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TBI VA Rating: Diagnostic Code 8045 and the 10-Facet Schedule

By Truth Veteran Benefits Desk · Reviewed by Truth Veteran Benefits Desk on

The VA rates residuals of traumatic brain injury (TBI) under 38 CFR 4.124a, Diagnostic Code 8045, across cognitive, emotional/behavioral, and physical dysfunction. Cognitive impairment and subjective symptoms are rated at 0%, 10%, 40%, 70%, or 100% using the 10-facet 'Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified' table, where the highest-scored facet sets the DC 8045 rating. Distinct physical diagnoses and separable mental disorders are rated separately and combined under 38 CFR 4.25.

Older veteran with traumatic brain injury (TBI) reviewing a daily memory notebook organizer at a kitchen table
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How the VA rates traumatic brain injury under Diagnostic Code 8045

Traumatic brain injury occurs when an external force—such as an explosive blast wave, vehicle rollover, training fall, or blunt head strike—disrupts normal brain function. Determining a tbi va rating depends on the chronic functional residuals that persist after the injury rather than the acute concussion itself. Within the VA disability ratings schedule, TBI residuals are rated under 38 CFR 4.124a, Diagnostic Code 8045 (Residuals of traumatic brain injury).

Under Diagnostic Code 8045, the VA evaluates TBI residuals across three main areas of dysfunction:

  1. Cognitive dysfunction: Decreased memory, concentration, attention, and executive functions of the brain (goal setting, processing speed, planning, organizing, prioritizing, self-monitoring, problem solving, judgment, decision making, spontaneity, and flexibility in changing actions when unproductive).
  2. Emotional and behavioral dysfunction: Evaluated under 38 CFR 4.130 (mental disorders) when a mental disorder is diagnosed, or under the DC 8045 facet table when there is no mental disorder diagnosis.
  3. Physical (including neurological) dysfunction: Evaluated separately under the appropriate diagnostic code for each condition, including motor and sensory dysfunction, visual impairment, hearing loss and tinnitus, loss of smell and taste, seizures, gait and balance problems, speech and communication difficulties (aphasia and dysarthria), migraine headaches, neurogenic bladder or bowel, cranial or autonomic nerve dysfunctions, and endocrine dysfunctions.

The highest-facet rule (0%, 10%, 40%, 70%, or 100%)

Cognitive impairment and subjective or emotional residuals not otherwise classified are rated under the table titled “Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified.” This table contains 10 facets scored at impairment levels of 0, 1, 2, 3, or Total. Not every facet includes every level: Subjective symptoms stops at Level 2, Social interaction and Neurobehavioral effects stop at Level 3, and Consciousness has only a Total level.

Rather than adding or averaging the 10 facets, the VA assigns a single percentage evaluation based on the level of the highest-scored facet:

  • Total in one or more facets = 100% rating ($3,938.58/month veteran alone, effective 2025-12-01).
  • Highest facet is Level 3 = 70% rating ($1,808.45/month veteran alone).
  • Highest facet is Level 2 = 40% rating ($795.84/month veteran alone).
  • Highest facet is Level 1 = 10% rating ($180.42/month veteran alone).
  • Highest facet is Level 0 = 0% noncompensable rating.

Scoring Level 3 in a single facet earns a 70% evaluation under DC 8045, even if the other nine facets are scored at Level 0.

Evaluation of Cognitive Impairment and Other Residuals of TBI table (DC 8045)

The table below sets out all 10 facets, their available levels and rating percentages, and the criteria in 38 CFR 4.124a. Under Note 2 to DC 8045, example symptoms listed at specific levels are illustrative only and not required to assign that evaluation.

