Several commenters have suggested that veterans with overlapping symptoms should not be compensated twice. This is prohibited under the statutory rule 38 CFR 4.14, Avoidance of pyramiding.
When a service member files for benefits for TBI, the VA will schedule them for a Compensation and pension examination, and a medical examiner will conduct this exam.
What is a VA TBI Disability Rating?
A veteran with a service-connected TBI may be eligible for disability benefits. The VA determines your disability rating based on the residual emotional/behavioral, physical, and cognitive dysfunction that results from your injury. A service-connected TBI can have a variety of effects, including difficulty working, trouble maintaining relationships, and impairments in daily living activities.
The severity of your TBI can be rated as mild (mTBI), moderate, or severe. To rate your TBI, the VA looks at your current symptoms and how they impact you, such as loss of memory, impaired concentration, or decreased appetite.
Understanding the process of determining a VA TBI disability rating involves undergoing assessments to evaluate the severity of the traumatic brain injury and its impact on a veteran’s daily life, guiding the assignment of a disability rating based on the extent of impairment caused by the injury.
The severity of your TBI can affect whether you qualify for aid and attendance benefits, which provide monthly compensation if you need help with daily activities. To win this benefit, you must prove that your TBI is severe enough to render you permanently unemployable and need regular care from another person. The VA uses diagnostic codes to rate your TBI and may make mistakes requiring a lawyer’s review.
How to do VA Rate TBI Residuals?
The severity of your traumatic brain injury does not determine the VA’s rating. Instead, the VA evaluates the residual emotional/behavioral, cognitive, and physical dysfunction that results from your TBI.
This includes any new symptoms that appear in medical records as a result of your brain injury, even those that don’t manifest until years after the injury. The symptoms may interfere with your daily life and relationships. They could affect your work or cause other health problems, such as an increased risk of seizures and infections.
The rating is determined by evaluating the individual facets of your cognitive impairment using a specific rating formula. Similarly, for emotional/behavioral residuals, the VA considers ten different components to rate your dysfunction. Combined ratings are also awarded according to a schedule the VA has established. Migraines, for example, fall under the DBQ category of cognitive dysfunction and are assigned a rating under 38 CFR SS 4.124a (Schedule of Ratings – Neurological Conditions and Convulsive Disorders), Diagnostic Code 8045). This helps to promote consistency in ratings for veterans suffering from migraines.
What are the VA’s TBI Rating Criteria?
If you suffer from a service-connected TBI, your condition may qualify for disability benefits. The VA’s TBI rating criteria are based on a set of symptoms that the VA evaluates using an examination and a standardized format.
The initial severity of the traumatic event or diagnosis does not factor into the ratings. The VA instead assesses your TBI based on the residual symptoms that manifest as short or long-term physical, cognitive, and behavioral disabilities.
The symptoms the VA examiner considers include memory, attention and concentration, judgment, social interaction, visual-spatial orientation, and motor activities. Often, the severity of TBI symptoms overlap with those of mental health conditions like PTSD. For this reason, veterans may receive a single TBI rating and a combined rating for both TBI and PTSD symptoms. However, proving that you have a nexus between the two conditions is one of the most challenging aspects of winning a TBI VA claim. It is essential to have a TBI VA claim attorney review your case and ensure that you are receiving the correct ratings and proper compensation.
How Can I Win a TBI VA Claim?
A traumatic brain injury (TBI) can have lasting consequences for a veteran. This is why veterans need to understand how the VA evaluates TBI residuals and assigns a disability rating.
The TBI rating schedule offers 0%, 10%, 40%, and 70% disability ratings. This is based on the severity of symptoms that affect a veteran’s ability to function independently.
When determining your TBI rating, the VA examiner will use rules and regulations to assess your symptoms and determine the correct disability percentage. This includes examining the criteria for each of the ten TBI facets to ensure that your symptoms are accurately evaluated.
It is also important to note that the VA does not award multiple ratings for overlapping symptoms. This means that you cannot receive compensation for migraines and a TBI at the same time. However, the VA offers special monthly compensation (SMC) for severe TBIs, including additional benefits such as in-home care assistance.