VA Ratings for Traumatic Brain Injuries (TBIs)

Category: Veterans Disability Law

Article by Daniel J. Tuley

The U.S. Department of Veterans Affairs (VA) has a responsibility to provide compensation to veterans who received specific VA-recognized disabilities during their time in the service. One of the disabilities that warrants compensation is a TBI.

Veterans who receive a TBI during their time in the military can file a claim for financial benefits that vary depending on the severity of their condition. The way in which the VA rates this severity depends on a number of factors and criteria already in place by the organization.

What is TBI?

As defined by the CDC, a traumatic brain injury (TBI) is a “disruption in the normal function of the brain caused by a bump, blow, or jolt to the head, or penetrating head injury.” Any damage to the brain that impacts how a person functions after the event has occurred can be labeled as a TBI. TBIs can lead to a variety of other secondary conditions if not properly taken care of, so it’s important to understand what they are and how to recognize them.

Symptoms of TBI in Veterans

The term TBI is vague because it can apply to almost any lasting physical, cognitive, emotional, and/or behavioral damage after a head injury. Due to individual differences, TBI should be evaluated on a case-by-case basis. Still, there are several signs and symptoms that can indicate TBI, such as:

• Attention issues
• Dizziness
• Loss of balance or consciousness
• Headaches
• Hearing loss or tinnitus
• Paralysis or stroke
• Seizures
• Nausea
• Irritability
• Confusion
• Vision changes
• Weak muscles
• Impaired memory
• Poor judgement or difficult concentrating

The presence and severity of these different symptoms is what determines the severity of the overall TBI. If you aren’t experiencing that many or that often, you may have a mild TBI, which can be relatively easy to deal with. Severe TBIs can lead to total unemployability and absolute inability to function in daily life.

If you notice any changes in behavior or demeanor after an injury that could have potentially caused damage to your brain, it may be in your best interest to see a health professional just to be safe.

Treatment for TBI in Veterans

Similar to the symptoms, treatment for TBI must be decided on a case-by-case basis. Depending on the symptoms an individual is experiencing, the medicine they take or procedures they undergo will vary. Mild TBIs typically require no treatment aside from pain relief medicine and constant rest. However, even somebody with a mild TBI should be monitored closely for new or worsening symptoms.

What Causes TBI?

TBI can be caused by a variety of different things. Most commonly, it’s caused by a blow to the head or an object penetrating the brain. Two major factors in how the brain is affected are the location and severity of the damage. Although it’s practically impossible to completely avoid situations in which a TBI might occur in daily life, the chances of getting a brain or head injury increase substantially in the military.

Why are Traumatic Brain Injuries in Combat Veterans so Prevalent?

Combat veterans are disproportionately affected by TBIs relative to the general population because of the intense physical trauma that individuals are exposed to during training and combat. TBI can be caused by blasts, vehicle collisions, or blows to the head, which are common in the military.

A common form of mild TBI is the concussion. Concussions occur in many different settings such as car accidents, fights, and sports. In the military, enlisted individuals are subjected to concussive grenades, exposed to explosions, and trained in physical combat. All of these are reasons why the VA recognizes a TBI as a likely service-connected disability.

TBI Military Statistics

The Defense and Veterans Brain Injury Center reported around 414,000 TBIs among service members between 2000 and late 2019. While the majority of these TBIs were classified as mild, TBI and its associated comorbidities can have a serious impact on people’s lives. Currently, more than 185,000 veterans who are using VA for their healthcare have been diagnosed at some point with at least one TBI.

For comparison, roughly 2% of U.S. citizens are living with a disability as the result of a TBI, while the percentage of deployed individuals with TBIs is estimated to be somewhere between 11-23%. Veterans are 5 to 10 times more likely than the general population to experience a TBI or a resulting disability.

How Does VA Rate TBI?

TBI can be a difficult condition to rate due to its overlap with mental health conditions.