Facet & LevelsRating %Criteria by Level Under 38 CFR 4.124a, Diagnostic Code 8045
1. Memory, attention, concentration, executive functions (0–3, Total)0% / 10% / 40% / 70% / 100%0 (0%): No complaints. 1 (10%): Complaint of mild loss of memory (difficulty following/recalling conversations, remembering new names, finding words, or misplacing items), attention, concentration, or executive functions, without objective evidence on testing. 2 (40%): Objective evidence on testing of mild impairment causing mild functional impairment. 3 (70%): Objective evidence on testing of moderate impairment causing moderate functional impairment. Total (100%): Objective evidence on testing of severe impairment causing severe functional impairment.
2. Judgment (0–3, Total)0% / 10% / 40% / 70% / 100%0 (0%): Normal. 1 (10%): Mildly impaired; for complex/unfamiliar decisions, occasionally unable to identify, understand, and weigh alternatives, understand consequences, and make a reasonable decision. 2 (40%): Moderately impaired; for complex/unfamiliar decisions, usually unable to weigh alternatives, understand consequences, and make a reasonable decision, though little difficulty with simple decisions. 3 (70%): Moderately severely impaired; for even routine/familiar decisions, occasionally unable to weigh alternatives, understand consequences, and make a reasonable decision. Total (100%): Severely impaired; for even routine/familiar decisions, usually unable to weigh alternatives, understand consequences, and make a reasonable decision (e.g., weather-appropriate clothing or avoiding danger).
3. Social interaction (0–3)0% / 10% / 40% / 70%0 (0%): Routinely appropriate. 1 (10%): Occasionally inappropriate. 2 (40%): Frequently inappropriate. 3 (70%): Inappropriate most or all of the time. (No Total level.)
4. Orientation (0–3, Total)0% / 10% / 40% / 70% / 100%0 (0%): Always oriented to person, time, place, and situation. 1 (10%): Occasionally disoriented to one of the four aspects. 2 (40%): Occasionally disoriented to two aspects, or often disoriented to one aspect. 3 (70%): Often disoriented to two or more aspects. Total (100%): Consistently disoriented to two or more aspects.
5. Motor activity (intact motor/sensory) (0–3, Total)0% / 10% / 40% / 70% / 100%0 (0%): Normal. 1 (10%): Normal most of the time, mildly slowed at times due to apraxia (inability to perform learned motor tasks despite normal motor function). 2 (40%): Mildly decreased or moderate slowing due to apraxia. 3 (70%): Moderately decreased due to apraxia. Total (100%): Severely decreased due to apraxia.
6. Visual spatial orientation (0–3, Total)0% / 10% / 40% / 70% / 100%0 (0%): Normal. 1 (10%): Mildly impaired; occasionally gets lost in unfamiliar surroundings, difficulty reading maps/directions, able to use GPS. 2 (40%): Moderately impaired; usually gets lost in unfamiliar surroundings, difficulty reading maps/directions and judging distance, difficulty using GPS. 3 (70%): Moderately severely impaired; gets lost even in familiar surroundings, unable to use GPS. Total (100%): Severely impaired; may be unable to touch/name own body parts when asked, identify relative spatial position of two objects, or find way between rooms in a familiar environment.
7. Subjective symptoms (0–2)0% / 10% / 40%0 (0%): Symptoms do not interfere with work, instrumental activities of daily living (IADLs), or close relationships (e.g., mild/occasional headaches, mild anxiety). 1 (10%): Three or more subjective symptoms mildly interfering with work, IADLs, or close relationships (e.g., intermittent dizziness, daily mild-to-moderate headaches, tinnitus, frequent insomnia, sound/light hypersensitivity). 2 (40%): Three or more subjective symptoms moderately interfering with work, IADLs, or close relationships (e.g., marked fatigability, blurred/double vision, headaches requiring rest most days). (No Level 3 or Total.)
8. Neurobehavioral effects (0–3)0% / 10% / 40% / 70%0 (0%): One or more effects (irritability, impulsivity, unpredictability, lack of motivation, verbal/physical aggression, belligerence, apathy, lack of empathy, moodiness, lack of cooperation, inflexibility, impaired awareness of disability) not interfering with workplace/social interaction. 1 (10%): Occasionally interfere with workplace and/or social interaction without precluding them. 2 (40%): Frequently interfere with workplace and/or social interaction without precluding them. 3 (70%): Interfere with or preclude workplace and/or social interaction on most days, or occasionally require supervision for safety of self or others. (No Total level.)
9. Communication (0–3, Total)0% / 10% / 40% / 70% / 100%0 (0%): Able to communicate and comprehend spoken and written language. 1 (10%): Spoken or written comprehension/expression only occasionally impaired; can communicate complex ideas. 2 (40%): Inability to communicate or comprehend spoken/written language more than occasionally but less than half the time; can generally communicate complex ideas. 3 (70%): Inability to communicate or comprehend spoken/written language at least half the time but not all the time; may use gestures/alternative modes; can communicate basic needs. Total (100%): Complete inability to communicate or comprehend spoken/written language; unable to communicate basic needs.
10. Consciousness (Total)100%Total (100%): Persistently altered state of consciousness, such as vegetative state, minimally responsive state, or coma.

