TBI VA Rating

If you or a loved one has service-related TBI, you may be able to receive compensation for related medical and mental health services in addition to tax-free monthly payments through VA disability. The amount of benefits that you qualify for depends upon the TBI VA rating given, with your disability rated in percentages ranging from 0 to 100 percent. Medical compensation is provided for any percentage rating, while tax-free monthly compensation for dependents is reserved for disability ratings at or above 30 percent. 

The process of applying for your VA disability benefits can be extensive, complex, and time-consuming. Without prior knowledge of what the VA is looking for, you may encounter a claims denial, which can result in years-long delays in the receipt of the benefits you deserve. Making sure that your application is supported by the evidence needed for the VA to recognize that your TBI is service-related, and to accurately rate it, is essential. 

It is helpful to consult this guide for important information about traumatic brain injuries, symptoms, and how the VA disability application process works. A VA disability lawyer can assist you with the appeals process if your initial claim for disability benefits has been denied. Our veterans compensation law firm can help gather necessary evidence, navigate the complex legal procedures, and advocate on your behalf to increase the chances of a successful appeal.

An Overview of Traumatic Brain Injuries in Veterans

A traumatic brain injury, or TBI, is an injury that impacts the way in which your brain functions. TBI is one of the leading causes of both death and disability in the United States. The Center for Disease Control (CDC) notes that each day in the US some 190 Americans die from a TBI-related injury, and in 2019 alone there were 223,000 TBI-related hospitalizations in the US. TBIs can change the way in which your brain functions, meaning all areas of your life are impacted, ranging from your personal to professional life. 

Whether caused by a slip-and-fall in a store or due to an explosion during active combat or training, a TBI can result in a permanent impact on your brain’s chemistry and in turn the way in which you function across all areas of life. When you experience a TBI, the impact to your head or a sudden movement of the body can cause: 

• Your brain to twist or bounce around in the skull 
• Chemical changes in your brain 
• The stretching and damaging of your brain cells 

Persons who experience a TBI can experience symptoms that change the way they think, learn, feel, act, and sleep. Substantial changes to any of these facets of life can lead to permanent and substantial changes in the way in which you are able to live your life and to maintain steady employment to support yourself and your family. When symptoms are long-term and life-altering, your TBI VA rating reflects this, and will increase the amount in compensation you receive to make up for the decrease in your ability to work and be gainfully employed.

Causes of Traumatic Brain Injuries

A traumatic brain injury is caused by a bump, blow, or penetrating wound to your head that causes your brain to come into contact with the inside of your skull. 

Common causes of TBIs in veterans include:

• Falls that result in a blow to the head: whether same-level, as in a slip-and-fall that can occur anywhere, or falls from heights, both often impact military personnel.
• Motor vehicle collisions: given the likelihood of the head being struck, motor vehicle accidents are one of the leading causes of TBIs in the United States and elsewhere. Additionally, when the body is hit and the brain moves quickly back and forth, a TBI can also happen, as may be the case with whiplash and other movements your body makes during a motor vehicle collision. 
• Sports and recreational accidents: sports, particularly football and boxing, are common causes of TBIs. Blows to the head, even while padded, can cause TBI. 

The type and severity of the TBI influence the symptoms. However,  even multiple minor TBIs can have a serious impact on the health and function of your brain. 

Combat Veterans are a High-Risk Population for Traumatic Brain Injuries

Veterans with combat experience are especially at risk of developing TBIs due to exposure to explosions during combat or training exercises. Data published by the VA Office of Research and Development notes that between 2000 and 2019, nearly 414,000 TBIs were reported among U.S. service members worldwide. Over 185,000 veterans who receive their healthcare from the VA have been diagnosed with 1 or more TBIs. The fact that so many veterans are diagnosed with multiple TBIs underlines the importance of seeking out treatment, and receiving an accurate diagnosis of your condition. 

While the majority of TBIs experienced by veterans are classified by the VA as mild, there are often secondary conditions linked to TBIs that result in what the VA notes as “a significant cause of disability outside of military settings.” The conditions that develop from TBIs that veterans experience include:

• Slower thinking
• Depression
• Memory problems
• Sleep disorders
• Irritability 
• Headaches
• Dizziness/Vertigo
• Ringing in the ears/Tinnitus

The various conditions that a veteran experiences as a result of TBIs can substantially impact their ability to maintain gainful employment following their service, their family life, and successful reintegration into the community. 

Types of Traumatic Brain Injuries 

The type of event or injury that led to your TBI will often determine the severity of your symptoms. However, severe brain injuries are possible from bumps or blows to the head that otherwise might not seem alarming. If you suspect you have a brain injury, regardless of the severity, reaching out to the nearest VA center for an assessment and treatment is suggested. 

