Why are so many TBI claims denied?

Mostly the diagnosis. For 880 denials, the decision summary named the diagnosis as missing in 69.9% of them: for example, examiners did not find TBI residuals or attributed the symptoms to something else.

Does combat service help a TBI claim?

Yes. Under 38 CFR 3.304(d), a combat veteran's credible account of a blast or head injury can prove it happened without a service record. Combat service was in 26.8% of grants and 10.3% of denials.

What separated grants from denials?

A positive nexus opinion (56.1% of grants, 12.5% of denials) and a favorable VA exam (49.2% vs 9.9%). With combat service and a positive opinion the Board granted 55.1%; with neither, 6.4%.

What does VA presume after a TBI?

38 CFR 3.310(d) presumes certain conditions are secondary to a moderate or severe TBI, such as Parkinsonism, unprovoked seizures, certain dementias and depression within set time limits.

TBI VA claims: what the Board relied on in grants and denials

What the Board of Veterans' Appeals' traumatic brain injury decisions contained when it granted service connection and when it denied it: combat service, medical opinions, credibility, and why most denials came down to the diagnosis.

What VA requires

A TBI claim needs a current diagnosis of TBI residuals, the injury in service, and a medical link. TBI is rated under DC 8045 in by its cognitive, emotional and physical effects. For combat veterans, lets a credible account of the injury prove it happened. Once a moderate or severe TBI is service connected, presumes certain conditions follow from it, such as Parkinsonism, unprovoked seizures, certain dementias and depression within set time limits.

Most claims are sent back first

Of 3,698 veterans whose TBI claim the Board decided from 2020 to 2025, it granted 13.8%, denied 31.1% and remanded 55.1%. The comparison below sets the 512 grants against the 1,150 denials.

What the Board's TBI decisions contained: grants vs denials

In grants (512 veterans) In denials (1,150 veterans)

The event in service

Combat service
27%
10%
Service records discussed
84%
92%

Medical evidence

Positive nexus opinion
56%
13%
Favorable VA exam
49%
10%
Private medical opinion
38%
24%
Treating doctor's opinion
11%
4%
Unfavorable VA exam
74%
86%
Negative nexus opinion
53%
63%

Statements and credibility

Veteran's own statement
87%
92%
Buddy statement
13%
6%
Board found the veteran credible
48%
13%
Board doubted the veteran's credibility
6%
24%

How the Board weighed it

Benefit of the doubt applied
71%
14%

Share of granted (green) and denied (gray) veterans whose decision contained each item, as extracted by AI from the decision text. Remanded claims are left out of this comparison. This shows what the decisions contained, not what caused the result.

The diagnosis is the main barrier

For 880 denials, the decision summary noted what would have been needed. It named the diagnosis in 69.9% of them, a medical link in 48.2% and the in-service injury in 43.4%. A favorable VA exam was in 49.2% of grants and only 9.9% of denials: the examination that confirms TBI residuals is often what decides the claim.

Combat and the medical opinion

Combat service and positive nexus opinion: how often the Board granted

Positive nexus opinion

No positive opinion

Combat service

55%

granted · 81 of 147

16%

granted · 56 of 360

No combat service

36%

granted · 206 of 568

granted · 169 of 2,623

One count per veteran; a remand counts as not granted.

With combat service and a positive opinion, the Board granted 81 of 147 (55.1%). A positive opinion without combat service was granted 36.3%, and combat service without a positive opinion 15.6%. With neither, 6.4%. The Board found the veteran credible in 47.7% of grants and 12.9% of denials.

Read the decisions

Recent decisions, with the Board's reasoning as summarized by AI:

, December 2025: granted; a blast injury during combat in Afghanistan, on the veteran's testimony corroborated by service records of an ear injury.
, December 2025: granted; reports of head injuries in service, supported by the Combat Action Ribbon and physicians' opinions.
, December 2025: denied; service records showed no head injury, the veteran's accounts were inconsistent, and an examiner found the earlier TBI diagnosis erroneous.

What the data cannot tell you

These are what the decisions contained, not what caused the result. Some items, such as a credibility finding or the benefit of the doubt, are part of how the Board explains a grant. The evidence items were extracted by AI and apply to the whole decision. Historical outcomes, not predictions.

For representatives

Secure the diagnosis first: a TBI examination that identifies residuals and ties them to the injury.
Document the event: blast or impact, unit, dates, buddy statements; for combat veterans, .
Keep accounts consistent across records; inconsistency was decisive in the denial above.
Once TBI is service connected, check and secondary claims such as migraine.