Question 1

How does VA rate TBI?

Accepted Answer

Under 38 CFR 4.124a DC 8045, TBI residuals are rated across three domains: cognitive (10 facets including memory, attention, executive function), emotional/behavioral (rated under mental health if a separate diagnosis exists), and physical (rated under appropriate body-system code). The cognitive rating uses a "highest facet wins" rule: your overall percentage equals the highest single facet score, NOT a sum.

Question 2

What are the 10 cognitive facets?

Accepted Answer

(1) Memory/attention/concentration/executive function, (2) Judgment, (3) Social interaction, (4) Orientation, (5) Motor activity, (6) Visual spatial orientation, (7) Subjective symptoms (headache, dizziness, sleep), (8) Neurobehavioral effects, (9) Communication, (10) Consciousness. Each is scored 0–3 with a "total" option (5). Highest single facet drives the overall rating: 0→0%, 1→10%, 2→40%, 3→70%, total→100%.

Question 3

Can I be rated separately for TBI cognitive AND for PTSD?

Accepted Answer

Yes — but with overlap considerations. If you have a separate mental health diagnosis (PTSD, depression, anxiety), the EMOTIONAL/BEHAVIORAL component of TBI is rated under that mental health code instead of DC 8045's emotional facet. Cognitive and physical TBI residuals are rated separately. This means many veterans get a combined rating across TBI (cognitive) + PTSD/depression (emotional) + other physical residuals.

Question 4

What's the evidence for a TBI claim?

Accepted Answer

In-service event documented in STRs (blast, vehicle accident, sports injury, fall) — even a brief loss of consciousness or being "dazed" can establish a TBI in service. Current diagnosis from a neurologist or neuropsychologist. Neuropsychological testing for cognitive facets (this is what drives the rating). Lay statements from family on changes in memory, mood, sleep since service. Headache log if migraines are a residual (often a separate DC 8100 rating).

Question 5

I had a "mild" TBI — does that limit me to a low rating?

Accepted Answer

No. "Mild TBI" (mTBI) is the medical classification of the INJURY severity, not the rating of the RESIDUALS. A mild TBI can produce severe persistent residuals — cognitive impairment, headaches, sleep disturbance, behavioral changes — and the rating depends entirely on current symptoms, not on the original injury severity.

Question 6

How do I avoid the C&P examiner low-balling me?

Accepted Answer

Bring symptom documentation (32-day mental status log, headache log, sleep journal). Bring lay statements from spouse/family describing what they observe. Don't minimize symptoms in the exam — TBI symptoms wax and wane, describe your WORST functional state, not your best. Request neuropsychological testing if it hasn't been ordered; it's the gold standard for cognitive facet rating.

VA TBI Rating — DC 8045

Score each cognitive facet

Memory, attention, concentration, executive function

Judgment

Social interaction

Orientation

Motor activity (cognitive)

Visual spatial orientation

Subjective symptoms (headache, dizziness, sleep, fatigue)

Neurobehavioral effects

Communication

Consciousness