Getting Up to 100% VA Rating for TBI

Nearly 1 in 4 U.S. veterans show signs of having a probable traumatic brain injury and are also more likely to develop other physical, cognitive and emotional/behavioral conditions associated with TBI. The VA rates TBI from 0% to 100% based on criteria that assess how the injury and its lasting effects impair the veteran’s life. 

This guide will help you understand how the VA evaluates TBI, the requirements for a disability rating, how to establish service connection and claim VA disability benefits, and what additional compensation you could qualify for. 

What Is a Traumatic Brain Injury?

Traumatic Brain Injury (TBI) is a serious medical condition that affects many veterans. It can result from a direct blow or jolt to the head, a penetrating injury, or exposure to explosive blasts. When the brain is injured, the veteran may experience a change of consciousness that can range from becoming mildly disoriented and/or confused to slipping into a coma. The veteran may also have memory loss for the time immediately before or after the event that caused the injury. 

Damage to the brain can be difficult to detect. Diffused injuries can cause an insufficient blood supply to the brain whereas localized damage can lead to bruising of the brain or hemorrhaging. Veterans suffering from TBI are likely to deal with physical, cognitive and/or psychological damage as a result of head trauma.

Veterans who have sustained moderate to severe or penetrating traumatic brain injuries may even face a higher risk of developing brain cancer compared with those without TBIs, according to recent research. A 2024 study of 1.9 million US veterans of the Iraq and Afghanistan wars found that veterans with more severe TBIs showed a significantly increased risk of brain cancer.

TBI Causes and How It Impacts Your Claim 

While traumatic brain injuries often share similar symptoms, the way in which they occur can differ significantly. This distinction plays a critical role in documenting service-connected injuries and pursuing a VA disability claim. 

Direct Impact TBIs 

Direct impact TBIs occur when the head sustains a forceful blow or jolt, causing the brain to move violently within the skull. This can result in damage to brain tissue, blood vessels, and nerves. Common scenarios where direct impact TBIs may occur include: 

• Combat and Explosive Devices: Blunt force trauma from enemy fire, shrapnel, or debris.
• Training Accidents: Falls or collisions during exercises.
• Vehicle Accidents: Collisions or rollovers involving military vehicles.
• Occupational Falls: Accidents occurring on bases, ships, or aircraft.

These injuries typically present with external signs of trauma and are more readily identifiable during medical evaluations. 

Blast-Related TBIs 

Known as “invisible injuries,” blast-related TBIs result from explosive shockwaves rather than physical impact. These waves rapidly change atmospheric pressure, causing internal brain injury without visible trauma. Such injuries commonly occur from: 

• IEDs and explosives 
• Artillery fire exposure 
• Live-explosive training exercises 

Blast-related TBIs are a hallmark injury of the Iraq and Afghanistan conflicts and often require specialized evaluation. 

What Do You Need for a TBI VA Rating? 

1. Document Your TBI Diagnosis

Ensure your TBI is diagnosed through a VA provider or private specialist. This is the foundation of your claim. 

2. Gather Evidence of In-Service Incidents

Include event documentation, service records, treatment details, and a personal statement outlining how the injury occurred and its ongoing impact. Consider asking for buddy statements from fellow service members who may remember the incident in which you were injured. 

3. Establish a Medical Nexus

A medical nexus links your current TBI diagnosis to service incidents. A strong nexus should explain changes in cognitive, physical, and emotional health. Find out from our VA-accredited attorneys how to establish service connection and get a rating for TBI: 

What Is the VA Disability Rating for TBI?

The VA rates TBI from 10% to 100% using Diagnostic Code 8045, which evaluates impairments across 10 domains including memory, attention, social functioning, communication, and more. The domains are evaluated as 0, 1, 2, 3 or “total”. The most severe level of impairment in any one domain determines the overall rating.

VA TBI Rating Levels 

• 0% rating: No residual symptoms affecting function.
• 10% rating: Mild or intermittent symptoms (assigned when the highest impairment is evaluated at 1). 
• 40% rating: Moderate impairment affecting work and social activities (the highest evaluation is 2). 
• 70% rating: Severe symptoms impacting independence and daily life (the highest evaluation is 3). 
• 100% rating: Total impairment requiring ongoing support or supervision.  

For the most serious cases, Special Monthly Compensation (SMC-T) may also be awarded. Also keep in mind that if a rating code outside diagnostic code 8045 would provide a higher rating for you, such as a separate rating for migraines, tinnitus or depression, VA is obligated to provide you with evaluation under the diagnostic code which is most advantageous to your claim.

Step by Step Guide to a TBI Rating

Step 1: Confirm the Diagnosis

If your TBI was not diagnosed during active service, you must get a diagnosis from a neurologist, psychiatrist, or neurosurgeon. The VA does not accept diagnoses from general practitioners or emergency room staff unless they are qualified specialists. You must also establish service connection, meaning the TBI must be linked to a specific incident during your military service (e.g., blast injury, fall, motor vehicle accident, training accident).

