VA Disability Ratings for Epilepsy and Seizure Disorder

In this article, VA disability expert Brian Reese reveals and explains how to get a VA rating for seizures.

The VA rates all types of seizures under “epilepsy” with ratings from 10% to 100% with breaks at 20%, 40%, 60%, and 80% depending on the diagnosis, severity of symptoms, and whether you have major (Grand Mal) or minor (Petit Mal) seizures.

Pro Tip: In accordance with § 4.121 identification of epilepsy, to warrant a VA rating for epilepsy, the seizures must be witnessed or verified by a physician. As to frequency, lay testimony emphasizing convulsive and immediate post-convulsive symptoms is acceptable for rating purposes.

Summary of Key Points

• Risk factors for seizures in veterans include: Traumatic Brain Injury (TBI), chemical exposures, psychological stress including PTSD, infectious diseases, stroke and vascular diseases, substance abuse and withdrawal nutritional deficiencies, and brain tumors.

• For VA rating purposes, epilepsy and seizures are both rated under the same general rating formula for epileptic seizures.

• VA ratings for seizures range from 10% to 100% with breaks at 20%, 40%, 60%, and 80% depending on the diagnosis, frequency, severity, and duration of symptoms, and whether you have major or minor seizures.

• VA raters should consider unemployability when evaluating evidence of seizures in veterans and determining the appropriate rating criteria.

What are Seizures?

Seizures are defined as sudden, uncontrolled electrical disturbances in the brain.

They can cause changes in behavior, movements, feelings, and levels of consciousness.

The nature of a seizure depends on the part of the brain where the disturbance originates and how far it spreads.

Difference Between Epilepsy and Seizures

A seizure refers to a singular event whereas epilepsy is a neurological disorder marked by the occurrence of two or more unprovoked seizures.

For VA rating purposes, epilepsy and seizures are both rated under the same general rating formula for epileptic seizures.

Types of Seizures

Seizures are primarily categorized into two main groups:

#1. Focal Seizures

Focal Onset Aware Seizures (simple partial seizures): During these seizures, the veteran remains conscious and aware of their surroundings, but they might experience changes in emotion, sensory perception, or motor skills.

Focal Onset Impaired Awareness Seizures (complex partial seizures): These involve a change or loss of consciousness or awareness. People may seem dazed and not respond normally to their environment or perform repetitive movements.

#2. Generalized Seizures

Absence Seizures (Petit Mal): Typically occurring in children, these involve brief, sudden lapses in attention. The person might stare into space or have subtle body movements such as eye blinking or lip smacking.

Tonic-Clonic Seizures (Grand Mal): These are what most people think of when they hear “seizure.” They cause a loss of consciousness, body stiffening and shaking, and sometimes loss of bladder control or biting the tongue.

Tonic Seizures: These involve stiffening of muscles, generally those in the back, legs, and arms.

Clonic Seizures: Characterized by repeated or rhythmic, jerking muscle movements, often affecting the neck, face, and arms.

Myoclonic Seizures: These usually appear as sudden brief jerks or twitches of the arms and legs.

Atonic Seizures (Drop Seizures): Muscle tone is lost for a few seconds to a minute, which may cause a sudden collapse or dropping down.

Common Signs and Symptoms of Seizures

Seizure symptoms can vary widely depending on the type of seizure and the veteran experiencing it.

Here’s a list of common signs and symptoms associated with seizures:

Aura: Some people experience a warning sign or sensation, known as an aura, before a seizure occurs. This can manifest as a strange taste or smell, a feeling of déjà vu, or a sudden emotional change.

Loss of consciousness: Many seizures involve a loss of consciousness, where the person becomes unresponsive and unaware of their surroundings.

Muscle stiffness or rigidity: During a seizure, muscles may become stiff or rigid, causing the body to tense up.

Muscle jerking or convulsions: In some seizures, muscles may jerk or convulse uncontrollably. These movements can affect one part of the body or spread throughout the entire body.

Uncontrollable shaking: Seizures may cause uncontrollable shaking or trembling movements, which can be mild or severe.

Temporary confusion or disorientation: After a seizure, the person may feel confused, disoriented, or have difficulty speaking or understanding others.

