Traumatic Brain Injury Residuals — VA Disability Rating Criteria (DC 8045)
Diagnostic Code 8045 · 38 CFR §4.124a
What Is It?
Traumatic Brain Injury (TBI) is caused by an external force to the head — blast exposure, vehicle accidents, falls, or direct impact during military service. The VA rates TBI residuals under a unique facet-based system that is different from how most other conditions are evaluated. Rather than matching overall symptoms to a single rating level, the VA evaluates cognitive impairment and subjective symptoms on a table of ten facets titled "Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified." Each facet is assigned a level of impairment from 0 to 3, or a fifth level labeled "total," though not every facet has every level. If any facet is "total," the evaluation is 100 percent; otherwise the highest facet sets the rating. Emotional and behavioral dysfunction is evaluated under the mental disorders schedule (38 CFR 4.130) when there is a diagnosis of a mental disorder, and on the facet table when there is not. Physical residuals, such as seizures, hearing loss, or visual impairment, are evaluated under their own diagnostic codes, and a residual with a distinct diagnosis such as migraine is rated separately rather than on the facet table. The same signs and symptoms are not used to support more than one evaluation.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | One or more facets is evaluated as "total." The facets with a total level are memory, attention, concentration, and executive functions (objective evidence on testing of severe impairment resulting in severe functional impairment); judgment; orientation; motor activity; visual spatial orientation; communication; and consciousness, which has only a total level (a persistently altered state of consciousness, such as vegetative state, minimally responsive state, or coma). The social interaction, subjective symptoms, and neurobehavioral effects facets have no total level. |
| 70% | The highest level of impairment on any facet is 3. For example, objective evidence on testing of moderate impairment of memory, attention, concentration, or executive functions resulting in moderate functional impairment; social interaction that is inappropriate most or all of the time; often being disoriented to two or more aspects of orientation; or neurobehavioral effects that interfere with or preclude workplace or social interaction on most days or that occasionally require supervision for safety of self or others. |
| 40% | The highest level of impairment on any facet is 2. For example, objective evidence on testing of mild impairment of memory, attention, concentration, or executive functions resulting in mild functional impairment; moderately impaired judgment; social interaction that is frequently inappropriate; or neurobehavioral effects that frequently interfere with workplace or social interaction but do not preclude them. |
| 10% | The highest level of impairment on any facet is 1. For example, a complaint of mild loss of memory, attention, concentration, or executive functions without objective evidence on testing; social interaction that is occasionally inappropriate; or three or more subjective symptoms that mildly interfere with work, instrumental activities of daily living, or close relationships. |
| 0% | The highest level of impairment on any facet is 0. The schedule maps level 0 to 0 percent. |
Evidence Needed
TBI claims require documentation of the in-service traumatic event and current residuals. Service treatment records noting concussion, blast exposure, loss of consciousness, or altered mental status are ideal. If no STRs exist, buddy statements describing the incident are valuable. For current residuals, neuropsychological testing provides the most comprehensive evidence of cognitive impairment. Medical records documenting ongoing symptoms such as memory problems, difficulty concentrating, headaches, dizziness, irritability, and sleep disturbance all support the claim. The VA uses a specific TBI examination protocol that evaluates all ten facets.
C&P Exam Tips
The TBI C&P exam is one of the most thorough VA examinations. The examiner evaluates ten facets: memory, attention, concentration, and executive functions; judgment; social interaction; orientation; motor activity; visual spatial orientation; subjective symptoms; neurobehavioral effects; communication; and consciousness. Be prepared for a long appointment that may include cognitive testing. Describe your symptoms honestly and specifically — do not say "my memory is fine" if you regularly forget appointments, lose your keys, or cannot follow conversations. Provide specific examples of how TBI residuals affect your daily life and work. If you have good days and bad days, make sure to describe the bad days. Bring a family member or close friend who can provide a statement about changes they have observed in your cognitive function and behavior since the TBI.
How to File
File on VA Form 21-526EZ listing TBI residuals as the claimed condition. Describe the specific in-service event that caused the brain injury — blast exposure, vehicle accident, fall, or impact. Include any service treatment records documenting the event or subsequent treatment. If you have residual conditions like migraines, memory loss, or mood changes, list each one. The VA should evaluate them all and determine which diagnostic code best captures each symptom. Consider filing secondary claims for conditions caused by the TBI (migraines, tinnitus, mood disorders) at the same time. A VSO experienced with TBI claims is particularly helpful for these complex evaluations.
Common Mistakes
The most common mistake is not claiming TBI at all because the veteran did not lose consciousness during the event. Loss of consciousness is not required — altered mental status such as feeling dazed, confused, or disoriented after a blast or impact qualifies. Another frequent mistake is not providing enough detail about cognitive symptoms during the C&P exam. Many veterans have adapted to their limitations and may not realize how much their function has declined. Having a spouse or close friend attend the exam or provide a buddy statement about observed changes is very helpful. Veterans also sometimes fail to file separate claims for TBI residuals that qualify for independent ratings under other diagnostic codes, such as migraines or mood disorders.
Frequently Asked Questions
What are the ten facets the VA evaluates for TBI?
The ten facets are: (1) memory, attention, concentration, and executive functions; (2) judgment; (3) social interaction; (4) orientation; (5) motor activity; (6) visual-spatial orientation; (7) subjective symptoms; (8) neurobehavioral effects; (9) communication; and (10) consciousness. Each is assigned a level of impairment from 0 to 3 or "total," though not every facet has every level. A "total" on any facet means 100 percent; otherwise the highest level sets the rating: 0 is 0 percent, 1 is 10 percent, 2 is 40 percent, and 3 is 70 percent.
Do I need to have lost consciousness to claim TBI?
No. Loss of consciousness is not required. The VA recognizes that a TBI can occur with altered mental status alone — feeling dazed, confused, disoriented, or experiencing memory gaps around the time of the event. Even a "mild" TBI (concussion) without loss of consciousness can produce lasting residuals.
Can I get separate ratings for TBI residuals?
Yes. If TBI causes conditions that are ratable under their own diagnostic codes — such as migraines (DC 8100), mood disorders, or hearing loss — those conditions can be rated separately. The VA should not "double count" the same symptom under DC 8045 and another code, but distinct residuals get their own evaluations.
What is neuropsychological testing and do I need it?
Neuropsychological testing is a comprehensive evaluation of cognitive functions including memory, attention, processing speed, executive function, and emotional regulation. While not required, it provides detailed objective evidence of cognitive impairment that strongly supports a TBI claim. Ask your VA healthcare provider for a referral if you have not had this testing.