Will VA Rate TBI and PTSD Separately or Together?

Will VA Rate TBI and PTSD Separately or Together?

Millions of Veterans throughout America suffer from the effects of TBIs and/or PTSD. These mental health-related conditions can arise due to one’s military service or from active combat. Whether you experience the effects of a TBI, PTSD, or both, you deserve to be compensated for your honorable service to our country.

You may wonder whether the VA will rate your TBI and PTSD separately or together. Let’s explore the answer to this question in detail.

What Is a TBI?

A TBI is a traumatic brain injury, such as a concussion. Brain injuries are usually caused by direct brain damage, like damage to the skull or penetration of the brain by an object. Because TBIs affect the brain, they often lead to severe and negative symptoms, including:

  • Headaches
  • Confusion
  • Dizziness
  • Nausea
  • Memory loss
  • Personality changes or disorders
  • Mood swings

While TBIs don’t always result in brain dysfunctions, they can in many cases. Unfortunately, TBIs can be caused due to many root issues or events, including:

  • Auto accidents
  • Personal assaults
  • Trips/slips and falls
  • Combat exposure
  • And more

Many US Veterans suffer from TBIs that result in persistent or chronic issues for years. Some TBIs and their effects only last for a few weeks or months, while others can result in permanent neurological damage or personality changes.

Many TBIs can be difficult to diagnose or understand at first. Doctors must analyze the symptoms of the person suffering from the TBI, identify brain damage, and conclude that the brain damage is the result of experienced symptoms. 

Because this process can take months or years, many Veterans don’t receive the disability benefits they are entitled to for their TBIs until long after developing their first symptoms.

TBI VA Disability Ratings

The VA rates disability ratings depending on their individual symptoms. All TBIs are rated under 38 CFR 4.124a and with a scale that ranges from 0 to Total. Each increment on the scale corresponds to a different disability rating ranging from 0% to 100%. 

Furthermore, the VA technically classifies TBI residuals into ten distinct subcategories. These subcategories include:

  • Inhibited social skills
  • Impairment of memory, attention, concentration, and other executive functions
  • Altered judgment
  • Orientation to person, time, place, and situation
  • Impaired motor activity
  • Ability to indicate
  • Neurobehavioral effects
  • Subjective symptoms
  • Visual-spatial orientation
  • Consciousness

Based on the above symptoms and TBI effects associated with each subcategory, the VA may assign affected Veterans a rating of:

  • Zero, which corresponds to 0% or normal functioning
  • One, which corresponds to 10% or mild symptoms
  • Two, which corresponds to 40% or moderate symptoms
  • Three, which corresponds to 70% or severe symptoms
  • Total, which corresponds to 100%

The VA rates an affected Veteran based on their highest-rated residual. 

For instance, imagine that you have a TBI with a residual of two out of the ten possible categories. Say you have a two for orientation but a three for ability to communicate. 

According to this rule, the VA should assign you a disability rating of three, which translates to a 70% disability rating for your TBI.

What Is PTSD?

Post-traumatic stress disorder (PTSD) is a mental health condition that may or may not be associated with physical brain injuries or damage such as TBIs.

Veterans may develop PTSD after experiencing a traumatic event, including:

  • Seen combat in person
  • Losing a comrade
  • Losing a family member while you are on duty

No matter how PTSD develops initially, Veterans may experience a wide range of symptoms and severity levels depending on their experiences and other factors. Some of the most common PTSD symptoms include:

  • Emotional numbness, which may be accompanied by avoidance of activities, people, or places that may remind the affected person of trauma
  • Anxiety and/or depression or related symptoms
  • Heightened arousal, which may make it difficult for affected individuals to sleep or concentrate
  • Constant reexperiencing of the trauma through distressing and/or intrusive recollections of the PTSD event
  • Nightmares or flashbacks

Like TBIs, PTSD can be difficult to both diagnose and rate by the VA. PTSD is typically diagnosed after collecting symptoms and testimony from both the affected individual and related parties like loved ones or family members who can vouch for claimed behavior.

