As a military veteran with service-connected cognitive impairment, this condition can have a significant impact on your life. It can make it hard to find and keep employment. It can interfere with your family and social life. This is why the U.S. Department of Veterans Affairs (the VA) provides disability ratings for cognitive impairment.If you need help with obtaining a VA rating for cognitive impairment, please call Stone Rose Law at (480) 498-8998 or use our contact form.
Although cognitive impairment has multiple possible causes, including Parkinson’s disease, Huntington’s disease, Alzheimer’s disease, and multiple sclerosis, the most common cause of cognitive impairment in veterans is head injury like a traumatic brain injury, or TBI.
Traumatic brain injury can occur during your military service as a result of a blow to the head, a fall, or being close to an explosion.
If you have a VA-recognized service-connected disability for cognitive impairment, then you can receive VA healthcare benefits and in some cases monthly disability compensation.
The VA can assign a disability rating for cognitive impairment from 0% to 100%. In especially severe cases, a veteran suffering from this disability may also be eligible to receive special monthly compensation benefits.
The disability rating you receive for cognitive impairment depends on the degree of severity of its impact on your motor, sensory, or mental functions.
The measure of cognitive impairment severity on your work life and how they impact daily life activities depends on the symptoms you experience. These symptoms include:
Not all of these symptoms may be present. Cognitive impairment may affect some functions more than others. Symptoms can also fluctuate from day to day.
When evaluating what disability rating to assign for TBI-based cognitive impairment, the VA considers 10 factors. Each factor has a range of increasing severity, from mild cognitive impairment to severe, that has an impairment level from 0 to 3.
Each of these impairment levels corresponds to a disability rating:
| Impairment Level | Disability Rating |
| 0 | 0% |
| 1 | 10% |
| 2 | 40% |
| 3 | 70% |
In addition, a “Total” impairment level also exists, which corresponds to a 100% disability rating.
The table below shows how these 10 factors and their impairment levels work to establish disability ratings.
| Facets of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified | Level of Impairment | Criteria |
| Memory, attention, concentration, executive functions | 0 | No complaints of impairment of memory, attention, concentration, or executive functions. |
| 1 | A complaint of mild loss of memory (such as having difficulty following a conversation, recalling recent conversations, remembering names of new acquaintances, or finding words, or often misplacing items), attention, concentration, or executive functions, but without objective evidence on testing. | |
| 2 | Objective evidence on testing of mild impairment of memory, attention, concentration, or executive functions resulting in mild functional impairment. | |
| 3 | Objective evidence on testing of moderate impairment of memory, attention, concentration, or executive functions resulting in moderate functional impairment. | |
| Total | Objective evidence on testing of severe impairment of memory, attention, concentration, or executive functions resulting in severe functional impairment. | |
| Judgment | 0 | Normal. |
| 1 | Mildly impaired judgment. For complex or unfamiliar decisions, occasionally unable to identify, understand, and weigh the alternatives, understand the consequences of choices, and make a reasonable decision. | |
| 2 | Moderately impaired judgment. For complex or unfamiliar decisions, usually unable to identify, understand, and weigh the alternatives, understand the consequences of choices, and make a reasonable decision, but with little difficulty with simple decisions. | |
| 3 | Moderately impaired judgment. For complex or unfamiliar decisions, usually unable to identify, understand, and weigh the alternatives, understand the consequences of choices, and make a reasonable decision, although with little difficulty making simple decisions. | |
| Total | Severely impaired judgment. For even routine and familiar decisions, usually unable to identify, understand, and weigh the alternatives, understand the consequences of choices, and make a reasonable decision. For example, unable to determine appropriate clothing for current weather conditions or judge when to avoid dangerous situations or activities. | |
| Social interaction | 0 | Social interaction is routinely appropriate. |
| 1 | Social interaction is occasionally inappropriate. | |
| 2 | Social interaction is frequently inappropriate. | |
| 3 | Social interaction is inappropriate most or all of the time. | |
| Orientation | 0 | Always oriented to person, time, place, and situation. |
| 1 | Occasionally disoriented to one of the four aspects (person, time, place, situation) of orientation. | |
| 2 | Occasionally disoriented to two of the four aspects (person, time, place, situation) of orientation or often disoriented to one aspect of orientation. | |
| 3 | Often disoriented to two or more of the four aspects (person, time, place, situation) of orientation. | |
| Total | Consistently disoriented to two or more of the four aspects (person, time, place, situation) of orientation. | |
| Motor activity (with intact motor and sensory system) | 0 | Motor activity normal. |
| 1 | Motor activity is normal most of the time, but mildly slowed at times due to apraxia (inability to perform previously learned motor activities, despite normal motor function). | |
| 2 | Motor activity mildly decreased or with moderate slowing due to apraxia. | |
| 3 | Motor activity moderately decreased due to apraxia. | |
| Total | Motor activity severely decreased due to apraxia. | |
| Visual-spatial orientation | 0 | Normal. |
| 1 | Mildly impaired. Occasionally gets lost in unfamiliar surroundings, has difficulty reading maps or following directions. Is able to use assistive devices such as GPS (global positioning system). | |
| 2 | Moderately impaired. Usually gets lost in unfamiliar surroundings, has difficulty reading maps, following directions, and judging distance. Has difficulty using assistive devices such as GPS (global positioning system). | |
| 3 | Moderately severely impaired. Gets lost even in familiar surroundings, unable to use assistive devices such as GPS (global positioning system). | |
| Total | Severely impaired. May be unable to touch or name own body parts when asked by the examiner, identify the relative position in space of two different objects, or find the way from one room to another in a familiar environment. | |
| Subjective symptoms | 0 | Subjective symptoms that do not interfere with work; instrumental activities of daily living; or work, family, or other close relationships. Examples are: mild or occasional headaches, mild anxiety. |