Mild TBIs, Commonly Referred to as Concussions

The type of TBI that is most often experienced is mild, and can impact your brain chemistry and function for a short period of time. Mild TBIs are often referred to as concussions and are those that are most often experienced in recreational sports. The symptoms of a mild TBI are generally mild and resolve themselves in days or weeks. However, it is important to note that ongoing mild TBIs can lead to significant and severe damage equivalent to severe TBIs.

Even a mild TBI, or what seems like a light blow to the head, can be a serious health problem. The CDC suggests that you seek out healthcare services as soon as possible if you suspect that you may have experienced a TBI. 

To determine the extent of your TBI when you report for treatment, your healthcare provider will inquire about your symptoms and perform tests to identify any issues you might have with learning, concentration, memory and problem-solving.

These “neuropsychological” or “neurocognitive” tests assist your healthcare provider in the identification of the effects of your TBI, and determine whether you have a mild TBI/concussion, or something more serious. 

Moderate to Severe Traumatic Brain Injuries 

A moderate or severe TBI is caused by a bump, blow, or penetrating wound to the head, but the symptoms are long-term and lead to life-altering health problems. The health issues associated with moderate to severe TBIs can drastically change a person’s lifestyle and capacity to work. Over the course of 5 years following a moderate to severe TBI, 22 percent of persons die, 30 percent become worse, 22 percent stay the same, and just 26 percent improve. 

If you are a veteran who has experienced a moderate to severe TBI, your cognitive functioning, mood, perceptions, and capacity to concentrate are all significantly affected. The TBI VA rating that you are assigned, and the criteria used by the VA, will ultimately determine the benefits that are available to you. 

VA Disability Rating Criteria for TBI

The VA evaluates your TBI and the benefits provided based on the symptoms of the trauma that you are presently experiencing. The rating criteria that the VA applies to your TBI assessment is through an “Evaluation of Cognitive Impairment and Other Residuals of TBI not Otherwise Classified” as listed under 38 CFR Sec. 4.124a. Your residual symptoms are classified on a scale of 0, 1, 2, 3, or total, with each number corresponding to the rating percentage of 0 percent, 10 percent, 40 percent, 70 percent, or 100 percent. 

The TBI rating criteria are broken down into 10 sub-categories that the VA measures to determine severity and level of impairment in each of the following areas of function: 

1. Impairment of your memory, concentration, attention, and executive function 
2. Alterations in your judgment
3. A negative impact on your social skills 
4. The level of awareness of your present environment or circumstances
5. Negative changes in your motor activity 
6. Visual-spatial disorientation
7. Experiencing subjective symptoms and other secondary mental health conditions like depression
8. An impact on your behavior, such as increased irritability, or a drop in your awareness
9. A decrease in your ability to communicate 
10. Your level of consciousness and awareness 

These criteria are assessed, which in turn are used to determine the physical disabilities, level of cognitive impairment, and any behavioral changes that the present symptoms linked to your TBI may be causing. The findings determine your TBI VA rating.

Rating Percentages Assigned by the VA to TBI

TBIs and their current symptoms are rated by the VA in a similar manner to mental health issues, with the consideration being whether and to what degree your TBI-related symptoms impact your ability to work and enjoy your life. 

The percentages that are assigned to traumatic brain injuries by the VA are:

• 0 percent – you have a diagnosis of a TBI, which may be achieved through a CT scan, but are not manifesting symptoms. This TBI VA rating will still provide you with compensation for medical and mental health care. 
• 10 percent – when your TBI-linked symptoms are resulting in an impact on your cognitive function, behavior, or mood on occasion, but they can be managed with medication, a 10 percent rating is generally warranted. 
• 40 percent – at a 40 percent rating, your symptoms have begun to impact your day-to-day life and ability to work. Medication is necessary to manage the symptoms, but may not be enough to prevent a negative impact on your ability to maintain gainful, steady employment. 
• 70 percent – at a 70 percent disability rating your TBI-related symptoms substantially impact your cognitive function and mood, and in turn, you cannot maintain steady employment, and experience difficulty engaging in social situations. Medication is necessary, but incapable of fully managing the symptoms. 
• 100 percent – your symptoms completely prevent you from leaving the home or working, and aid and assistance is needed to enable you to engage in everyday activities and the essentials of day-to-day life. 

When you have one 60 percent disability, or through the combination of multiple conditions hit a combined percentage of 70 or more with at least one disability rated at 40 percent or higher, you may qualify for disability at the 100 percent rate because you cannot work a substantially gainful job. VA calls this entitlement to a total disability rating based on individual unemployability, or  TDIU. Your veterans benefits attorney can help advise you on what your best options are concerning your TBI VA rating and the rating you may receive for related conditions. 

Filing a TBI Claim 

While it would be ideal if you were automatically awarded VA disability benefits, that is not the case, and an extensive application process must be properly completed before you can even be considered for VA disability benefits. 