Step 2: File a Claim with the VA

 You can file a claim using form 21-526EZ, the online portal on VA.gov or an accredited Veterans Service Organization. Include your medical records, any prior diagnoses, and a clear statement explaining the incident that caused your TBI.

Step 3: Attend the VA C&P Exam

After your claim is submitted, VA will schedule a Compensation & Pension exam. The examiner uses a TBI-specific Disability Benefits Questionnaire (DBQ) to evaluate each of the 10 facets. This C&P exam is the primary evidence VA uses to assign your rating. If you have secondary symptoms (e.g., PTSD, migraines), they should be discussed during the exam for potential separate ratings.

Step 4: VA Review and Rating Assignment

A VA Rating Specialist will: 

• Review your DBQ and service/medical records
• Compare symptoms against the VASRD criteria (38 C.F.R. § 4.124a and § 4.130 if mental disorders apply)
• Assign a disability rating from 0% to 100%

Example: If your worst-rated facet is judged to be at the “3” level (severe impairment), your overall rating would be 70%. If any facet is marked as “Total,” you receive 100%.

Step 5: Reevaluation and Changes Over Time

The VA may schedule reexaminations to determine whether your condition has improved. You can also request reevaluation if symptoms worsen.

Did the VA Assign the Wrong Rating?

Normally, during the first round of decision-making, the VA will automatically go with the opinion of the C&P examiner, regardless of what any of the other evidence shows, even if favorable. Therefore, the veteran may have to appeal the initial decision and get an independent medical opinion. 

This is where neuropsychology comes in. Neuropsychology is a branch of clinical psychology that deals with the assessment and treatment of individuals with brain injuries or brain diseases. Because of the way that the VA evaluates TBI claims, it is to the veteran’s advantage to actively pursue the right treatment and the right evaluations, ahead of time. An evaluation from a neuropsychologist can help in this regard, because a neuropsychologist is specifically trained to look for and diagnose symptoms that may appear to be caused by something else, but could in fact be symptoms from TBI.

For example, cognitive impairment, headaches, dizziness, tinnitus, concentration problems, memory problems, or even insomnia, can be the result of TBI.  A neuropsychologist can also administer comprehensive psychological tests, which are designed to look for TBI and designed to objectively assess the severity of any TBI residuals. 

When looking at the VA’s rating chart for TBI, if a veteran has ‘mild’ memory loss or loss of attention or concentration, he or she is entitled to a 10% rating. However, if there is objective evidence on testing of “moderate” impairment, then the veteran is entitled to a higher rating. A thorough neuropsychological evaluation can make the difference between a denial and no denial, or the difference between a 0% rating versus a 40% rating. 

Maximizing Your TBI VA Rating

The 70% VA Rating for TBI

A 70% rating is assigned when symptoms reflect severe functional impairment in several areas:

• Memory and Attention: Trouble retaining information. 
• Judgment: Risky or poor decision-making. 
• Social Interaction: Inappropriate behaviors or isolation. 
• Orientation: Disorientation even in familiar settings. 
• Motor Skills: Difficulty with basic tasks. 
• Visual-Spatial: Trouble navigating or recognizing objects. 
• Subjective Symptoms: Panic attacks, mood swings. 
• Neurobehavioral Effects: Aggression, apathy. 
• Communication: Impaired speech or understanding. 
• Consciousness: Episodes of confusion or brief blackouts.   

Pathways to a 100% TBI Rating 

To go beyond the 70% rating and achieve a 100% rating, the veteran typically must show severe or total impairment across multiple domains: 

• Severe Cognitive Dysfunction: Inability to perform basic tasks such as dressing or preparing meals. 
• Complete Physical Dependence: Requiring full-time care or supervision.  

VA examiners consider how these symptoms limit independent functioning across daily environments. Veterans can also achieve 100% through secondary service connection for vertigo, headaches, tinnitus, or insomnia.

Denied or Underrated? Get the Help You Deserve 

If your TBI claim was denied or underrated, don’t face the appeals process alone. Legal complexities should not stand between you and the benefits you’ve earned. Get a free case evaluation with our legal team today. 

Secondary Conditions Related to TBI 

Traumatic brain injury can lead to additional service-connected conditions, including: 

• Headaches 
• Tinnitus 
• Vertigo 
• Seizures 
• Parkinsonism 
• Dementia
• Depression
• Anxiety or Somatic Disorders
• Insomnia 

Each of these may be eligible for secondary service connection, further increasing your overall disability rating. Find out more about filing for TBI secondary conditions. 

TDIU: Additional Benefits When You Can’t Work 

If your TBI prevents you from maintaining substantially gainful employment, you may qualify for Total Disability based on Individual Unemployability (TDIU). To qualify, you must: 

• Have one disability rated at 60% or more or multiple disabilities combining to 70% with one rated at least 40%. 
• Prove that your service-connected conditions prevent steady employment.   

TDIU provides compensation at the 100% disability rate even if your combined rating is less than 100%. If your TBI makes it difficult for you to keep a job, our experienced TDIU attorneys may be able to help you get the maximum compensation.

Frequently Asked Questions