| 1 | Three or more subjective symptoms that mildly interfere with work; instrumental activities of daily living; or work, family, or other close relationships. Examples of findings that might be seen at this level of impairment are: intermittent dizziness, daily mild to moderate headaches, tinnitus, frequent insomnia, hypersensitivity to sound, hypersensitivity to light. | |
| 2 | Three or more subjective symptoms that moderately interfere with work; instrumental activities of daily living; or work, family, or other close relationships. Examples of findings that might be seen at this level of impairment are: marked fatigability, blurred or double vision, headaches requiring rest periods during most days. | |
| Neurobehavioral effects | 0 | One or more neurobehavioral effects that do not interfere with workplace interaction or social interaction. Examples of neurobehavioral effects are: irritability, impulsivity, unpredictability, lack of motivation, verbal aggression, physical aggression, belligerence, apathy, lack of empathy, moodiness, lack of cooperation, inflexibility, and impaired awareness of disability. Any of these effects may range from slight to severe, although verbal and physical aggression are likely to have a more serious impact on workplace interaction and social interaction than some of the other effects. |
| 1 | One or more neurobehavioral effects that occasionally interfere with workplace interaction, social interaction, or both but do not preclude them. | |
| 2 | One or more neurobehavioral effects that frequently interfere with workplace interaction, social interaction, or both but do not preclude them. | |
| 3 | One or more neurobehavioral effects that interfere with or preclude workplace interaction, social interaction, or both on most days or that occasionally require supervision for safety of self or others. | |
| Communication | 0 | Able to communicate by spoken and written language (expressive communication), and to comprehend spoken and written language. |
| 1 | Comprehension or expression, or both, of either spoken language or written language is only occasionally impaired. Can communicate complex ideas. | |
| 2 | Inability to communicate either by spoken language, written language, or both, more than occasionally but less than half of the time, or to comprehend spoken language, written language, or both, more than occasionally but less than half of the time. Can generally communicate complex ideas. | |
| 3 | Inability to communicate either by spoken language, written language, or both, at least half of the time but not all of the time, or to comprehend spoken language, written language, or both, at least half of the time but not all of the time. May rely on gestures or other alternative modes of communication. Able to communicate basic needs. | |
| Total | Complete inability to communicate either by spoken language, written language, or both, or to comprehend spoken language, written language, or both. Unable to communicate basic needs. | |
| Consciousness | Total | Persistently altered state of consciousness, such as vegetative state, minimally responsive state, coma. |
Source: National Library of Medicine, “Evaluation of the Disability Determination Process for Traumatic Brain Injury in Veterans“
The consciousness factor does not provide for an impairment level other than total. This is because any level of impaired consciousness would be totally disabling.
Your disability rating will be the highest highest impairment level among all the factors. For example:
If your cognitive impairment disability condition does not qualify you for a 100% disability rating on its own, then you may still be able to receive total disability compensation through TDIU.
To qualify for schedular TDIU benefits, you must be unable to keep substantially gainful employment and meet one of the following conditions:
If you cannot qualify for schedular TDIU, in some circumstances the VA may still consider you eligible in an extra-schedular capacity based on an unusual or exceptional disability.
To receive VA disability benefits for a cognitive impairment condition, you must file a claim with the VA using VA Form 21-526EZ.
With this form, along with additional supporting documentation, you must convince the VA that:
During your treating physician’s diagnosis of your cognitive impairment disability, your doctor or a referral specialist may perform assessment tests on you. These tests may include:
To support your claim, you will need to have documentation evidence to establish a service connection. This documentation can include any of the following:
You can submit your benefits claim online, by mail, or in person at your nearest VA Regional Office.
After you submit your benefits claim, the VA may schedule you for a Compensation and Pension (C&P) exam. The purpose of a C&P exam is to enable the VA, through a VA examiner, to better assess whether you suffer from cognitive impairment and, if you do, to gain a better idea of the severity of your condition.
C&P exams play an important role in whether the VA approves your disability claim and in the disability rating it assigns you. Therefore, it is essential that if the VA schedules a C&P exam for you that you make every effort to show up for it.
Failing to attend your scheduled C&P exam can have negative effects on how the VA assesses your claim. It can delay processing, or even result in a claim denial.
During a C&P exam, the VA examiner will follow a procedure that ordinarily involves the following steps:
When the C&P exam is complete, the VA examiner will prepare a report. You, or the lawyer you hire to help you with your claim, will receive a copy of the report.
The VA does not always approve first-time benefits claims. This can happen for many reasons. Some of the more common ones that we have seen include:
If the VA denies your claim for disability benefits for cognitive impairment, then you have options to seek to overturn that denial. Your main choices are to:
Although it is possible to try to file your initial VA disability benefits claim on your own without the help of an experienced VA disability benefits attorney, if you must appeal a denied claim, it is best to have an attorney who understands the appeals process. Making an appeal can be complicated and requires a thorough understanding of how the procedure works and the important deadlines you must meet.
At Stone Rose Law, our VA-accredited attorneys provide affordable, high-quality legal assistance for veterans’ appeals throughout the VA claims process.
For more information about how one of our VA disability lawyers can help you with your VA disability cognitive impairment compensation claim or appeal, request a free assistance consultation at (480) 498-8998.
You can also reach us online to ask a question or set up a free case evaluation.
