TBI VA Rating 2026: DC 8045 Criteria

What is TBI and how does it affect veterans?

Traumatic Brain Injury (TBI) is one of the signature injuries of recent military conflicts, though it affects veterans of all eras. TBI occurs when a sudden trauma — blast exposure from IEDs, concussions from vehicle accidents, falls, combat impacts, or training injuries — causes damage to the brain. TBI ranges from mild (concussion) to severe (penetrating injury or prolonged loss of consciousness), and the effects can be temporary or permanent.

Veterans with TBI may experience a wide range of symptoms across cognitive, physical, emotional, and behavioral domains. Cognitive effects include memory problems, difficulty concentrating, slowed thinking, and impaired judgment. Physical symptoms can include chronic headaches, dizziness, balance problems, and sensitivity to light and noise. Emotional and behavioral changes often include irritability, mood swings, depression, anxiety, and impulsivity. Many of these symptoms overlap with PTSD, making accurate diagnosis essential.

Unlike other mental health conditions, TBI is rated under a completely different system. While PTSD, depression, and anxiety use the General Rating Formula for Mental Disorders under 38 CFR § 4.130, TBI is evaluated under DC 8045 per 38 CFR § 4.124a using a facet-based rating system. This distinction matters because TBI can be rated separately from a mental health condition when the symptoms of each are clearly separable, and residuals with their own diagnosis (such as migraines) are rated under their own codes.

VA diagnostic code for TBI

TBI is rated under Diagnostic Code (DC) 8045 per 38 CFR § 4.124a, Schedule of Ratings — Neurological Conditions and Convulsive Disorders.

The TBI rating system is unique within the VA disability framework. Rather than using the General Rating Formula for Mental Disorders, DC 8045 evaluates cognitive impairment and subjective symptoms across 10 facets in a table titled “Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified.” Each facet is assigned a severity level, and the overall rating is determined by the highest facet level. Physical residuals (such as seizures, hearing loss, or balance problems) and residuals with their own diagnosis (such as migraine) are rated separately under their own diagnostic codes. Emotional and behavioral symptoms are rated under the mental disorders schedule (38 CFR § 4.130) when there is a diagnosed mental disorder.

TBI and mental health overlap. The regulation says VA must not “assign more than one evaluation based on the same manifestations.” If the manifestations of TBI and a mental disorder “cannot be clearly separated,” VA assigns “a single evaluation under whichever set of diagnostic criteria allows the better assessment of overall impaired functioning due to both conditions. However, if the manifestations are clearly separable, assign a separate evaluation for each condition.”

Rating criteria for TBI

The VA rates TBI using a facet-based system that is fundamentally different from other conditions. Here are the 10 facets evaluated:

1. Memory, attention, concentration, executive functions
2. Judgment
3. Social interaction
4. Orientation
5. Motor activity (with intact motor and sensory system)
6. Visual spatial orientation
7. Subjective symptoms
8. Neurobehavioral effects
9. Communication
10. Consciousness

Each facet has criteria for levels 0 through 3 and a fifth, highest level labeled “total.” Not every facet has every level: social interaction and neurobehavioral effects stop at level 3, subjective symptoms stop at level 2, and consciousness has only a “total” level. The regulation converts the highest facet level into your TBI rating:

The symptoms listed at each level are examples only. The regulation notes they “are not symptoms that must be present in order to assign a particular evaluation.” The terms “mild,” “moderate,” and “severe” TBI in your medical records describe the injury at the time it happened and do not affect the rating under DC 8045.

0% rating

Criteria: The highest level for every facet is 0.

Monthly payment: $0 (but establishes service connection, which matters for future increases and secondary claims)

What the facets look like at level 0: Level 0 does not always mean “no symptoms.” It includes:

• Memory, attention, concentration, executive functions: No complaints of impairment
• Judgment: Normal
• Social interaction: Routinely appropriate
• Orientation: Always oriented to person, time, place, and situation
• Motor activity and visual spatial orientation: Normal
• Subjective symptoms: Symptoms that do not interfere with work, instrumental activities of daily living, or work, family, or other close relationships (for example, mild or occasional headaches, mild anxiety)
• Neurobehavioral effects: One or more effects (such as irritability or moodiness) that do not interfere with workplace or social interaction
• Communication: Able to communicate and understand spoken and written language

10% rating — $180.42/month

Criteria: The highest facet level is 1.