PTSD VA Disability Ratings

The VA rates PTSD and associated symptoms after a Veteran demonstrates a connection between their symptoms and PTSD. They must prove that:

  • They have a current diagnosis of PTSD from a licensed medical professional
  • A medical opinion from a doctor or other medical professional proving a medical nexus between PTSD and one’s military service

If a Veteran can prove both of the above elements, they may receive a service connection from the VA and associated disability rating. Disability ratings for PTSD can range from 0% to 100%:

  • 0% rating for Veterans with formally diagnosed PTSD but asymptomatic or very mild symptoms
  • 10% rating for Veterans who experience occupational and/or social impairment or issues because of mild and/or transient symptoms
  • 30% rating for Veterans who experience both occupational and/or social impairment. They also usually see decreases in work efficiency, inability to perform certain tasks during intermittent periods, and related symptoms like depression, anxiety, sleep impairment, panic attacks, and more
  • 50% rating for Veterans who experience the above in addition to symptoms such as panic attacks, impaired judgment, disturbances of motivation and mood, impaired short and long-term memory, and more
  • 70% rating for Veterans who experience the above in addition to heightened or severe symptoms like suicidal ideation, impaired impulse control, spatial disorientation, and more
  • 100% rating for Veterans who experience the above as well as total occupational and social impairment with symptoms like persistent delusions or hallucinations, inappropriate behavior, memory loss, disorientation, and more

Are TBIs and PTSD Related?

Because TBIs and PTSD both affect the brain, they sometimes share certain symptoms, such as memory loss, disorientation, mood swings, difficulty concentrating, and headaches. Many Veterans believe that they cannot be rated for both PTSD and a traumatic brain injury, but this is not true.

Does the VA Rate TBIs and PTSD Together or Separately?

The VA can rate both traumatic brain injuries and PTSD together. However, the VA does not rate shared symptoms twice to avoid a practice called pyramiding.

Pyramiding and VA Benefits

Pyramiding refers to counting a symptom or experience shared between two disabilities or conditions twice. 

For example, imagine that you have both a concussion and PTSD. You experience some disorientation but can’t identify which of the two conditions causes the disorientation overall or whether it’s both.

However, the VA will not count disorientation as a symptom when rating both your traumatic brain injury and your PTSD. Instead, the VA is required by law to count disorientation as the condition that results in the highest disability rating for you.

For instance, if disorientation results in a higher rating for PTSD than it does for a concussion, the VA will classify your disorientation symptom under your PTSD rating, not your concussion rating. 

Maximizing Your Benefits

Skilled Veterans law attorneys can help you maximize your benefits by:

  • Filing application for disability benefits in the right order. For example, you can file a claim for PTSD first, then a claim for your chronic brain injury, to make sure any shared symptoms are rated for the highest possible benefits.
  • Helping you file for a new application if one or another condition develops after the other. For example, maybe you were initially diagnosed with a traumatic brain injury, then were diagnosed with PTSD after. 

Remember, the VA must rate each shared symptom between a TBI and PTSD, but it always assigns you the highest possible disability rating. 

Contact Veterans Law Attorneys Today

Ultimately, you deserve maximum benefits for your traumatic brain injury and/or PTSD, no matter how severe your symptoms are. Berry Law can make sure you get what you deserve when you contact us today for a free case evaluation.

With our help, you’ll fully grasp how combined disability ratings work, understand how to file an application for benefits, and ensure that the VA rates your disabilities at their highest threshold possible. Contact Berry Law today to learn more.


38 CFR § 4.124a – Schedule of ratings – neurological conditions and convulsive disorders | 

38 CFR § 4.130 – Schedule of ratings – Mental disorders. | CFR | US Law | LII / Legal Information Institute

Traumatic Brain Injury / Concussion |

Berry Law

The attorneys at Berry Law are dedicated to helping injured Veterans. With extensive experience working with VA disability claims, Berry Law can help you with your disability appeals.

This material is for informational purposes only. It does not create an attorney-client relationship between the Firm and the reader, and does not constitute legal advice. Legal advice must be tailored to the specific circumstances of each case, and the contents of this blog are not a substitute for legal counsel.

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