Required Forms 

To begin the process of collecting VA disability for your TBI and TBI-related injuries, you’ll need to fill out the following: 

• VA Form 21-526EZ – Application for Disability Compensation and Related Compensation Benefits – This is the general form to apply for your VA disability benefits, and requires that you submit sufficient evidence to demonstrate your current diagnosis, and medical evidence to demonstrate that your current condition is linked to your service. A compensation & pension (C&P) Exam is generally a part of this process, although if you submit sufficient medical evidence of your own, a C&P Exam may be deemed unnecessary by the VA. 
• VA Form 21-4138 – Statement in Support of Claim – This form allows you to submit both nexus letters in addition to “buddy statements”, which are statements from individuals who witnessed your injury, or the symptoms that it has resulted in. The nexus letter is provided by a medical expert who has reviewed your current condition and relevant military records and health records, while buddy statements are generally written by families and fellow service members. 

The VA needs sufficient evidence to recognize your current diagnosis and its connection to your qualifying active service to approve your claim or reverse your denial on appeal. If your claim is denied, working with a veterans’ benefits law firm like ours with the experience and know-how to get your claim approved and your TBI VA rating maximized ensures you receive the full benefits you deserve during the appeal process.

The Importance of Supporting Medical Evidence 

The VA will review your VHA treatment records and service records, but presenting your case in an organized and convincing manner is essential. Important evidence concerning the severity of a TBI for a veteran the VA notes is the duration of time that consciousness was lost following the TBI, or how it was altered if not lost. 

The length of memory loss as well as the level of responsiveness of the veteran following the injury also help the VA determine the extent of the TBI. It is possible that your official VA medical records will not provide these specific details, as the only individuals who may have witnessed them were fellow service members. 

When you have friends and fellow service members who were present at or following the injury that caused your TBI, statements of what they witnessed through buddy statements as mentioned above can be central to the approval of your VA disability claim and your TBI VA rating. 

Providing your own medical evidence helps the VA to fully assess your claim and to assign an accurate TBI VA rating. The use of a CT scan, computed tomography, is common and used to identify evidence of brain bleeding, bruising, or swelling. Our in-house physician can help with the diagnosis of your TBI, while our network of medical experts can assist in the identification of any symptoms or conditions you may be experiencing as a result of your TBI. 

The Nexus Letter and Proving Your Service-Related Disability 

A nexus letter is a medical opinion that links an injury, illness, or event during our active service to a current condition. The medical expert will rate the likelihood that your current diagnosis is linked to your active service on the following scale:

• Not likely
• At least as likely as not
• More than likely
• Highly likely

When the medical opinion notes that your current condition is “at least as likely as not” linked to an event, injury, or illness during your qualifying active service, the VA will generally approve your disability claim. We have an in-house physician and a network of medical experts to ensure that you receive an accurate and complete diagnosis and the supporting medical evidence and nexus letter you need for the highest TBI VA rating possible in your unique claim. 

Connect with a VA Disability Attorney for Help with Your Service-Related TBI Claim

TBIs are serious injuries that can forever change the way you live your life. Changes in your ability to concentrate, your personality, and your behavior impacts your life in social and occupational environments and entitles you to disability compensation. To explore options on how we can help with your denied TBI VA rating and disability claim, give us a call at 888-878-9350 or visit our site to schedule a free case evaluation.

FAQs

How is a 70 percent TBI VA Rating measured?

To receive a 70 percent TBI VA rating you must have a severity level of 3 on a scale of 0-4. The severity of the present symptoms of your TBI-related injury during your qualifying active service is analyzed through the use of 10 different sub-categories. The purpose of the assessment is to determine the overall impact on your cognitive function, behavior, and ability to work. At 70 percent, your symptoms are severe and largely prevent you from working, and may qualify you for payments at the 100 percent disability level. 

What is the VA rating for TBI headaches? 

Under Diagnostic Code 8100, the VA rates migraine headaches with “characteristic prostrating attacks averaging one in two months over at least several months” at 10 percent disabling. When the frequency and severity of the TBI headaches increase, so can the rating that is assigned by the VA, with cases demonstrating that up to 30 percent can be awarded. This means that if you have a TBI VA rating of 40 percent, and a 30 percent for TBI headaches, your total rating is 70 percent and you could qualify for 100 percent compensation through TIDU. 

What is the VA percentage for mild TBI? 

A mild TBI may result in a percentage rating of 10 or 30 percent being assigned to your VA disability claim. What matters is the impact that the present symptoms of TBI have upon your day-to-day life, your ability to work, and whether or not medication can manage the symptoms. At 10 or 30 percent you will qualify for medical compensation, and may also qualify for tax-free monthly compensation payments. 

What are the rates of TBI in veterans?  

Veterans who have encountered explosions in training or combat, or have been in combat or other qualifying active duty are especially at-risk of experiencing traumatic brain injuries. The VA reports that between 2000 and late 2019, some 414,000 TBIs were reported by U.S. Service Members across the globe. The prevalence of TBIs underlines the importance of filing a complete and accurate VA disability claim to recover the VA disability benefits you deserve.