Binding notes and separate residual ratings under DC 8045

  • Objective testing for Facet 1 (Levels 2, 3, and Total): Under Facet 1, subjective complaints of mild memory or attention loss warrant Level 1 (10%) without objective testing, whereas Level 2 (40%), Level 3 (70%), and Total (100%) require objective evidence on testing (such as formal neuropsychological testing).
  • IADLs vs. ADLs (Note 3): Instrumental activities of daily living (IADLs) in Facet 7 refer to meal preparation, housework, shopping, traveling, laundry, managing medications, and telephone use, whereas basic Activities of daily living (ADLs) cover bathing, dressing, eating, transferring from bed or chair, and toileting.
  • Acute TBI labels vs. current rating (Note 4) & pre-2008 reviews (Note 5): Under Note 4, medical record labels of “mild,” “moderate,” and “severe” TBI classify acute injury status near the time of trauma and do not affect the rating assigned under DC 8045. Under Note 5, veterans rated under DC 8045 before October 23, 2008 may request a review under current DC 8045 criteria regardless of whether their condition worsened.
  • Separately rated physical diagnoses: Any residual with a distinct diagnosis ratable under another diagnostic code—even if based on subjective symptoms—must be rated separately rather than under Facet 7. Common examples include migraine headaches (DC 8100) up to 50%, tinnitus (DC 6260) at 10%, hearing loss (DC 6100), peripheral vestibular disorders (DC 6204) or Meniere’s disease (DC 6205), visual impairments, cranial nerve paralysis, loss of smell (DC 6275, 10%) or taste (DC 6276, 10%), seizures, neurogenic bladder or bowel, and erectile dysfunction.
  • Comorbid mental disorders (Note 1 and 38 CFR 4.14): When a veteran has both TBI and a mental disorder under 38 CFR 4.130—such as PTSD (DC 9411), depression (DC 9434), or anxiety (DC 9400)—Note 1 prohibits assigning multiple evaluations for the same manifestations (38 CFR 4.14). If manifestations are clearly separable, the VA assigns separate ratings; if overlapping symptoms cannot be clearly separated, the VA assigns a single combined evaluation under whichever criteria better assess overall impaired functioning.

Presumptive secondary conditions under 38 CFR 3.310(d)

Under 38 CFR 3.310(d)(1), five secondary conditions are held to be the proximate result of a service-connected TBI—absent clear evidence to the contrary—when initial TBI severity and manifestation windows are met:

  • Parkinsonism (including Parkinson’s disease): Following moderate or severe TBI (no time limit).
  • Unprovoked seizures: Following moderate or severe TBI (no time limit).
  • Specified dementias (presenile Alzheimer type, frontotemporal, and Lewy body dementia): Manifesting within 15 years following moderate or severe TBI.
  • Depression: Manifesting within 3 years of moderate or severe TBI, or within 12 months of mild TBI.
  • Diseases of hormone deficiency from hypothalamo-pituitary changes: Manifesting within 12 months of moderate or severe TBI.

Under 38 CFR 3.310(d)(3)(i)–(ii), initial TBI severity is ranked at the highest level in which any criterion at or shortly after injury is met:

  • Mild TBI: Normal structural imaging; loss of consciousness (LOC) 0–30 minutes; alteration of consciousness (AOC) up to 24 hours; post-traumatic amnesia (PTA) 0–1 day; or Glasgow Coma Scale (GCS) 13–15.
  • Moderate TBI: Normal/abnormal imaging; LOC > 30 minutes and < 24 hours; AOC > 24 hours; PTA > 1 and < 7 days; or GCS 9–12.
  • Severe TBI: Normal/abnormal imaging; LOC > 24 hours; AOC > 24 hours; PTA > 7 days; or GCS 3–8.

Under 38 CFR 3.310(d)(2), claims outside these severity or time rules are still decided under standard secondary service connection rules (38 CFR 3.310(a)–(b)) when supported by a medical nexus opinion (including secondary claims for migraines, sleep apnea, or later-onset depression).