The VA may only provide one disability rating even if a veteran is experiencing symptoms from both TBI and mental health conditions. Symptoms can be added together to raise the disability rating, but they will ultimately still be based around their effect on a veteran’s ability to work. VA compensation for TBI and PTSD may often be higher than compensation for one or the other, because they will both have certain unique debilitating symptoms, even though one may have developed as a direct result of the other.

VA TBI Rating Scale

The VA uses code 38 CFR § 4.124a – Schedule of ratings – neurological conditions and convulsive disorders to rate TBI in veterans based on medical imagine, trauma assessments, and the severity of symptoms. The rating scale consists of 0, 1, 2, 3, and total, with each value corresponding to a TBI VA rating:

Scale Value	VA TBI Rating
0	0 percent
1	10 percent
2	40 percent
3	70 percent
Total	100 percent

 

The TBI VA ratings are based on 10 categories created by the VA that address the residual symptoms. Each of the following categories is then assessed for its level of severity:

• Altered judgement
• Social skill inhibition
• Diminished motor activity
• Subjective symptoms
• Visual-spatial disorientation
• Worsened communication ability
• Neurobehavioral effects
• Impairment of memory, attention, concentration, and executive functions
• Veteran level of awareness
• Veteran consciousness

The final TBI VA rating will be assigned based on these categories and a C&P examination.

TBI Compensation and Pension Exam

A compensation and pension (C&P) exam is an assessment of a veteran’s level of disability proctored by a VA-approved healthcare professional. C&P exams are used by the VA to get more information on a veteran’s alleged condition before making a decision about their VA rating. Before the exam, the proctor will review your TBI claim and previously submitted evidence. During the 20-minute exam, the examiner will attempt to determine if your disability is truly service connected and identify its severity.

C&P exams are of no cost to veterans because it’s the VA’s “duty to assist” veterans obtaining evidence for claim support. It’s very important to attend this exam and document details about the process. Is the examiner qualified? Are they being fair? If the VA makes an unfavorable decision, it will significantly help your appeal if you have this information available.

Filing a TBI Claim

If you believe you may be eligible to receive monetary compensation for your service-connected TBI, you need to file a claim with the VA. This process involves gathering evidence related to your VA disability such as medical or hospital records associated with the claimed condition. It’s also important to include supporting statements from peers and/or relatives that can clarify how the condition has affected your life and its progression.

How to Prove TBI VA Disability

Similar to other VA disabilities, proving a TBI disability requires three things:

• A current diagnosis — A diagnosis from a medical professional that states you currently have a TBI or are experiencing symptoms as a result of a TBI.
• Proof of a traumatic incident — Evidence that something occurred during your time in the military which altered your physical, mental, emotional, or behavioral state to a significant degree.
• A medical nexus — An opinion from a medical professional linking the traumatic event to the current diagnosis, establishing that your TBI is service-connected.

Proving that the event is related to the diagnosis is one of the most difficult and also important parts of receiving disability compensation. Beyond just getting benefits, you should also ensure that your TBI VA rating is accurate to receive the funds that you deserve.

Appealing a VA Decision

If you have your TBI claim denied for one reason or another, you are allowed to dispute the VA’s decisions through the appeals process. The Board of Veterans’ Appeals (BVA) will hear your case and amend your TBI VA rating if sufficient information is provided. To receive a different decision, you will typically have to prove that the C&P examiner you had performed an inadequate assessment. This could be due to inexperience, general bias, or a lack of available information at the time.

There are two things you can do to prepare yourself for an appeal. First, document the entire claim process, keep detailed records of your condition, how it affects your life, and how the C&P examination reflected those factors. The second action which can significantly increase the chances of a positive outcome is to hire a VA disability lawyer.

Tuley Law Office

Working with a VA disability lawyer that has experience navigating the dense and sometimes confusing language of the VA can drastically reduce the headache involved with filing or appealing a claim. The attorneys at Tuley Law Office have the knowledge to guide you through each step of the process. From gathering necessary information to helping you organize the structure of your VA disability claim, seeking legal assistance is one way to ensure you receive the compensation you deserve.

Schedule a meeting with one of our lawyers or read more about how we can help you earn compensation for your service-connected TBI on our website.

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