Rating guide · Neurological
TBI Claims: Rating Every Effect
IED blasts, rollovers, breaching and hard landings left many soldiers with brain injuries nobody wrote down. A TBI claim works best when every lasting effect is identified and rated.
- Facet table
- Separate residuals
- Presumptive links
- Building the record
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Cognitive Effects: The Facet Table
The VA scores 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 highest-scoring facet sets this rating.
Effects Rated on Their Own
Any residual with its own diagnosis is rated separately and combined:
- Migraines and other headaches
- Tinnitus and hearing loss
- Seizures, vision changes, dizziness and balance problems
- Mood and behavior changes, under the mental health formula when there’s a mental health diagnosis
No symptom can be counted twice, so the examiner needs to separate which problems come from where.
Conditions Presumed to Come From the TBI
With a service-connected TBI, these are presumed connected unless there’s 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
Severity is classified by what happened at the time of the injury, such as how long you were unconscious, not by how you function today.
Building a record years later
Statements from those who were there, records of headaches, memory or mood problems after the event, and a current neurological evaluation can establish an injury that was never documented.
TBI VA Rating: Common Questions
Can I be rated for both TBI and PTSD?
Yes, when separate symptoms support each rating. The examiner may need to distinguish them.
Are headaches part of the TBI rating?
No. Diagnosed headaches like migraines are rated separately in addition to the facet rating.
How is TBI severity decided?
By signs at the time of injury, including length of unconsciousness, post-traumatic amnesia and Glasgow Coma Scale score.
My TBI was never diagnosed. Can I still claim it?
Yes. Lay statements about the event and later symptoms, plus a current evaluation, can support the claim.
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