TBI Severity Drives Higher Disability Ratings and Compensation for Veterans

A large-scale retrospective study of over 1.3 million post-9/11 US veterans has revealed that the severity of traumatic brain injury (TBI) significantly influences disability compensation determinations and benefit levels. Conducted using data from the Veterans Healthcare Administration (VHA) and Veterans Benefits Administration (VBA), the study underscores the lasting impact of TBI—especially among Army personnel—and raises important questions about recognition and compensation for service-related brain injuries occurring outside of combat zones.

TBI has affected over half a million service members between 2000 and 2024, with the majority (82%) categorized as mild cases. Researchers analyzed how TBI severity and various military service factors—such as deployment history, branch, rank, and combat exposure—correlated with service-connected disability (SCD) ratings and financial compensation.

Out of the 1.3 million veterans, 93 911 (7.1%) received an SCD rating for TBI. The findings revealed that having a TBI SCD rating increased average monthly compensation by $362 in unadjusted models and $45 in adjusted models. Greater TBI severity was directly associated with higher SCD ratings and increased monthly disability payments.

Interestingly, the study found that female veterans, despite receiving lower TBI SCD percentage ratings on average (−3.03 percentage points), were awarded slightly higher monthly compensation ($37 more) compared to their male counterparts.

Deployment status also played a complex role. While veterans who had been deployed were more likely to have a TBI SCD determination, non-deployed individuals received higher TBI SCD percentage ratings. This suggests that TBIs sustained during non-combat activities such as training may be more severe or more consistently documented. Combat exposure, on the other hand, was not associated with higher TBI ratings but did correlate with an additional $46 in monthly compensation.

The researchers call for expanded efforts to assess TBI risk across all military environments and ensure that veterans receive appropriate evaluations and benefits, regardless of deployment history. As the military and the US Department of Veterans Affairs continue to address the long-term consequences of TBI, such studies offer vital insights for shaping equitable compensation policies.

Reference

Dismuke-Greer CE, Esmaeili A, Pugh MJ, et al. Association of clinical TBI severity and military factors with veteran TBI service-connected disability ratings and total compensation: a long-term impact of military brain injury consortium (LIMBIC) study. J Head Trauma Rehabil. 2025 Apr 1. doi: 10.1097/HTR.0000000000001052