VA Ratings for Service-Connected Traumatic Brain Injuries
Hundreds of thousands of U.S. veterans have been diagnosed with traumatic brain injury (TBI). If the TBI is service-connected, the veteran may be eligible for VA disability benefits. However, TBIs vary significantly in severity, so the disability rating assigned and specific disability benefits available will also vary.
Traumatic brain injuries are especially common in veterans who served in Iraq and Afghanistan. One study concluded that 17.3% of post-9/11 veterans met the criteria for in-service TBI. The rate of TBI disabilities among the general population in the U.S. is about 2%.
What is a Traumatic Brain Injury?
A traumatic brain injury is an injury that in some way impairs brain function. The injury may result from a blow to the head, a penetrating head wound, or even an extreme jolt that bangs the brain against the inside of the skull. In other words, it is possible to suffer a TBI without actually hitting your head.
Someone suffering from a traumatic brain injury might experience a wide variety of symptoms, some of which may not be obviously connected to the head injury. Some of the most common include:
- Loss of consciousness
- Headache
- Seizures
- Visual disturbances
- Eye pain
- Light sensitivity
- Unequal pupils
- Nausea
- Vomiting
- Clear fluid draining from nose or ears
- Weakness in arms or legs
- Slurred speech
- Loss of balance
- Difficulty waking
- Confusion or disorientation
- Dizziness
- Memory problems
- Cognitive impairment
- Mood changes
- Anxiety
- Depression
A traumatic brain injury may be classified as mild, moderate, or severe. But, even a mild TBI can impact your daily life. There is overlap among the symptoms experienced in each category, and the VA’s assessment of the degree of disability does not depend on the standard classifications.
Service Connection for Traumatic Brain Injury
Despite the known prevalence of TBI in post-9/11 veterans, there are currently no presumptive service connections for TBI.
To receive veterans disability benefits for TBI, the veteran must show that:
- You suffer from residual effects of a traumatic brain injury, and
- The condition is a result of or was aggravated by an in-service injury
However, there are five conditions that are presumed secondary to TBI. That is if you have a service connection for TBI and suffer from one of the following conditions, that second condition will also be considered service-connected. These are:
- Parkinsonism, including Parkinson’s disease, after a moderate or severe TBI
- Unprovoked seizures after a moderate or severe TBI
- Certain types of dementia, including presenile dementia of the Alzheimer type, frontotemporal dementia, and dementia with Lewy bodies (must manifest within 15 years after a moderate or severe TBI
- Depression if it manifests within three years of a moderate or severe TBI or 12 months of a mild TBI
- Hormone deficiency conditions that result from hypothalamo-pituitary changes (must manifest within 12 months of moderate or severe TBI)
Note that the timelines for manifestation and the severity levels listed above are required only for presumptive secondary connection to TBI. If one of these conditions is not met, the veteran could still pursue a secondary service connection but would be required to establish the connection.
How Does the VA Assess Traumatic Brain Injuries?
The VA TBI assessment is one of the most complex veterans disability assessments. Unfortunately, that means the decision-maker sometimes gets it wrong. If you are pursuing a VA disability rating for a traumatic brain injury, it is especially important to work with an experienced disability advocate, to ensure that your documentation is thorough and well-presented and that you have someone on your side who can identify appealable errors in your disability rating.
The VA rates your disability due to TBI based on your residual functional impairment. This assessment focuses on three areas: cognitive, emotional/behavioral, and physical. Subjective symptoms are considered if they are consistent with the diagnosis and the veteran does not have another condition that better explains the symptom.
10 facets are considered, and the disability rating is assigned based on the highest level of impairment among these 10. The possible levels vary from facet to facet but may include 0, 1, 2, 3 or, Total. These facets are:
- Memory, attention, concentration, and executive function
- Judgment
- Social interaction
- Orientation
- Motor activity
- Visual-spatial orientation
- Subjective symptoms
- Neurobehavioral effects
- Communication
- Consciousness
If the highest level of impairment for any facet is 0, the VA disability rating will be zero. Other ratings are assigned as follows:
- Highest level of impairment is 1: 10% disability rating
- Highest level of impairment is 2: 40% disability rating
- Highest level of impairment is 3: 70% disability rating
- Highest level of impairment is Total: 100% disability rating
However, the assessment isn’t quite as straightforward as it appears. For example, if the veteran has also been diagnosed with a mental disorder, symptoms that could otherwise be attributed to TBI will be evaluated under the mental health condition–the same symptom can’t be counted for two different conditions.
In addition, a veteran suffering from TBI may be entitled to a higher rating or special classification. For example:
- A veteran who has a 60% disability rating for one condition or a combined rating of 70% with one condition rated at 40% or greater who is unable to work due to their disability or disabilities may be deemed totally disabled due to individual unemployability (TDIU) and receive benefits at the 100% level
- A veteran who needs aid and attendance to avoid institutional care may be eligible for special monthly compensation
- The veteran has another service-connected condition that may result in a higher combined rating
- The veteran has a secondary-connected condition, not limited to the conditions listed above that may be presumed connected
Pursuing a VA Disability Rating for Traumatic Brain Injury
To receive a disability rating for TBI, you must show that your TBI is service-connected, and that symptoms caused by that condition qualify you for a specific rating. Your medical records will be critical in establishing the symptoms necessary to show impairment at a particular level. Some veterans make the mistake of downplaying symptoms of their TBI with their medical providers, leaving out symptoms they are self-conscious about, or just not following up with TBI-related care. Omissions like these can seriously hurt your chances of being assigned the appropriate VA disability rating.
The experienced disability experts at Disability Help Group can explain exactly what is required to establish your TBI-related claim and help assemble the evidence necessary to support the rating you deserve. To learn more, call (800) 800-3332 or click here.
