How to file a VA claim for traumatic brain injury (TBI) residuals — the DC 8045 facets, presumed secondary conditions and SMC
VA rates the residuals of a service-connected traumatic brain injury under 38 CFR 4.124a, diagnostic code 8045. Cognitive and subjective residuals are scored on a ten-facet table and the highest facet sets the rating: 0 = 0%, 1 = 10%, 2 = 40%, 3 = 70%, and any facet rated "total" = 100%. Emotional or behavioral residuals with a diagnosed mental disorder are rated under the mental-disorder schedule instead, and physical residuals such as migraine, seizures, hearing loss or neurogenic bladder are rated separately under their own codes and combined. Under 38 CFR 3.310(d), parkinsonism, unprovoked seizures, certain dementias, depression and hormone-deficiency diseases are presumed secondary to a moderate or severe TBI within set time windows. This guide covers the evidence VA needs, how the facets work, and the special monthly compensation available when TBI residuals require aid and attendance.
What you'll need
- VA Form 21-526EZ
- Service records that document the injury or blast event: incident or casualty reports, line-of-duty determinations, post-deployment health assessments, sick-call notes
- Medical records from the time of injury if any exist: loss or alteration of consciousness, post-traumatic amnesia, imaging, Glasgow Coma Scale
- Current neurology, neuropsychology or rehabilitation records and any cognitive testing
- Lay statements (VA Form 21-10210) from people who knew you before and after the injury
- A free accredited representative (CVSO or VSO)
Step-by-step
Step 1: Document the in-service injury
Service connection needs an in-service event and a current diagnosis of TBI residuals linked to it. Gather anything that places the injury in service: incident or casualty reports, post-deployment health assessments that mention a blast or head injury, treatment notes, award citations and statements from witnesses. The severity level VA uses for the 3.310(d) presumptions is based on the symptoms at the time of injury or shortly after — loss of consciousness, alteration of consciousness, post-traumatic amnesia, Glasgow Coma Scale and imaging — so records from that time matter even if no one wrote "TBI" at the time.
Step 2: Know the severity table and the presumed secondary conditions
Under 38 CFR 3.310(d) a TBI is mild with loss of consciousness of 0–30 minutes, alteration of consciousness of up to 24 hours, post-traumatic amnesia of 0–1 day or a Glasgow Coma Scale of 13–15; moderate with loss of consciousness over 30 minutes but under 24 hours, amnesia of more than 1 but less than 7 days or GCS 9–12; and severe with loss of consciousness over 24 hours, amnesia over 7 days or GCS 3–8. After a moderate or severe service-connected TBI, VA presumes these are caused by it unless there is clear evidence otherwise: parkinsonism, including Parkinson's disease; unprovoked seizures; presenile dementia of the Alzheimer type, frontotemporal dementia or dementia with Lewy bodies within 15 years; depression within 3 years (or within 12 months of a mild TBI); and hormone-deficiency diseases from hypothalamic-pituitary changes within 12 months. Outside those windows you can still claim a secondary condition with a medical opinion.
Step 3: Understand how DC 8045 rates residuals
The claim exam scores ten facets of cognitive impairment and subjective symptoms — memory, attention, concentration and executive functions; judgment; social interaction; orientation; motor activity; visual-spatial orientation; subjective symptoms; neurobehavioral effects; communication; and consciousness — each from 0 to 3 or "total". If any facet is total the rating is 100%; otherwise the highest facet sets it: 0 = 0%, 1 = 10%, 2 = 40%, 3 = 70%. Emotional or behavioral residuals are rated under 38 CFR 4.130 when a mental disorder is diagnosed. Residuals with a distinct diagnosis — migraine, Meniere's disease, seizures, hearing loss and tinnitus, loss of smell or taste, neurogenic bladder or bowel, endocrine dysfunction and others — are rated separately under their own diagnostic codes and combined under 4.25, as long as the same symptom is not counted twice.
Step 4: File and prepare for the claim exam
File VA Form 21-526EZ online, by mail or through a free accredited representative, listing TBI residuals and each distinct residual you want rated (for example "migraine secondary to TBI"). VA will usually schedule a TBI claim exam; if you have had neuropsychological testing or imaging in service or since, submit it. Bring a family member's statement describing changes in memory, mood, sleep or behavior — the facets are scored partly on how you function day to day.
Reference: https://www.va.gov/disability/file-disability-claim-form-21-526ez/
Step 5: Special monthly compensation when TBI residuals need aid and attendance
Under 38 USC 1114(t), a veteran who needs regular aid and attendance because of TBI residuals, is not eligible for SMC(r)(2), and without that care would need hospital, nursing home or other residential institutional care receives an aid-and-attendance allowance at the (r)(2) rate — $11,271.67 a month for a veteran alone, effective December 1, 2025. DC 8045 also directs raters to consider SMC for loss of use of an extremity, certain sensory impairments, erectile dysfunction, housebound status, or the need for protection from everyday hazards because of cognitive impairment.
Critical tips
- One symptom cannot be counted twice: a headache rated as migraine cannot also raise the subjective-symptoms facet, but each distinct residual earns its own rating.
- If a mental health condition is also diagnosed, VA rates it under 4.130 and the TBI cognitive facets separately, as long as the symptoms are different.
- The 3.310(d) windows run from the date of the TBI, so document the injury date; the 12-month depression window after a mild TBI is easy to miss.
- VA's Polytrauma System of Care treats TBI; ask your VA primary care team for a referral.
- A county veterans service officer can help with the claim for free: warriorsfund.org/find-cvso.
- In crisis: dial 988 then press 1, or text 838255.
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