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How the VA Rates TBI Residuals Under Diagnostic Code 8045

9 min read

How the VA Rates TBI Residuals Under Diagnostic Code 8045

The ten facets of cognitive impairment in Diagnostic Code 8045, how the levels translate into a 0, 10, 40, 70, or 100 percent evaluation, and what the regulation actually says.

Diagnostic Code 8045 does not work like most of the rating schedule. Instead of a list of percentage criteria, it uses a table of facets with assigned levels of impairment. Understanding that structure explains a lot of TBI decisions.

This guide is part of our series on VA claims for traumatic brain injury.

The three areas of residuals

38 CFR 4.124a, Diagnostic Code 8045 groups TBI residuals into cognitive impairment, emotional and behavioral dysfunction, and physical or neurological dysfunction. Only the first area is evaluated through the facet table. The other two are evaluated under the diagnostic codes for the specific conditions involved.

The facets

The evaluation table in the regulation assigns a level of impairment to each of the following facets:

  • Memory, attention, concentration, and executive functions
  • Judgment
  • Social interaction
  • Orientation
  • Motor activity, with intact motor and sensory system
  • Visual spatial orientation
  • Subjective symptoms
  • Neurobehavioral effects
  • Communication
  • Consciousness

Where veterans start

Every case is different, and there is no obligation at any step. When veterans want to understand what their records actually support, these are the two most common starting points:

  • Medical records review

    A licensed physician reviews your records for a $250 flat fee and identifies which conditions the available evidence may support. The fee is refunded in full if nothing supportable is identified.

  • Nexus letter

    When the records support one, a licensed provider writes the medical opinion that addresses the link between your condition and your service.

How levels become a percentage

Each facet receives a level of 0, 1, 2, 3, or total. The regulation then converts the highest level assigned to any single facet into the overall evaluation: 0 for level 0, 10 percent for level 1, 40 percent for level 2, 70 percent for level 3, and 100 percent for total.

That structure means a single severely affected facet can carry the rating, while several mildly affected facets may not. When the evidence is evenly balanced between two levels, 38 CFR 4.7 and 38 CFR 3.102 direct the higher evaluation and resolution of reasonable doubt in the veteran's favor. Our benefit of the doubt guide explains that rule.

Subjective symptoms are a facet, not an afterthought

Headaches, dizziness, light sensitivity, insomnia, and fatigue appear in the regulation as subjective symptoms, with levels tied to how much they interfere with work, family, and other activities. When a subjective symptom has its own diagnosis, such as migraine headaches, the regulation directs evaluating it under its own diagnostic code instead.

This guide is educational. It summarizes the VA's own published rules and links to the exact sources it relies on. It is not legal or claims advice, and it is not a substitute for an accredited representative, who can advise you about your specific claim. Accredited help is free - search the VA's accreditation database to find a Veterans Service Organization, accredited agent, or attorney.

Frequently asked questions

What are the TBI facets?

Diagnostic Code 8045 in 38 CFR 4.124a evaluates cognitive impairment and other residuals through ten facets, including memory and attention, judgment, social interaction, orientation, motor activity, visual spatial orientation, subjective symptoms, neurobehavioral effects, communication, and consciousness.

How does the highest facet level set the rating?

Each facet is assigned a level of impairment from 0 to 3, or total. The regulation converts the single highest level into the overall evaluation: level 0 is 0 percent, level 1 is 10 percent, level 2 is 40 percent, level 3 is 70 percent, and total is 100 percent.

Can two facets be combined for a higher rating?

No. Under the regulation the overall evaluation comes from the highest single facet level, not from adding facets together.

Sources

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