The TBI DBQ works unlike any other form in the schedule. Residuals of a traumatic brain injury are rated under 38 CFR § 4.124a, Diagnostic Code 8045 across ten separate “facets” of cognitive and behavioral function. Each facet is scored on a ladder — 0, 1, 2, 3, or “total” — and here is the part that matters most: your overall rating is set by the single highest facet, not by an average. One severely-impaired facet drives the entire evaluation.
The ten facets the examiner scores
The DBQ asks the examiner to rate each of these from 0 (normal) up to 3 or “total”:
- Memory, attention, concentration, executive functions — the most commonly elevated facet.
- Judgment — ability to make reasonable decisions, including in complex or unfamiliar situations.
- Social interaction — how often behavior is inappropriate.
- Orientation — to person, place, time, and situation.
- Motor activity — with intact motor and sensory systems (apraxia).
- Visual spatial orientation — getting lost, difficulty with directions.
- Subjective symptoms — headaches, dizziness, fatigue, sensitivity to light/sound.
- Neurobehavioral effects — irritability, impulsivity, aggression, lack of motivation.
- Communication — ability to comprehend and express spoken and written language.
- Consciousness — altered states; this facet is scored only as “normal” or “total.”
How a facet climbs the ladder
Using the cornerstone facet — memory/attention/concentration/executive function — as the example, the levels read roughly like this:
Subjective complaints but objective testing is normal, with no functional impairment.
A mild, objectively-shown impairment of memory, attention, or executive function, but it does not interfere with work, social, or daily activity.
Objectively-shown moderate impairment that interferes with work, social functioning, or instrumental activities of daily living, though the veteran can generally function independently with some difficulty.
Severe impairment that requires assistance, or makes the veteran unable to perform some activities of daily living without help.
Total impairment of the facet — e.g., a persistent altered state of consciousness, or being completely unable to communicate.
The mental-health / TBI overlap rule
Many TBI residuals (irritability, memory, mood, concentration) also look like mental-health symptoms. Under DC 8045, if you have a separately diagnosed mental-health condition (PTSD, depression), the VA evaluates the emotional/behavioral symptoms under § 4.130 (the mental-disorders formula) and the cognitive/physical TBI residuals under DC 8045 — and may assign separate ratings, as long as it does not count the same symptom twice (pyramiding, § 4.14). Make sure the examiner and rater distinguish which symptoms belong to which diagnosis so you are not under-rated by having everything lumped into one.
What to surface at the exam (and in the record)
Magic words for this tier
Aim each statement at the facet it supports:
- Memory/executive: “I lose track of tasks, miss appointments, and can’t follow multi-step instructions at work.”
- Judgment: “I make decisions I later realize were unreasonable; I need others to check me.”
- Neurobehavioral: “I have unprovoked irritability and impulsivity that have cost me relationships and jobs.”
- Subjective: “I have daily headaches, dizziness, fatigue, and sensitivity to light and noise.”
- Visual spatial: “I get lost driving familiar routes.”
Each facet is scored on its own merits, so describing your worst-functioning facet in concrete, functional terms is how you protect the rating — because that one facet sets the whole tier.
What NOT to say
What NOT to say
- “I’ve learned to work around it.” (Compensating strategies read as no impairment — describe the underlying deficit.)
- “It’s about the same as everyone my age.” (Normalizes a ratable deficit.)
- “Just headaches.” (Subjective symptoms are a full facet — describe frequency and severity.)
- “My memory’s fine, I just write things down.” (The writing-down is the impairment.)
Bring objective support
Neuropsychological testing, a treating-provider statement, and a family lay statement describing day-to-day functioning all help the examiner score the facets accurately. The DBQ asks for objective findings — testing results that show a level 2 impairment are far stronger than subjective report alone.
Use this with the rest of the site
- ▸ TBI condition guide — the full rating schedule, evidence checklist, and tactical plays.
- ▸ C&P Exam Prep generator — builds a personalized checklist for your specific conditions.
- ▸ Claim Coach — walks you through the 10 steps including C&P prep at Step 7.
- ▸ Full C&P exam guide — the universal say/don’t-say rules that apply to every exam.
Educational content only. DBQ structures are public knowledge from M21-1 and archived sources; VA discontinued public DBQ distribution in 2020 but the rating criteria these forms map to remain in 38 CFR Part 4. Not legal or medical advice. Always consult a VA-accredited VSO or attorney for claim-specific guidance. CFR citations: 38 CFR § 4.124a Diagnostic Code 8045 (residuals of traumatic brain injury, ten-facet evaluation table), § 4.130 (mental-disorder residuals evaluated separately where separately diagnosed), § 4.14 (anti-pyramiding)..