TBI VA Rating: From Facets to a Final Number

The VA describes three areas a brain injury can damage, and each one is evaluated its own way:

• Cognitive. Memory, attention, concentration and executive functions such as planning, organizing and making decisions. These go through the facet table explained below.
• Emotional and behavioral. If you have a diagnosed mental health condition, such as depression or PTSD, it is rated under the mental disorders formula. If you have symptoms like irritability but no mental health diagnosis, they are scored in the facet table instead.
• Physical. Headaches, hearing loss, tinnitus, vision problems, lost smell or taste, seizures, balance trouble, speech problems, bladder or bowel changes, nerve damage and hormone problems are each rated under their own diagnostic code.

All of those ratings are combined, with one limit: the same symptom can't be counted twice. If memory trouble already drives your facet score, it can't also raise a separate rating.

The cognitive part of a TBI rating comes from a table of ten facets:

• Memory, attention, concentration and executive functions
• Judgment
• Social interaction
• Orientation
• Motor activity, with motor and sensory systems otherwise intact
• Visual spatial orientation
• Subjective symptoms, such as headaches, dizziness or light sensitivity that don't have their own diagnosis
• Neurobehavioral effects
• Communication
• Consciousness

The examiner scores each facet at a level from 0 to 3, or "total." Not every facet uses every level, and consciousness only has "total," because any impaired consciousness is totally disabling. The VA then ignores everything except your single highest facet. Say your memory scores a 1, judgment a 2, and the rest 0. Your TBI rating is 40%, which pays $795.84 a month at 2026 rates for a veteran alone. Two facets at level 2 still produce 40%, because levels across facets are not added together.

Once your TBI is service-connected, the VA presumes certain later conditions grew out of it, unless clear evidence points elsewhere:

• Parkinsonism, including Parkinson's disease, after a moderate or severe TBI
• Unprovoked seizures after a moderate or severe TBI
• Certain dementias (presenile dementia of the Alzheimer type, frontotemporal dementia and dementia with Lewy bodies) appearing within 15 years of a moderate or severe TBI
• Depression appearing within 3 years of a moderate or severe TBI, or within 12 months of a mild one
• Hormone deficiency diseases caused by changes to the hypothalamus or pituitary gland, appearing within 12 months of a moderate or severe TBI

How severity is decided

Mild, moderate and severe refer to what happened at or near the time of injury: how long you were knocked out or dazed, how long memory gaps lasted, your Glasgow Coma Scale score, and what brain imaging showed. The VA uses the highest category any single factor reaches. A 45-minute loss of consciousness alone, for example, places the injury in the moderate group even if your scans were normal.

Two points worth knowing. These severity labels don't change your facet-table rating at all; they only matter for the presumptions. And missing a time limit or a severity level doesn't end the claim. You can still connect the condition with medical evidence the ordinary way.

Plenty of blasts and hard hits were never written down. Units were busy, and many service members shook it off and went back out. The VA can still connect a TBI without an in-service diagnosis when other evidence shows the event happened:

• Post-deployment health assessments where you reported a blast, headaches or memory trouble
• Combat records, unit histories, award citations, a Purple Heart, or a combat action badge or ribbon
• Sick call notes for headaches, dizziness or "getting your bell rung" after an incident
• Statements from people who were in the vehicle or on the range with you

If you served in combat, the law lets your own account establish an injury from that combat when it fits the circumstances of your service. Separately, when no TBI diagnosis is already in your records, VA exam rules call for one of four specialists to make it: a physiatrist, psychiatrist, neurosurgeon or neurologist. If your initial TBI exam was done by someone else, that is worth raising.

Irritability, poor sleep, trouble concentrating and memory gaps can come from a brain injury, from PTSD or from both. The VA's approach is specific. When an examiner can separate which symptoms come from which condition, each condition gets its own rating. When the symptoms can't be clearly separated, the VA assigns one rating under whichever set of criteria better captures your overall functioning.

At the exam, it helps to describe when each problem started. A veteran whose headaches and word-finding trouble began right after a blast, while nightmares and hypervigilance came later, is giving the examiner what's needed to split the picture. The PTSD guide covers the mental health side of that claim.