TBI VA Rating Guide — Diagnostic Code 8045

Where TBI lives in the rating schedule

Traumatic brain injury residuals are rated under 38 CFR § 4.124a, Diagnostic Code 8045 — 'Residuals of traumatic brain injury (TBI).' The current scoring framework took effect October 23, 2008. Veterans rated under the older pre-2008 criteria can request review under the current criteria if it would produce a higher rating.

DC 8045 covers three groups of residuals: cognitive (memory, attention, judgment, executive function); emotional/behavioral (irritability, impulsivity, anxiety, depression secondary to TBI); and physical (headaches, dizziness, seizures, sensory loss, sleep disturbance, motor problems). The cognitive and emotional/behavioral residuals are scored on the 10-facet table. Physical residuals get their own diagnostic codes and are combined.

The 10 facets and level scoring

• Memory, attention, concentration, executive functions.
• Judgment.
• Social interaction.
• Orientation.
• Motor activity (with intact motor and sensory system).
• Visual spatial orientation.
• Subjective symptoms (mild memory complaints, mild headache, intermittent dizziness, etc.).
• Neurobehavioral effects (irritability, impulsivity, lack of cooperation, etc.).
• Communication.
• Consciousness.

How the level becomes a percentage

1. Each facet is scored 0, 1, 2, 3, or Total based on the severity description in the table.
2. The highest single facet score determines the overall TBI rating — VA does not average. One facet at level 3 produces a 70% rating even if every other facet is at 0 or 1.
3. Level 0 = 0%, Level 1 = 10%, Level 2 = 40%, Level 3 = 70%, Total = 100%.
4. Physical residuals (migraines under DC 8100, seizures under DCs 8910-8914, vision loss under § 4.79, etc.) are rated under their own diagnostic codes and combined with the DC 8045 rating using the combined ratings table.

TBI as a gateway to secondary claims

TBI is one of the strongest primary conditions for secondary service connection because brain injury research has documented downstream effects on mood, sleep, hormones, and pain processing. Common secondary claims include PTSD or major depression secondary to TBI, migraine headaches, sleep apnea (mechanism: brainstem dysregulation), tinnitus, hypopituitarism, and chronic insomnia.

For mental health claims secondary to TBI, VA must rate the mental disorder under § 4.130 unless the symptoms cannot reasonably be separated from the TBI itself, in which case the mental symptoms are scored on the TBI facet table to avoid pyramiding.

Where these claims break down

• ×Treating TBI as 'just headaches' — request a full DBQ that scores all 10 facets, not just the physical residuals.
• ×Missing the secondary mental health, migraine, and sleep apnea pathways — these often add more rating than the TBI itself.
• ×Accepting an older pre-2008 rating without checking whether the current DC 8045 criteria would produce a higher percentage.
• ×Failing to document concussions in service — even undocumented blast exposures with witnesses can establish in-service incurrence with 21-10210 buddy statements.

Frequently Asked Questions