How Does the VA Rate Traumatic Brain Injury?

by Stephani Bennett, Attorney at Law and US Air Force Veteran

A traumatic brain injury, commonly known as a TBI, typically occurs when a person receives a hit to their head. Immediate symptoms include loss of consciousness, confusion, blurred vision, headache, nausea, fatigue, problems with speech, and concentration difficulty. Typically, most symptoms fade as the injury heals. However, many Veterans experience long term TBI symptoms, which can affect all aspects of their lives. If they received the injury to the head in service, they may want to pursue service connection for those symptoms.

Rating criteria of TBI

Since no two brains react the same way to a head injury, the rating criteria is broken down into ten facets of TBI, which are listed below.

  1. Memory, attention, concentration, executive function
  2. Judgement
  3. Social interaction
  4. Orientation
  5. Motor activity
  6. Visual spatial orientation
  7. Subjective symptoms
  8. Neurobehavioral effects
  9. Communication
  10. Consciousness

During an evaluation, a VA examiner assigns a level of impairment for each of the categories listed above. Most facets are given a value range of 0 to 3, or sometimes 0 to “total.” The exception is facet ten, consciousness, which can only be only rated as zero or total.

Ratio of level of impairment to rating

The VA then bases their percentage rating on the highest level of impairment in any facet. For instance, if the highest level of impairment were “total” in the consciousness facet, the Veteran would be given a rating of 100 percent. If the highest level of impairment were a 3 in any facet, the rating would be 70 percent, if it were 2 the rating would be 40 percent, and if it were 1 the rating would be 10 percent.

That may seem confusing, so we’ll go through an example. Let’s say a Veteran was involved in an explosion in service and lost consciousness. When she woke up, she was dizzy, confused, and she had a headache. As time went on, her symptoms grew worse until she could hardly remember anything or concentrate at all. When she got out of the service, she filed for VA disability benefits based on her symptoms and a VA examiner assigned the following level of severity to each facet.

  1. Memory, attention, concentration, executive function (level of impairment – total)
  2. Judgement (level of impairment – 3)
  3. Social interaction (level of impairment – 2)
  4. Orientation (level of impairment – 1)
  5. Motor activity (level of impairment – 0)
  6. Visual spatial orientation (level of impairment – 2)
  7. Subjective symptoms (level of impairment – 3)
  8. Neurobehavioral effects (level of impairment – 1)
  9. Communication (level of impairment – 1)
  10. Consciousness (level of impairment – 0)

The examiner in example assigned a total level of impairment to her memory, attention, concentration, or executive functions. Regardless of the level of impairment given to other facets, she would be given a 100 percent rating based on her total impairment in this facet. The above is a rare example of extremely severe residuals of TBI. Much more likely, a Veteran will be given a 10 or 40 percent rating for their TBI.

Additional analysis for service connection

The analysis mustn’t end there because there are a few other benefits associated with a TBI in the VA system. For instance, if the Veteran developed depression as a result of the TBI, they can file for service connection. In fact, if the depression developed within 3 years of a moderate or severe TBI or 1 year of a mild TBI, it will be presumptively service connected. Other common secondary conditions include Parkinson’s and dementia.

Finally, a TBI may qualify a Veteran for special monthly compensation (SMC), which is additional money paid regardless of the Veteran’s overall combined compensation. In other words, a Veteran would receive additional money for SMC even if they were rated 100 percent. A Veteran’s TBI qualifies them for a special kind of SMC if they meet the following criteria: Veteran requires regular aid and attendance due to their TBI (they need help bathing, dressing, feeding, using the restroom, etc.), Veteran would otherwise require residential care, and Veteran does not qualify for a higher level of aid and attendance (under another type of SMC). If all three criteria are met, the Veteran may qualify for SMC.

Veterans Serving Veterans

Berry Law Firm was founded by Vietnam War Veteran and legendary trial lawyer John Stevens Berry Sr. We are proud to have many military Veterans among our attorneys and staff who understand what it means to serve and know, firsthand, the struggles many of our clients face every day.

If your VA disability claim has been denied, Berry Law Firm may be able to help. We have been successfully representing Veterans for decades. Contact us today for a free evaluation.