C&P exam DBQs, SMC(t), combined ratings, and accredited help

  • TBI DBQ and C&P exam: Per the VA Public DBQ directory, the Initial and Review Evaluation of Residuals of Traumatic Brain Injury DBQs are restricted from public use; initial TBI diagnoses require a physiatrist, psychiatrist, neurologist, or neurosurgeon. Private specialists can still provide objective neuropsychological testing for Facet 1 and nexus opinions, and family lay statements help document daily facet impairments.
  • TDIU (38 CFR 4.16) and SMC(t) (38 CFR 3.350(j)): A 70% DC 8045 rating meets the single-disability threshold for TDIU, and a 40% rating meets the 40% anchor when combined ratings reach 70%. Under 38 CFR 3.350(j) and 38 CFR 3.352, veterans needing regular aid and attendance for TBI residuals who would otherwise require institutional care may qualify for SMC(t) at the SMC(r)(2) rate.
  • Combined ratings and VSO help: The 10-facet evaluation combines with separate physical or mental ratings under 38 CFR 4.25 using our VA combined rating calculator. For claim or appeal help, Veterans Service Organizations (VSOs) provide free VA-accredited representation, and accredited claims agents or attorneys assist with appeals; no representative can guarantee an outcome. Verify credentials via the VA OGC Accreditation Search.

This guide explains the rules; it is not legal or medical advice. VA decisions depend on your records. Free help is available from accredited Veterans Service Organizations.

Frequently asked questions

How does the VA calculate a TBI VA rating under the 10-facet table?

Under 38 CFR 4.124a, Diagnostic Code 8045, the examiner scores 10 facets at Level 0, 1, 2, 3, or Total. The single highest facet level sets your DC 8045 rating: 0 = 0%, 1 = 10%, 2 = 40%, 3 = 70%, and Total = 100%.

Does a mild TBI diagnosis limit the VA disability percentage I can receive?

No. Note 4 to Diagnostic Code 8045 states that mild, moderate, and severe TBI classifications describe acute severity near the time of injury and do not affect the rating assigned for current residuals under DC 8045. Your VA disability rating is determined by your current cognitive and subjective impairment across the 10 facets at 0%, 10%, 40%, 70%, or 100%.

Can I get separate VA ratings for TBI, PTSD, and migraine headaches?

Distinct diagnoses such as migraine headaches (DC 8100) or tinnitus (DC 6260) are rated separately rather than under the subjective symptoms facet. Under Note 1 to DC 8045, comorbid PTSD or depression (38 CFR 4.130) receives a separate rating if its manifestations are clearly separable from TBI facets, or one combined rating if overlapping symptoms cannot be separated.

Why is the subjective symptoms facet capped at 40%?

Not every facet in the DC 8045 table has every severity level. Subjective symptoms peaks at Level 2 (40%) for three or more symptoms moderately interfering with work, instrumental activities of daily living, or close relationships. Social interaction and neurobehavioral effects peak at Level 3 (70%), while consciousness has only a Total (100%) level.

What conditions are presumptively secondary to TBI under 38 CFR 3.310(d)?

Under 38 CFR 3.310(d)(1), five conditions are presumed secondary to service-connected TBI absent clear evidence to the contrary: Parkinsonism following moderate/severe TBI; unprovoked seizures following moderate/severe TBI; presenile Alzheimer-type, frontotemporal, or Lewy body dementia within 15 years of moderate/severe TBI; depression within 3 years of moderate/severe TBI or 12 months of mild TBI; and hypothalamo-pituitary hormone deficiency within 12 months of moderate/severe TBI.

Can my private doctor complete the Initial TBI Disability Benefits Questionnaire?

No. Per the VA Public DBQ directory, the Initial and Review Evaluation of Residuals of TBI DBQs are restricted from public use because initial TBI diagnoses require specialist credentials (physiatry, psychiatry, neurology, or neurosurgery). Private specialists can still submit neuropsychological test results and nexus opinions.

Sources

  1. 38 CFR 4.124a, Schedule of ratings - neurological conditions and convulsive disorders (DC 8045)
  2. 38 CFR 3.310, Disabilities that are proximately due to, or aggravated by, service-connected disease or injury
  3. 38 CFR 3.303, Principles relating to service connection
  4. 38 CFR 4.14, Avoidance of pyramiding
  5. 38 CFR 4.25, Combined ratings table
  6. 38 CFR 3.350, Special monthly compensation ratings
  7. 38 CFR 3.352, Criteria for determining need for aid and attendance and permanently bedridden
  8. VA Public Disability Benefits Questionnaires (DBQs) Directory