Rating criteria · 38 CFR §4.124a
Traumatic Brain Injury (TBI): VA Rating Criteria
The exact rating criteria below are quoted from the Code of Federal Regulations as currently in force, not paraphrased. Compensation amounts come from the current VA rate tables.
By Mario Bailey, U.S. Air Force veteran · current Air National Guard member. Data updated 2026-07-10.
Plain-language guide
What this rating actually turns on
With TBI, one number decides everything: the level of your single worst facet. Under 38 CFR 4.124a, Diagnostic Code 8045 does not assign one percentage for “how bad your TBI is.” It evaluates ten separate facets of cognitive impairment and other residuals, each scored on its own: memory/attention/concentration/executive functions; judgment; social interaction; orientation; motor activity; visual spatial orientation; subjective symptoms; neurobehavioral effects; communication; and consciousness. Each facet is assigned a level of 0, 1, 2, 3, or “total.”
Here is the part people get wrong: the facet levels do not add up. Your overall evaluation is set by the single highest facet, not the sum. Per the regulation, if no facet is “total,” the highest facet level maps to your rating this way: level 0 = 0 percent, level 1 = 10 percent, level 2 = 40 percent, level 3 = 70 percent. If any one facet is scored “total,” the whole condition is 100 percent. So one facet at level 2 with the other nine at 0 is a 40 percent evaluation, and there is no such thing as a 20, 30, 50, 60, 80, or 90 for TBI residuals under this table. The gap between the tiers is why the exact level assigned to your worst facet is the entire fight.
DC 8045 also recognizes three areas of dysfunction after a brain injury: cognitive, emotional/behavioral, and physical. That structure matters because two of them get pulled out of the 8045 table and rated on their own scales, which usually pays more, not less.
A worked example
A Marine caught a mounted IED blast and now has documented TBI residuals. On the Evaluation of Residuals of TBI DBQ the examiner scores the ten facets: memory/attention/concentration/executive functions at level 2 (he needs written reminders for tasks he used to hold in his head, and misses appointments without them), judgment at level 1, social interaction at level 1, neurobehavioral effects at level 1, and the remaining six facets at level 0.
It is tempting to add those up. Do not. The overall 8045 evaluation is the single highest facet level, full stop, and level 2 maps to 40 percent. The three facets at level 1 underneath it contribute nothing to that number; if all ten facets were level 1 the evaluation would still be only 10 percent, and it takes exactly one facet reaching level 2 to pull the whole rating to 40. Reading the table as a running total is the single most common way veterans undervalue a TBI claim.
Here is what actually raises this Marine’s award. He was also diagnosed with post-traumatic migraine headaches and, separately, with major depressive disorder. Neither belongs in the 8045 facets. The migraine is rated on its own under DC 8100, and because there is a diagnosed mental disorder, the depression is rated under the § 4.130 mental-disorders formula, each on its own scale. Those two evaluations are then combined with the 40 percent TBI figure under 38 CFR 4.25, not summed with it and not folded into the facets, so long as the same symptom is never counted twice (38 CFR 4.14). That is why a real TBI claim is usually three or four ratings stacked, not one number.
What the C&P exam measures
Residuals of TBI are examined on VA’s Initial or Review Evaluation of Residuals of Traumatic Brain Injury DBQ. Those two forms are not in VA’s public DBQ library; by regulation and training rules they are restricted to qualified examiners (for initial diagnosis, one of four specialists: physiatrist, psychiatrist, neurosurgeon, or neurologist), so you cannot have a general provider fill one out for you the way you can with many musculoskeletal DBQs. The exam walks each of the ten facets and assigns a level to each. Because your rating comes from your worst facet, describe your hardest days specifically: not “my memory is bad,” but what you forget, how often, and what it has cost you (missed appointments, repeated instructions at work, safety incidents). Level 2 versus level 1 on a single facet like memory or judgment is the difference between 40 percent and 10 percent.
What to have in your file
Per VA’s evidence requirements: the record of the head injury itself (blast exposure, combat incident report, MVA, line-of-duty documentation), any acute treatment or LOC/altered-consciousness notes, and neuropsychological testing that objectively grades cognition. Statements from a spouse, coworkers, or squadmates (VA Form 21-10210) are especially load-bearing for TBI because facets like social interaction, judgment, and neurobehavioral effects are best documented by the people who see you daily, not by a snapshot exam.
Common mistakes
- Letting a diagnosed mental-health condition get folded into the TBI facets. When emotional/behavioral symptoms rise to a diagnosed mental disorder, the regulation says to rate them under 38 CFR 4.130, the mental-disorders schedule, not the 8045 table. That is often a higher and separate evaluation. See the PTSD and mental-health page.
