one of the four specialties the regulation requires for an initial TBI evaluation.
Facet-by-facet scoring of all ten areas: memory and attention; judgment; social interaction; orientation; motor activity; visual spatial orientation; subjective symptoms; neurobehavioral effects; communication; and consciousness.
Neuropsychological testing where indicated, with the raw results attached rather than summarized.
A clear separation of the residuals that are cognitive from those that are emotional or behavioral, because emotional and behavioral residuals may be evaluated under the mental disorder criteria instead, and the two cannot be pyramided.
Identification and separate evaluation of physical residuals — headaches, seizures, dizziness, tinnitus, sleep disturbance, visual and hearing changes — each of which carries its own diagnostic code.
A detailed history of the injury event: the mechanism, loss of consciousness, post-traumatic amnesia, Glasgow Coma Scale if recorded, and blast exposure history.
Lay statements from a spouse, family member or fellow service member describing the change in you, because TBI deficits are frequently invisible to the person who has them.
What Happens Once the C&P Exam Is Complete
The examiner compiles a detailed report — your medical history, physical findings, and diagnostic results — and assesses the severity, symptoms, and impact of your condition. That report is sent to the VA Regional Office handling your claim and becomes part of your official file, reviewed alongside your other evidence.
The VA may send the report back for corrections, clarification, or a second opinion if it finds it incomplete or unclear. This can delay your claim, because the VA requires thorough and accurate information to decide. Your claim only moves to the decision phase once the VA is satisfied with the evidence — which is exactly why the quality of the file we build for you matters so much. Once decided, your effective date controls how far back your back pay reaches, and any denial can be challenged through a Supplemental Claim, Higher-Level Review, or Board appeal.
The Advocate’s Take
TBI ratings require a trained examiner and precise facet scoring. A generalist exam often undercounts the deficits that matter most.
Every Level the VA Can Assign You
These percentages come straight out of the rating schedule that governs tbi & head injuries — Diagnostic Code 8045. Read them slowly. If your current rating does not match what your records actually show, that gap is exactly what an appeal exists to correct.
0%
Highest facet level of “0” — no complaints of impairment, and normal objective findings.
10%
Highest facet level of “1” — a mild loss such as mild memory impairment or occasional mildly inappropriate social interaction.
40%
Highest facet level of “2” — for example, objective evidence of moderate impairment of memory, attention or executive function.
70%
Highest facet level of “3” — for example, frequently inappropriate social interaction or often being disoriented to two of the four aspects of orientation.
100%
Highest facet level of “total” — for example, a persistently altered state of consciousness such as vegetative state, or total impairment of an evaluated facet.
Secondary Claims — Both Directions
Under 38 CFR §3.310, a condition caused or made worse by an already service-connected condition is itself service connected. That runs in both directions, and it is the single largest pool of unclaimed compensation in the system.
What can cause tbi & head injuries
If one of these is already service connected, this condition can be claimed as secondary to it.
Combat and blast exposure
Documented exposure supports both TBI residuals and a coexisting PTSD claim.
Service-connected seizures or stroke
Neurologic injury from another service-connected condition produces the same cognitive residuals.
What tbi & head injuries can cause
If this condition is already service connected, each of these is a separate claim you may be owed.
Headaches, including migraine
Post-traumatic headache is the most common TBI residual and is rated separately under the migraine criteria.
Sleep apnea and sleep disturbance
Brainstem and hypothalamic disruption after TBI is a recognized cause of both central and obstructive sleep apnea.
Depression, anxiety, and irritability
Rated separately when the diagnosis is a distinct comorbid mental disorder rather than the same neurobehavioral facet.
Tinnitus, vertigo, and vision problems
Vestibular and visual residuals carry their own diagnostic codes.
Hormone dysfunction
Post-traumatic hypopituitarism is underdiagnosed and produces fatigue, low testosterone, and weight change.
A secondary claim still needs two things: a current diagnosis of the secondary condition, and a medical opinion saying it is at least as likely as not caused or aggravated by the service-connected condition. You do not have to prove it happened in service.
Building a TBI & Head Injuries Claim That Wins
Every claim stands on three legs. Knock one out and the claim falls over, no matter how bad your symptoms are. Before you file, look at your file and find all three.
