VA Disability Rating for Cerebral Hemorrhage (DC 8009)
Diagnostic Code 8009 · 38 CFR §4.124a
What Is It?
DC 8009 is printed in the schedule as "Brain, vessels, hemorrhage from" — bleeding into the brain from a ruptured vessel. It presents abruptly with severe headache, weakness, speech loss, vision change, vomiting, or loss of consciousness, and the damage comes from the destroyed tissue and from the pressure the blood exerts on everything around it. For veterans the routes in are head trauma during service, uncontrolled hypertension traceable to a service-connected condition, and vascular malformations. This is also the code that carries the shared instruction for the whole brain-vessel group: the six-month 100 percent and the 10 percent residual floor are printed beneath it and apply to DC 8007 and DC 8008 as well. 38 CFR §3.309(a) lists "Brain hemorrhage" among the chronic diseases, so a hemorrhage 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 8009 has an empty rating cell of its own; the two figures come from the instruction printed under it.
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
The CT or MRI from the acute event documents the bleed and its location, and follow-up imaging shows the residual cavity, encephalomalacia, or hydrocephalus. Operative notes matter where a craniotomy, shunt, or clipping was done, including any resulting skull defect. Because the percentage after six months is built from the residuals, the evidence that sets it is the deficit workup: strength and sensation by extremity and nerve distribution, formal visual field testing, speech-language evaluation, a swallowing study where indicated, EEG and a seizure log, and neuropsychological testing. Service treatment records document an in-service head injury; blood pressure records carry the secondary-connection argument where hypertension is the cause.
C&P Exam Tips
Describe what you could do before the hemorrhage and what you can do now, in concrete terms rather than generalities, and bring a family member statement about the changes they see. Demonstrate weakness, coordination problems, and balance difficulty rather than compensating. Bring the neuropsychological testing, visual field results, and speech evaluation, and ask that each deficit be documented under its own code — that is what the decision must cite for any evaluation above the 10 percent floor. Report seizures with type and frequency, and mention any skull defect or shunt. Describe your worst days and how often they come, and request a special monthly compensation evaluation if you need regular help from another person.
How to File
File VA Form 21-526EZ claiming cerebral hemorrhage under DC 8009 and cite 38 CFR §4.124a. Attach the acute imaging, the operative records, the follow-up imaging, and the current neurological examination. If the hemorrhage occurred in service the connection is direct; if it followed service-connected hypertension or another service-connected condition, file it as secondary with the medical evidence linking 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, because those are the codes any evaluation above the floor must be built from and 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 hemorrhage is a rupture and bleeding into the brain; a thrombosis is a clot forming in the vessel itself; an embolus forms elsewhere and travels there. All three take the same figures, and the instruction that sets them is printed under 8009: "Rate the vascular conditions under Codes 8007 through 8009, for 6 months — 100," then "Rate residuals, thereafter, minimum — 10." They differ on the presumptive route: §3.309(a) names brain hemorrhage and brain thrombosis, but not embolism.
How does the VA actually rate stroke residuals?
Not as a single number attached to the stroke. After the six-month 100 percent period the schedule sets a 10 percent floor and then applies the proportion rule: §4.124a's preamble and §4.120 direct that disability be rated in proportion to the impairment of motor, sensory, or mental function, with partial loss of use of a limb rated by comparison with the peripheral nerve codes. So hemiparesis is evaluated under the nerve codes for the affected extremities, aphasia and dysphagia under theirs, visual field loss under §4.79, and cognitive impairment under §4.130. The Note closing the 8000-8025 block requires the decision to cite each code it used.
Can a hemorrhage that happened after service be service-connected?
Yes. If it occurred during active duty the connection is direct. If it happened later but followed a service-connected condition — uncontrolled hypertension is the usual one — it can be claimed as secondary with medical evidence showing the causal link. And 38 CFR §3.309(a) lists brain hemorrhage among the chronic diseases, so one that became manifest to a degree of 10 percent or more within a year of separation is presumed service-connected under §3.307(a)(3), without a nexus opinion.