Understanding the Cognitive Impairment VA Rating

Veterans may experience cognitive decline for a variety of reasons. For aging veterans, changes in cognitive function may be natural, normal, and minor – occasionally stumbling over a name or forgetting why you’ve walked into a room. For others, cognitive decline can be a sign of a serious brain injury or disease that requires medical attention and, if connected to military service, warrants VA disability compensation benefits.

In this article, we will discuss what cognitive impairment is, causes of cognitive issues in veterans, and how to get a cognitive impairment VA rating.

What is cognitive impairment?

Cognitive deficit, cognitive dysfunction, cognitive impairment, mental decline. You may have heard all of these terms and more used interchangeably. 

Where each term overlaps is that they describe changes in our cognition and mental faculties. Cognition is defined as the processes of acquiring, storing, pulling from, and applying knowledge. 

An example of this is being scheduled for a doctor’s appointment. When you are first told you have an appointment, your brain should take in the information and store it. Later, you may need to retrieve that information to write it down on your calendar or ask a family member for a ride. Even if you don’t remember the exact time and date of your appointment, you are aware one is coming up. Finally, the day of the appointment, you’ll need to apply the knowledge by understanding you need to go into the doctor’s office, and figuring out how to get there. 

When someone experiences a cognitive deficit, or their cognition is impaired, there may be a wide range of issues with attention, memory, decision-making, communicating, reasoning, and comprehension. A person may struggle to take in new information, process it, or know what to do with it.

For the purposes of this article, we will be using ‘cognitive impairment’ as an umbrella term to discuss multiple conditions that affect cognition and the brain functions listed above.

What are some causes of cognitive impairment?

There are many causes of impaired cognition, and it can be temporary or chronic.

Acute causes of cognitive impairment include:

• Hormone imbalances 
• Nutritional deficiencies
• Dehydration
• Infection
• Low blood pressure
• Medication side effects

Additionally, cognitive impairment can be caused by a long-term, chronic health issue such as:

• Traumatic brain injuries (TBI)
• Alzheimer’s disease
• Lewy body dementia
• Chronic traumatic encephalopathy (CTE)

Severe mental health disorders can also affect cognition over time.

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Cognitive impairment VA ratings

A cognitive impairment VA rating depends on three main factors:

1. What the cause of your cognitive impairment is
2. How severe your cognitive impairment is
3. Whether your cognitive impairment is service connected

Below, we will explain some of the possible cognitive impairment VA ratings.

Alzheimer’s and dementia VA ratings

Dementia is one common cause of cognitive impairment and decline. It is an umbrella term for diseases that cause memory loss and impaired thinking. Veterans with PTSD, depression, and TBI may have increased chances of developing dementia.

There are multiple types of dementia, including Alzheimer’s disease, vascular dementia, and Lewy body dementia. Alzheimer’s is the most common. The disease destroys brain function over time, making daily tasks more difficult. For some, the effects of Alzheimer’s can eventually lead to being completely unable to take care of oneself. 

The VA typically rates forms of dementia under one of the following diagnostic codes:

• 9305 Major or mild vascular neurocognitive disorder
• 9310 Unspecified neurocognitive disorder
• 9312 Major or mild neurocognitive disorder due to Alzheimer’s disease

Regardless of the diagnostic code, dementia is assessed using the General Rating Formula for Mental Disorders as follows:

Description	VA Rating	Monthly payment (vet only)
Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name.	100%	$3,938.58
Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a work-like setting); inability to establish and maintain effective relationships.	70%	$1,808.45
Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships.	50%	$1,132.90
Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events).	30%	$552.47
Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication.	10%	$180.42
A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication.	0%	None

Head injury VA ratings

Head injuries can occur in service for a number of reasons, including vehicle crashes, explosions, and falls. If you had a head injury in service and now have cognitive impairment, you may be owed VA disability benefits.

A traumatic brain  injury (TBI) results from a blow or bump to the head, a severe jolt of your body, or something penetrating your skull. The trauma doesn’t just break the bones of your skull, but it affects your brain functions. TBIs may be mild, moderate, or severe, and can cause a variety of issues, including difficulties learning, remembering, explaining, and making decisions.

A head injury may also lead to chronic traumatic encephalopathy (CTE), which is only diagnosed after death. It can lead to cognitive, mood, and personality changes.

Head injuries like TBIs are rated using diagnostic code 8045, assessing cognitive, emotional/behavioral, and physical dysfunction. Cognitive health is measured based on memory, judgment, social interactions, mental orientation, communication, and several other factors.

In some cases, cognitive impairment from a head injury may be rated using diagnostic code 9304, for major or mild neurocognitive disorder due to traumatic brain injury. This DC uses the rating criteria found in the General Ratings Formula for Mental Disorders.

Other VA ratings for cognitive impairment

Because cognitive impairment is a general term with many long- and short-term causes, there are other ways the VA may handle a claim for cognitive impairment. 

In some cases, the VA may provide a memory loss VA rating, linking your memory loss to the condition causing it. In other cases, memory loss can be caused by an injury or accident, and the VA will use the most appropriate diagnostic criteria to assess your condition.

The VA also recognizes cognitive impairment caused by HIV or other infections, or induced by medications or substances. In these cases, the VA will use the General Ratings Formula for Mental Disorders to assign a rating.

Regardless of the exact cause, if you can show your cognitive impairment is caused by your military service or tied to another service-connected condition, you should be eligible for VA disability.

You can learn more about building your case and gathering evidence to support your claim here.

TDIU for cognitive impairment

100% or TDIU, Which is Better for Your VA Claim or Appeal?

In some cases, a veteran may be awarded total disability based on individual unemployability (TDIU) for cognitive impairment. TDIU is also known as individual unemployability or simply IU. Veterans are eligible for these benefits if they can’t hold down “substantially gainful” employment due to their service-connected conditions.

Veterans who receive TDIU benefits are compensated at the same level as those with a 100% disability rating, even though their combined rating is below 100%.

Veterans will typically be eligible for TDIU if they have:

• At least one service-connected disability rated at 60% or more disabling OR
• Two or more service-connected disabilities with at least one rated at 40% or more disabling and a combined rating of 70% or more

How Woods & Woods can help

Our TDIU lawyers have helped thousands of veterans nationwide who can no longer work because of their service-connected conditions. Call us today for your free, confidential TDIU case evaluation. You won’t pay us unless we win your claim.

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