- Not claiming residuals with their own diagnosis. A residual with a distinct diagnosis, such as migraine headache or Meniere’s disease, is rated separately under its own diagnostic code even when the diagnosis rests on subjective symptoms. Post-traumatic headaches are a classic missed claim; see migraines.
- Assuming the facets combine. They do not. Reporting five facets at level 1 does not build toward 70 percent; it is still a 10 percent evaluation unless one facet reaches level 2 or higher.
Worth knowing
Physical and neurological residuals (motor and sensory loss, seizures, tinnitus, hearing loss, balance and coordination problems, neurogenic bladder or bowel) are each rated under their own diagnostic codes and then combined with the 8045 evaluation under 38 CFR 4.25, as long as the same signs and symptoms are not counted twice (38 CFR 4.14). For purposes of that combination, the whole 8045 table counts as a single condition. Because separately rated residuals stack, a well-documented TBI claim is frequently several ratings, not one. The regulation also directs raters to consider special monthly compensation, including aid and attendance where cognitive impairment creates a need for protection from everyday hazards.
Rating criteria from the CFR
| Rating criteria | Rating |
|---|---|
| There are three main areas of dysfunction that may result from TBI and have profound effects on functioning: cognitive (which is common in varying degrees after TBI), emotional/behavioral, and physical. Each of these areas of dysfunction may require evaluation. | |
| Cognitive impairment is defined as decreased memory, concentration, attention, and executive functions of the brain. Executive functions are goal setting, speed of information processing, planning, organizing, prioritizing, self-monitoring, problem solving, judgment, decision making, spontaneity, and flexibility in changing actions when they are not productive. Not all of these brain functions may be affected in a given individual with cognitive impairment, and some functions may be affected more severely than others. In a given individual, symptoms may fluctuate in severity from day to day. Evaluate cognitive impairment under the table titled “Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified.” | |
| Subjective symptoms may be the only residual of TBI or may be associated with cognitive impairment or other areas of dysfunction. Evaluate subjective symptoms that are residuals of TBI, whether or not they are part of cognitive impairment, under the subjective symptoms facet in the table titled “Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified.” However, separately evaluate any residual with a distinct diagnosis that may be evaluated under another diagnostic code, such as migraine headache or Meniere's disease, even if that diagnosis is based on subjective symptoms, rather than under the “Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified” table | |
| Evaluate emotional/behavioral dysfunction under § 4.130 (Schedule of ratings—mental disorders) when there is a diagnosis of a mental disorder. When there is no diagnosis of a mental disorder, evaluate emotional/behavioral symptoms under the criteria in the table titled “Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified.” | |
| Evaluate physical (including neurological) dysfunction based on the following list, under an appropriate diagnostic code: Motor and sensory dysfunction, including pain, of the extremities and face; visual impairment; hearing loss and tinnitus; loss of sense of smell and taste; seizures; gait, coordination, and balance problems; speech and other communication difficulties, including aphasia and related disorders, and dysarthria; neurogenic bladder; neurogenic bowel; cranial nerve dysfunctions; autonomic nerve dysfunctions; and endocrine dysfunctions. | |
| The preceding list of types of physical dysfunction does not encompass all possible residuals of TBI. For residuals not listed here that are reported on an examination, evaluate under the most appropriate diagnostic code. Evaluate each condition separately, as long as the same signs and symptoms are not used to support more than one evaluation, and combine under § 4.25 the evaluations for each separately rated condition. The evaluation assigned based on the “Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified” table will be considered the evaluation for a single condition for purposes of combining with other disability evaluations | |
| Consider the need for special monthly compensation for such problems as loss of use of an extremity, certain sensory impairments, erectile dysfunction, the need for aid and attendance (including for protection from hazards or dangers incident to the daily environment due to cognitive impairment), being housebound, etc |
SOURCE: eCFR, 38 CFR Part 4 (issue date 2026-07-10, current through 2026-07-10) · retrieved 2026-07-14
If your rating came back lower than this
A decision that ignores the criteria above is a frequent reason veterans are underpaid. Line your decision up against the levels on this page. If the evidence supports a higher level than VA assigned, you have three ways to challenge it, and the right one depends on why it went wrong:
- Something was missing from the record (an exam finding, a prescription, a flare-up statement, a nexus letter): add it with a Supplemental Claim.
- The evidence was already there and VA misread it: ask for a Higher-Level Review by a more senior rater, with no new evidence needed.
- A legal or judgment error: take it to the Board of Veterans' Appeals.
Line your decision up against the criteria on this page. Which review lane fits depends on why the rating is wrong: new evidence that was missing, a misread of evidence already in the file, or a legal error. All three are laid out in the decision reviews and appeals guide.
Before you file, recombine this rating with your others (VA math does not add ratings), check how long each lane is taking right now, and remember a VA-accredited representative or VSO will help you for free. You can also browse every other condition's criteria to make sure you are claiming everything you are owed.