Understanding TBI Ratings
TBI is rated under DC 8045 using a unique multi-facet evaluation system at 38 C.F.R. § 4.124a. Unlike most conditions, TBI is rated based on 10 facets of cognitive and functional impairment. The highest facet level determines the overall rating: Level 0 = 0%, Level 1 = 10%, Level 2 = 40%, Level 3 = 70%, Total = 100%.
Per M21-1, Part IV.ii.3, the RVSR evaluates each facet independently and assigns the rating based on the highest single facet. Residual conditions like headaches, vision problems, and mental health disorders may be rated separately if they are distinct from the TBI facet evaluation. Combat veterans benefit from the 38 U.S.C. § 1154(b) presumption for blast exposure events.
TBI Evaluation Facets
Memory, attention, concentration, executive functions
0 = Normal, 1 = Mild, 2 = Moderate, 3 = Severe, Total = Complete impairment
Judgment
0 = Normal, 1 = Mildly impaired, 2 = Moderately impaired, 3 = Severely impaired
Social interaction
0 = Always appropriate, 1 = Occasionally inappropriate, 2 = Frequently inappropriate, 3 = Total inability
Orientation
0 = Always oriented, 1 = Occasionally disoriented, 2 = Occasionally disoriented x2, 3 = Consistently disoriented
Motor activity / Visual spatial orientation
0 = Normal, 1 = Mildly impaired, 2 = Moderately impaired, 3 = Severely impaired
Communication
0 = Normal, 1 = Comprehension/expression mildly impaired, 2 = Unable sometimes, 3 = Complete inability
Consciousness
Normal, Mildly impaired, Persistently altered state
Subjective symptoms (3 or more)
Headaches, dizziness, fatigue, blurred vision, difficulty concentrating, sleep disturbance, irritability
Neurobehavioral effects
0 = None, 1 = One or more that do not interfere, 2 = One or more that occasionally interfere, 3 = One or more that frequently interfere