VA Disability Rating for Brain Thrombosis / Stroke (DC 8008)
Diagnostic Code 8008 · 38 CFR §4.124a
What Is It?
DC 8008 is printed in the schedule as "Brain, vessels, thrombosis of." A thrombotic stroke happens when a clot forms in a cerebral artery itself, usually on top of atherosclerotic plaque, and cuts off blood flow to the territory beyond it. It is the most common stroke mechanism, and the deficit tracks the territory: hemiparesis or hemiplegia, aphasia, visual field loss, dysphagia, and cognitive impairment. For veterans the usual route is secondary service connection through hypertension, diabetes, or another service-connected vascular risk factor. There is also a presumptive route: 38 CFR §3.309(a) lists "Brain thrombosis" among the chronic diseases, so a thrombotic stroke that became manifest to a degree of 10 percent or more within one year of separation is presumed service-connected under §3.307(a)(3). 38 CFR §4.124a opens the neurological schedule with a bracketed instruction: disability from the diseases it lists "may be rated from 10 percent to 100 percent in proportion to the impairment of motor, sensory, or mental function," referring the rater to the appropriate body system of the schedule for each manifestation. Inside the 8000–8025 block the schedule prints either a single flat percentage, a single minimum rating, or no percentage at all — there is no severity ladder anywhere in it. A Note closing the block adds two conditions: the minimum ratings for residuals require ascertainable residuals, and when a rating above the minimum is assigned, the diagnostic codes used as the basis of that evaluation must be cited alongside the code identifying the diagnosis. DC 8008 has an empty rating cell of its own; the figures come from the shared instruction printed under DC 8009: 100 percent for six months, then residuals with a minimum of 10.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Rate the vascular conditions under Codes 8007 through 8009, for 6 months. The schedule assigns 100 percent for six months from the vascular event itself, across all three brain-vessel codes together. It is a fixed period tied to the event, not a severity tier — when it ends, the evaluation moves to the residuals below. |
| 10% | Rate residuals, thereafter, minimum. After the six-month period the evaluation is made on the residuals, with 10 percent as the floor. The schedule prints no steps between 10 and 100 for these codes. §4.124a's preamble and §4.120 both govern what happens above the floor: disability in this field is rated in proportion to the impairment of motor, sensory, or mental function, with partial loss of use of one or more extremities from a neurological lesion rated by comparison with the mild, moderate, severe, or complete paralysis of the relevant peripheral nerves. The Note closing the 8000–8025 block requires ascertainable residuals for the minimum and requires that any rating above it cite the diagnostic codes used as its basis. |
Evidence Needed
Brain CT or MRI showing the infarct and its territory establishes the event, and vessel imaging documents the underlying disease. Because the percentage after six months is built from the residuals, the evidence that actually sets it is the deficit workup: strength, tone, and reflexes by extremity and nerve distribution, formal visual field testing, a speech-language pathology evaluation for aphasia or dysarthria, an objective swallowing study for dysphagia, and neuropsychological testing quantifying memory, attention, executive function, and processing speed. Rehabilitation records show what recovered and what plateaued. Treatment records for hypertension, diabetes, or another service-connected risk factor carry the secondary-connection argument, and a dated diagnosis against the separation date matters for the §3.309(a) route.
C&P Exam Tips
Demonstrate every physical deficit — weakness, coordination, balance, gait — rather than compensating for it, and describe the cognitive ones with specific examples of what you can no longer do. Bring the neuropsychological testing, the visual field study, and the speech and swallowing evaluations. Ask that each deficit be recorded under its own code and in that code's terms, because the decision has to cite those codes for any evaluation above the 10 percent floor. Describe your worst days and how often they come, and list every task that now needs help or takes far longer. If dressing, bathing, feeding, or medication management requires another person, request a special monthly compensation evaluation for aid and attendance.
How to File
File VA Form 21-526EZ claiming brain thrombosis under DC 8008 and cite 38 CFR §4.124a. Attach the brain imaging, the neurological examination, and the rehabilitation records. Where the stroke followed a service-connected condition such as hypertension or diabetes, file it as secondary and attach the medical evidence connecting them; if it became compensably disabling within a year of separation, cite 38 CFR §3.309(a) and §3.307(a)(3). Claim each residual by name — the weakness by limb, the aphasia, the visual field loss, the dysphagia, the cognitive impairment — since those are the codes any evaluation above the floor is built from and must be cited under.
Common Mistakes
Reading 10 / 30 / 60 / 100 as a severity ladder. The schedule prints a six-month 100 percent and a 10 percent floor for residuals, and nothing in between; everything above the floor is built from the codes for the individual deficits. Claiming "stroke" as one thing and letting the rater guess at the deficits, instead of documenting hemiparesis, aphasia, visual field loss, dysphagia, and cognitive impairment each in its own terms. Skipping neuropsychological testing. Not claiming the underlying service-connected condition that caused the event. Not asking that the decision cite the codes used as the basis of evaluation, which the Note closing the 8000-8025 block requires.
Frequently Asked Questions
What is the difference between DC 8007, 8008, and 8009?
The schedule prints them as three separate vessel events: 8007 is "Brain, vessels, embolism of," 8008 is "Brain, vessels, thrombosis of," and 8009 is "Brain, vessels, hemorrhage from." A thrombus forms in the brain vessel itself; an embolus forms elsewhere and travels there; a hemorrhage is a rupture and bleeding. All three take the same figures — the instruction printed under 8009 reads "Rate the vascular conditions under Codes 8007 through 8009, for 6 months — 100," followed by "Rate residuals, thereafter, minimum — 10." They differ on the presumptive route: §3.309(a)'s chronic-disease list names brain thrombosis and brain hemorrhage, but not embolism.
Is there a 30 or 60 percent rating for stroke?
Not as a printed tier under these codes. The schedule gives DC 8008 exactly two figures — 100 percent for six months from the event, and a 10 percent minimum for residuals after that — and prints nothing between them. Most veterans with real stroke residuals are rated well above 10 percent, but that total is built in proportion to the impairment of motor, sensory, or mental function under the codes for the specific deficits, and the Note closing the 8000-8025 block requires the decision to cite the codes it used. There is no 30 or 60 percent step attached to DC 8008 itself.
Can I claim a stroke that happened after I left service?
Yes, through two routes. The common one is secondary service connection: military service caused or aggravated hypertension, diabetes, or another vascular risk factor, and that condition later caused the stroke — the claim needs medical evidence linking them. The second is the chronic-disease presumptive: 38 CFR §3.309(a) lists brain thrombosis, so a thrombotic stroke manifest to a degree of 10 percent or more within one year of separation is presumed service-connected under §3.307(a)(3) without a nexus opinion.