A current diagnosis
A doctor has to say you have it, now, in writing. Not "reports symptoms of" — a diagnosis. Without this leg, nothing else in the file matters.
A link to your service
An event, an injury, an exposure, or an already service-connected condition. Service records, unit records, buddy statements, and your own account all count as evidence.
A nexus that ties the two together
A medical opinion stating it is at least as likely as not that your service caused or aggravated the condition. That phrase is a legal standard: 50 percent or better. It is the leg most denials break.
Document the problem before you file
• Keep a dated symptom log for at least 30 days. Frequency, severity, and what it stopped you from doing.
• Get statements from people who see it — a spouse, a coworker, a battle buddy. Lay evidence is legal evidence.
• Pull your private treatment records. The VA only has to help; it does not have to go find everything.
• Write down what you have stopped doing. Lost work, lost sleep, lost activities. That is what impairment looks like on paper.
Your Rights in This Process
It costs nothing to file
Filing a VA claim is free. Accredited representatives may only charge for work on an appeal after an initial decision, and those fees are capped by 38 CFR §14.636.
The VA has a Duty to Assist you
Under 38 CFR §3.159 the VA must help you get the evidence it needs, and it must tell you what is missing before it denies you for missing it.
You can ask for a different examiner
You may request a trauma-informed clinician, or a clinician of a specific gender, for a C&P examination. Ask before the exam is scheduled.
You can claim every condition you have
There is no limit and no penalty. Primary conditions, secondary conditions, and conditions made worse by service all get filed.
You can appeal and be re-evaluated
A denial is not the end. You may submit new evidence, request a higher-level review, appeal to the Board, and ask for re-evaluation when your condition worsens.
You must be considered for TDIU
If your service-connected conditions keep you from holding substantially gainful employment, you may be paid at the 100 percent rate without a 100 percent rating.
Questions Veterans Ask About TBI & Head Injuries Claims
Nothing about a head injury is in my service records. Can I still win?
Yes. The VA must consider lay evidence. Statements from you and from people who served with you describing the blast, the rollover, or the change they saw in you afterward can establish the in-service event. A retrospective medical opinion then links the current residuals to it.
How is my TBI rating actually calculated?
Each of the ten facets gets a level. The highest single facet level determines the rating: a level 3 in any one facet supports 70 percent, level 2 supports 40 percent, level 1 supports 10 percent. Read your exam report facet by facet, because an understated facet is the most common and most expensive error.
Will my PTSD rating be reduced if I claim TBI?
They are rated so as not to compensate the same impairment twice, but when symptoms cannot be medically separated the law requires resolving that uncertainty in your favor. Distinct diagnoses with distinct documented symptoms are the way to hold both ratings.
When You Are Ready to File
Talk to an accredited representative before you file. It costs nothing to ask, and the order you file in changes what the VA is allowed to award you. Albert L. Thombs Jr. is VA-Accredited Claims Agent #45147.
The application itself
This is the form that opens a disability compensation claim. List every condition you are claiming, and name the secondary conditions explicitly.
Release for private records
Authorises the VA to request records from your private doctors. Without it, treatment outside the VA may never reach your file.
Lay or buddy statement
The official form for your own statement and for statements from people who witnessed the event or the change in you.
Resources Worth Keeping
These are real, staffed VA lines. Tap to call from your phone.
Veterans Crisis Line
988
Then press 1. Text 838255. Available 24 hours a day, every day. You do not need to be enrolled in VA health care.
VA Benefits & Facility Line
1-800-827-1000
Claim status, general benefits questions, and help finding the right VA office.
Women Veterans Call Center
1-855-829-6636
Call or text. Staffed by women veterans who can connect you to services in your area.
Vet Centers
1-877-927-8387
Community-based counselling for combat veterans and their families. No VA enrollment required.
