Diagnostic Code 8045 · 38 CFR §4.124a
Traumatic Brain Injury (TBI) is caused by an external force to the head — blast exposure, vehicle accidents, falls, or direct impact during military service. The VA rates TBI residuals under a unique facet-based system that is different from how most other conditions are evaluated. Rather than matching overall symptoms to a single rating level, the VA evaluates ten specific facets of cognitive, emotional, and physical function. Each facet receives a severity level, and the highest facet determines the overall rating. Residuals that are already rated under other diagnostic codes (such as migraines, PTSD, or hearing loss) are evaluated separately and not counted again under DC 8045.
| Rating | Criteria |
|---|---|
| 0% | All ten facets are evaluated at level 0 (normal functioning). The veteran had a documented TBI but has no current measurable residual impairment on any facet. |
| 10% | The highest facet severity level is 1. This represents mild impairment in one or more areas — for example, mildly impaired memory or attention, or occasional mild headaches (if not separately rated). |
| 40% | The highest facet severity level is 2. This represents moderate impairment — for example, moderate memory problems, impaired judgment, or social interaction difficulties that occasionally require supervision. |
| 70% | The highest facet severity level is 3. This represents severe impairment in at least one area — markedly impaired cognitive function, severely impaired social interaction, or the need for frequent supervision for safety. |
| 100% | Total occupational and social impairment. The highest severity level is the maximum on one or more facets, indicating the veteran cannot function independently in virtually any capacity due to TBI residuals. |
TBI claims require documentation of the in-service traumatic event and current residuals. Service treatment records noting concussion, blast exposure, loss of consciousness, or altered mental status are ideal. If no STRs exist, buddy statements describing the incident are valuable. For current residuals, neuropsychological testing provides the most comprehensive evidence of cognitive impairment. Medical records documenting ongoing symptoms such as memory problems, difficulty concentrating, headaches, dizziness, irritability, and sleep disturbance all support the claim. The VA uses a specific TBI examination protocol that evaluates all ten facets.
The ten facets are: (1) memory, attention, concentration, and executive functions; (2) judgment; (3) social interaction; (4) orientation; (5) motor activity; (6) visual-spatial orientation; (7) subjective symptoms; (8) neurobehavioral effects; (9) communication; and (10) consciousness. Each is assigned a severity level, and the highest level determines the overall rating.
No. Loss of consciousness is not required. The VA recognizes that a TBI can occur with altered mental status alone — feeling dazed, confused, disoriented, or experiencing memory gaps around the time of the event. Even a "mild" TBI (concussion) without loss of consciousness can produce lasting residuals.
Yes. If TBI causes conditions that are ratable under their own diagnostic codes — such as migraines (DC 8100), mood disorders, or hearing loss — those conditions can be rated separately. The VA should not "double count" the same symptom under DC 8045 and another code, but distinct residuals get their own evaluations.
Neuropsychological testing is a comprehensive evaluation of cognitive functions including memory, attention, processing speed, executive function, and emotional regulation. While not required, it provides detailed objective evidence of cognitive impairment that strongly supports a TBI claim. Ask your VA healthcare provider for a referral if you have not had this testing.