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Seizure disorders are relatively uncommon among veterans but carry substantial functional and legal implications when they occur. Many veteran seizure cases are secondary to traumatic brain injury, stroke, brain tumor, infectious encephalitis, or medications prescribed for other service-connected conditions. Under 38 CFR 4.124a, the VA rates seizure disorders using Diagnostic Codes 8910 through 8914, with criteria based on seizure type, frequency, and documentation.
Grand mal seizures, medically known as generalized tonic-clonic seizures, are rated under DC 8910. The rating levels are 10 percent for a confirmed diagnosis with a history of seizures; 20 percent for at least one major seizure in the last two years, or at least two minor seizures in the last six months; 40 percent for at least one major seizure in the last six months or two in the last year, or averaging at least five to eight minor seizures weekly; 60 percent for averaging at least one major seizure in four months over the last year, or nine to 10 minor seizures per week; 80 percent for averaging at least one major seizure in three months over the last year, or more than 10 minor seizures weekly; and 100 percent for averaging at least one major seizure per month over the last year.
Petit mal seizures, medically known as absence seizures, are rated under DC 8911 using a similar frequency-based framework. Definitions of major and minor seizures differ slightly between the codes. Under DC 8910, a major seizure is characterized by generalized tonic-clonic convulsion with unconsciousness; a minor seizure consists of a brief interruption in consciousness or conscious control with momentary staring or jerking of parts of the body.
Other seizure-related diagnostic codes include DC 8912 for jacksonian and focal motor or sensory epilepsy, DC 8913 for reflex epilepsy, and DC 8914 for psychomotor (complex partial) epilepsy. Each references the rating levels established under DC 8910 or 8911 as appropriate.
A confirmed diagnosis is the threshold requirement for any epilepsy rating. The VA generally requires documentation of seizures through either electroencephalogram (EEG) findings, witnessed seizures documented in medical records, or clinical diagnosis by a neurologist. Patient report of spells alone is not usually sufficient without some form of medical corroboration.
A seizure diary is one of the most important pieces of evidence a veteran can maintain. Every seizure episode should be logged with the date, time, duration, description, any trigger, the veteran's state before and after, and witness information if available. This contemporaneous record maps directly onto the frequency criteria in the rating code and is often cited in C&P exam summaries and rating decisions.
Witness accounts are critical for seizure documentation. Many seizures, particularly generalized tonic-clonic types, result in loss of consciousness, so the veteran cannot accurately describe the episode. Family members, coworkers, or bystanders who witness seizures should provide lay statements describing what they observed. Buddy statements can be particularly valuable from military peers who witnessed seizure activity during service.
Service connection for seizures is most commonly secondary to TBI, which is the most medically established cause of post-traumatic epilepsy. Under 38 CFR 3.310, post-traumatic seizures are generally service-connected when the TBI that caused them is service-connected. The latency between head injury and seizure onset varies, and seizures can emerge years after the traumatic event. Veterans with service-connected TBI who develop new-onset seizures should pursue secondary service connection.
Other causes of secondary seizures include stroke in a veteran with service-connected hypertension or diabetes, brain tumor related to service, infectious encephalitis from service-related exposures, and medication effects from drugs prescribed for service-connected conditions. Each can support a secondary claim with appropriate evidence.
Evidence for a seizure claim includes service treatment records if any seizure activity was documented during service, TBI or other causative condition records, neurology consultation notes, EEG results, imaging such as MRI of the brain, a detailed seizure diary, witness statements, and a list of current anti-epileptic medications and their efficacy.
The C&P exam for seizures includes a neurological history and examination, review of records and imaging, and completion of the epilepsy DBQ. The examiner cannot directly witness a seizure during the exam in most cases, so the history you provide, the documentation you bring, and any witness accounts become the foundation for the rating determination. Be thorough and specific.
Legal and functional implications of seizures are significant. Many states require physicians to report seizure patients to driving authorities, leading to license suspension. Occupational restrictions can be substantial. These functional impacts inform the overall rating picture and may support TDIU if the veteran cannot maintain substantially gainful employment due to the seizure disorder.
The Claim Recon Rating Calculator helps you model how seizure ratings combine with underlying TBI or other causative conditions. The C&P Exam Simulator prepares you for the epilepsy DBQ questions. The Secondary Condition Finder maps seizures to their common causes including TBI, stroke, and medication effects. The Health Logger is particularly well-suited to maintaining the seizure diary that the rating criteria require.
Disclaimer: This article is for educational and informational purposes only. It does not constitute legal, medical, or VA claims advice. Seizure rating criteria under 38 CFR 4.124a are subject to change. Always verify current criteria at VA.gov or consult with an accredited VSO, attorney, or claims agent before making decisions about your benefits.
Written by Claim Recon Editorial