What This Rating Is Worth (2026)
| 10% | $180.42/mo |
| 20% | $356.66/mo |
| 30% | $552.47/mo |
| 40% | $795.84/mo |
| 50% | $1,132.90/mo |
| 60% | $1,435.02/mo |
| 70% | $1,808.45/mo |
| 80% | $2,102.15/mo |
| 90% | $2,362.30/mo |
| 100% | $3,938.58/mo |
Rates shown are the veteran-alone amounts effective December 1, 2025. A spouse, children, or dependent parents increase your payment at 30% and above. Every 10% you are under-rated can cost you thousands of dollars a year for the rest of your life.
Estimate Your Exact Pay
Veteran RepresentationYour VA Claim Exam: What to Expect
This official VBA video walks you through the entire C&P exam process. Understanding what happens in that room is the difference between a rating that reflects your true condition and one that undervalues you.
Veteran RepresentationWhat It Takes to Win These Benefits
The Three-Part Test
Service connection under 38 CFR §3.303 requires all three:
- 1A current, diagnosed disability
- 2An in-service event, injury, or exposure
- 3A medical nexus linking the two
Veteran RepresentationThe medical evidence the VA is actually looking for:
VA Claim Exams: Neurological
This exam is specific to your body system. The examiner uses a specialized DBQ for this category of conditions, and the tests they perform determine your exact rating level. Watch this before your appointment.
What to Expect at Your C&P Exam
Your Compensation & Pension (C&P) exam is not treatment. It is a rating tool. The examiner will not fix anything — they complete a Disability Benefits Questionnaire (DBQ) and check the boxes that decide your rating. What happens in that room can move your rating an entire level, so walk in prepared.
Veteran RepresentationThe Forms You File — We Prepare Them For You
These are the forms that drive this claim. Start any of them on our site and an accredited agent prepares and files it for you — correctly, the first time.
Application for Disability Compensation
The core application that opens or reopens your claim.
Start this with usStatement in Support of Claim
Your own account and buddy/lay statements that fill the gaps in your record.
Start this with usAppoint Us as Your Representative
Authorizes our accredited agent to act on your behalf with the VA.
Start this with usUnemployability (TDIU) Application
Claims 100% pay when your conditions keep you from working — even below 100%.
Start this with usDisability Benefits Questionnaire
The exam form that captures the severity criteria for this specific condition.
Start this with usSMC & TDIU — When Your Rating Isn't the Whole Story
TDIU — Paid at 100% Without a 100% Rating
Total Disability based on Individual Unemployability (38 CFR §4.16) pays you at the 100% rate when your service-connected conditions prevent substantially gainful employment — even if your combined rating is lower. You may qualify if:
- One condition is rated 60% or higher, or
- Two+ conditions combine to 70% with at least one rated 40%, and
- Those conditions keep you from holding steady, gainful work.
- Cannot meet the numbers? Extraschedular TDIU under §4.16(b) may still apply.
Special Monthly Compensation (SMC)
SMC (38 CFR §3.350) pays above the normal schedule for especially serious losses — loss or loss of use of a body part, being housebound, or needing the aid and attendance of another person. Common levels:
- SMC-K — Loss / loss of use — Add-on for loss or loss of use of a specific body part (hand, foot, eye, reproductive organ, or certain other losses). Paid on top of your regular compensation. Can stack (up to the statutory cap).
- SMC-S — Housebound — Statutory housebound: a single 100% disability plus additional disabilities of 60%+, or substantially confined to your home. Veteran-alone rate shown.
- SMC-L — Aid & Attendance — You need the regular aid and attendance of another person, or have anatomical loss/loss of use of both feet, one hand and one foot, blindness, or are permanently bedridden. Veteran-alone rate shown.
- SMC-M — Higher Aid & Attendance — A higher level of aid and attendance (e.g., loss of use of both hands, or loss of use of both legs at a higher level). Veteran-alone rate shown.
These are the benefits veterans most often leave on the table because no one told them they qualified. If any of this sounds like your situation, call an accredited agent at 702-992-4883 — we screen for SMC and TDIU on every case.
Talk to a VA-accredited claims agent about tbi & head injuries
Albert L. Thombs Jr. is a US Army veteran, VA-Accredited Claims Agent #45147, and 100% service-connected himself. He personally reviews every request. Fees are capped by 38 CFR §14.636 — and there are no fees unless you win.
Three Ways to Put an Accredited Agent on TBI & Head Injuries
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