What the facets look like at level 1:

• Memory, attention, concentration, executive functions: A complaint of mild loss of memory (such as difficulty following a conversation, recalling recent conversations, remembering names of new acquaintances, finding words, or often misplacing items), attention, concentration, or executive functions, but without objective evidence on testing
• Judgment: Mildly impaired — for complex or unfamiliar decisions, occasionally unable to weigh the alternatives, understand the consequences, and make a reasonable decision
• Social interaction: Occasionally inappropriate
• Orientation: Occasionally disoriented to one of the four aspects (person, time, place, situation)
• Motor activity: Normal most of the time, but mildly slowed at times due to apraxia (inability to perform previously learned motor activities despite normal motor function)
• Visual spatial orientation: Mildly impaired — occasionally gets lost in unfamiliar surroundings or has difficulty reading maps or following directions, but is able to use aids such as GPS
• Subjective symptoms: Three or more subjective symptoms that mildly interfere with work, instrumental activities of daily living, or close relationships (examples: intermittent dizziness, daily mild to moderate headaches, tinnitus, frequent insomnia, sensitivity to sound or light)
• Neurobehavioral effects: One or more effects that occasionally interfere with workplace or social interaction but do not preclude them
• Communication: Comprehension or expression of spoken or written language is only occasionally impaired; can communicate complex ideas

40% rating — $795.84/month

Criteria: The highest facet level is 2.

What the facets look like at level 2:

• Memory, attention, concentration, executive functions: Objective evidence on testing of mild impairment, resulting in mild functional impairment
• Judgment: Moderately impaired — for complex or unfamiliar decisions, usually unable to make a reasonable decision, although has little difficulty with simple decisions
• Social interaction: Frequently inappropriate
• Orientation: Occasionally disoriented to two of the four aspects, or often disoriented to one aspect
• Motor activity: Mildly decreased, or moderate slowing due to apraxia
• Visual spatial orientation: Moderately impaired — usually gets lost in unfamiliar surroundings; has difficulty reading maps, following directions, judging distance, and using GPS
• Subjective symptoms: Three or more subjective symptoms that moderately interfere with work, instrumental activities of daily living, or close relationships (examples: marked fatigability, blurred or double vision, headaches requiring rest periods during most days). This is the highest level for this facet.
• Neurobehavioral effects: One or more effects that frequently interfere with workplace or social interaction but do not preclude them
• Communication: Unable to communicate or comprehend spoken or written language more than occasionally but less than half of the time; can generally communicate complex ideas

70% rating — $1,808.45/month

Criteria: The highest facet level is 3.

What the facets look like at level 3:

• Memory, attention, concentration, executive functions: Objective evidence on testing of moderate impairment, resulting in moderate functional impairment
• Judgment: Moderately severely impaired — for even routine and familiar decisions, occasionally unable to make a reasonable decision
• Social interaction: Inappropriate most or all of the time
• Orientation: Often disoriented to two or more of the four aspects
• Motor activity: Moderately decreased due to apraxia
• Visual spatial orientation: Moderately severely impaired — gets lost even in familiar surroundings; unable to use GPS
• Neurobehavioral effects: One or more effects that interfere with or preclude workplace or social interaction on most days, or that occasionally require supervision for safety of self or others
• Communication: Unable to communicate or comprehend spoken or written language at least half of the time but not all of the time; may rely on gestures; able to communicate basic needs

100% rating — $3,938.58/month

Criteria: VA assigns 100% “if ‘total’ is the level of evaluation for one or more facets.” This is not the “total occupational and social impairment” test used for mental disorders — it depends on reaching the “total” level in at least one facet that has one:

• Memory, attention, concentration, executive functions: Objective evidence on testing of severe impairment, resulting in severe functional impairment
• Judgment: Severely impaired — for even routine and familiar decisions, usually unable to make a reasonable decision (for example, unable to choose clothing for the weather or to judge when to avoid dangerous situations)
• Orientation: Consistently disoriented to two or more of the four aspects
• Motor activity: Severely decreased due to apraxia
• Visual spatial orientation: Severely impaired — may be unable to find the way from one room to another in a familiar environment
• Communication: Complete inability to communicate or comprehend spoken or written language; unable to communicate basic needs
• Consciousness: Persistently altered state of consciousness, such as vegetative state, minimally responsive state, or coma

What this looks like: You have severe deficits in at least one area of brain function — for example, severe impairment shown on cognitive testing, consistent disorientation, or an inability to communicate basic needs. Many veterans at this level need substantial help with daily living.

What evidence do you need?

Building a strong TBI claim requires several types of evidence:

Service records

• Service treatment records documenting the traumatic brain injury event (blast exposure, concussion, vehicle accident, fall)
• Incident reports, combat action records, or line-of-duty investigations
• Post-deployment health assessments that screen for TBI
• Any in-service neurological evaluations or brain imaging (CT, MRI)

Medical evidence

• Current diagnosis of TBI residuals from a qualified neurologist, neuropsychologist, or other specialist
• Neuropsychological testing results documenting cognitive deficits — the memory, attention, concentration, and executive functions facet turns on objective evidence on testing, so formal testing can make the difference between level 1 and level 2 or higher
• Brain imaging (MRI, CT, PET scans) showing structural or functional changes if available
• Treatment records showing ongoing symptoms and their progression over time
• Documentation of all medications prescribed for TBI-related symptoms

Nexus letter

A medical opinion letter connecting your current TBI residuals to the in-service traumatic event. A strong nexus letter should explain the mechanism of injury, the expected progression of symptoms, and how current deficits are consistent with the documented TBI. For blast-related TBI, the letter should address how blast wave physics can cause brain injury even without direct head impact.

Buddy statements

Statements from fellow service members, family, or friends who can describe:

• The traumatic event that caused the brain injury, if they witnessed it
• Changes in your cognitive abilities, personality, and behavior before and after the injury
• Specific examples of memory problems, judgment issues, or behavioral changes
• How TBI residuals affect your daily life and ability to work

Personal statement

Your own detailed account of the injury event and how TBI affects your current daily functioning. Describe specific problems across the 10 facets: “I get lost driving to the grocery store I’ve been going to for five years. Last month I left the stove on three times. I can’t remember my children’s phone numbers anymore. I’ve had four car accidents since my TBI because I misjudge distances.”

C&P exam tips for TBI

The Compensation & Pension (C&P) exam for TBI is different from mental health exams. Here’s how to prepare:

What the examiner evaluates

The examiner uses the TBI-specific evaluation protocol and assesses each of the 10 facets of brain function individually. The exam typically includes:

• A detailed history of the traumatic event(s)
• Cognitive testing and screening
• Evaluation of motor function and coordination
• Assessment of communication abilities
• Review of neurobehavioral symptoms
• Determination of the highest facet impairment level

How to prepare

1. Document the injury event clearly. Know the dates, circumstances, and immediate symptoms (loss of consciousness, confusion, amnesia) of your TBI. If you had multiple TBIs, document each one.
2. Don’t downplay cognitive deficits. If you struggle with memory, concentration, or finding words, say so honestly. Don’t try to appear sharper than you typically are.
3. Bring someone who knows you well. A spouse or family member can describe cognitive and behavioral changes that you may not be aware of — people with TBI often lack full insight into their own deficits.
4. Describe typical days and flare-ups. If you have good days and bad days, explain both and how often each happens. Give specific examples for each facet that causes problems. Use only events that are true for you.
5. Mention all secondary conditions. Tell the examiner about headaches, sleep problems, depression, dizziness, tinnitus, and any other symptoms that developed after the TBI.

Common mistakes

• Minimizing cognitive deficits because you’ve developed compensating strategies (using phone reminders, relying on your spouse for navigation)
• Not connecting current symptoms back to the in-service TBI event
• Failing to report all TBI events — many veterans had multiple concussions during service
• Not mentioning secondary conditions that the VA should evaluate separately

Common secondary conditions linked to TBI

TBI frequently causes or aggravates other conditions. These can — and should — be claimed as secondary service-connected disabilities, as they are often rated separately from the TBI itself:

• Migraines — Post-traumatic headaches are one of the most common residuals of TBI. Chronic migraines following a TBI are well-documented in medical literature and can qualify for a separate rating of up to 50%.
• Depression — TBI causes structural and chemical changes in the brain that frequently lead to Major Depressive Disorder. Depression is one of the most common psychiatric conditions secondary to TBI.
• Sleep apnea — TBI can disrupt the brain’s control of breathing during sleep, and the association between TBI and obstructive sleep apnea is well-established in research.
• Tinnitus — Blast exposure and head trauma commonly damage the auditory system, causing persistent ringing in the ears. Tinnitus is rated separately at up to 10%.
• Hearing loss — The same blast exposure or head trauma that causes TBI frequently damages hearing. Sensorineural hearing loss is commonly service-connected secondary to TBI.

How to calculate your monthly payment

Your total VA disability payment depends on your combined rating across all service-connected conditions, not just TBI alone. Because TBI generates many separately-rated secondary conditions, your combined rating is often significantly higher than the TBI rating itself. Use our VA disability calculator to:

• Calculate your combined rating with multiple conditions
• See how VA math combines ratings differently than simple addition
• Estimate your monthly payment including dependents

For the full breakdown of payment amounts at every rating level, see our 2026 VA disability pay rates page.

Disclaimer: This content is for informational purposes only and does not constitute legal or medical advice. For personalized guidance on your VA disability claim, consult a VA-accredited Veterans Service Organization (VSO), attorney, or claims agent. You can find accredited representatives at VA.gov.