Loss of bladder or bowel control: Seizures can sometimes cause loss of bladder or bowel control, leading to involuntary urination or defecation.

Changes in sensation: Some veterans may experience unusual sensations during a seizure, such as tingling, numbness, or a feeling of “pins and needles.”

Altered consciousness or awareness: During certain types of seizures, veterans may experience altered consciousness or awareness, such as staring blankly into space or being unable to respond to stimuli.

Automatisms: These are repetitive, purposeless movements or behaviors that can occur during certain types of seizures. Examples include lip-smacking, chewing movements, or picking at clothing.

Risk Factors and Causes of Seizures in Veterans

Seizures in veterans can occur due to a variety of reasons, often related to their unique experiences and exposures during military service.

Here are some common causes of seizures in veterans:

Traumatic Brain Injury (TBI)

Head Trauma and TBI: Veterans are at risk of traumatic brain injuries from combat-related activities such as explosions, falls, and vehicle accidents. TBI is a significant risk factor for developing post-traumatic epilepsy.

Chemical Exposure

Exposure to Neurotoxic Agents: Certain chemicals, such as those encountered in combat or as part of military operations (e.g., nerve agents or exposure to other neurotoxic chemicals), can lead to neurological damage and subsequent seizures.

Psychological Stress and Post-Traumatic Stress Disorder (PTSD)

PTSD: While PTSD is primarily a psychiatric disorder, the intense stress and anxiety associated with PTSD can sometimes manifest in physical symptoms, including seizures. These are often referred to as psychogenic nonepileptic seizures (PNES), which resemble epileptic seizures but do not have the typical electrical discharges seen in epilepsy.

Infectious Diseases

Exposure to Infectious Agents: Veterans who have served in various geographic locations may be exposed to infectious agents that can affect the brain, such as malaria, which can potentially lead to seizures.

Stroke and Vascular Diseases

Vascular Health Issues: Conditions like stroke, which can be more common in veterans due to a combination of lifestyle factors and exposures, can lead to seizures. Strokes cause damage to brain tissue which can be a focal point for seizure activity.

Substance Abuse and Withdrawal

Alcohol and Drugs: Substance abuse, which is higher among veterans compared to the general population, particularly with substances like alcohol and prescription drugs, can lead to seizures either during use or withdrawal (especially in the case of alcohol).

Nutritional Deficiencies

Poor Nutrition: Certain nutritional deficiencies, such as low levels of magnesium, calcium, or vitamin B6, which might occur due to lifestyle factors, can contribute to seizure activity.

Brain Tumors

Cancer: Although less common, brain tumors can occur as primary conditions or metastatic spread from other cancers, leading to seizures due to the disruption of normal brain activity.

What are the VA Ratings for Epilepsy and Seizures?

The VA rates different types of seizures under “epilepsy” with ratings from 10% to 100% with breaks at 20%, 40%, 60%, and 80% depending on the diagnosis, severity of symptoms, and whether you have major (Grand Mal) or minor (Petit Mal) seizures.

Major Seizures (Grand Mal): These involve generalized tonic-clonic convulsions and unconsciousness. They are considered more severe and have a greater impact on a person’s rating.

Minor Seizures (Petit Mal): These include brief interruptions of consciousness, often with subtle physical signs like blinking or nodding. Variants like myoclonic (sudden jerking movements) and akinetic (loss of postural control) also fall under minor seizures.

Epilepsy and Seizure Disorder VA Disability Ratings

The VA uses six different Diagnostic Codes (DCs) to rate epilepsy and seizure disorders; however, they are all rated under the general rating formula for epileptic seizures.

• DC 8910: Epilepsy, Grand Mal – This code is used for cases of major or generalized tonic-clonic seizures. Grand mal epilepsy, also known as generalized tonic-clonic epilepsy, is a type of epilepsy characterized by seizures that involve the entire brain.

• DC 8911: Epilepsy, Petit Mal – This code applies to minor seizures, specifically absence seizures characterized by brief, sudden lapses in consciousness. Petit mal epilepsy, also known as absence seizures, is a type of epilepsy that primarily affects consciousness.

• DC 8912: Epilepsy, Jacksonian and focal motor or sensory – This code is for focal seizures that may involve localized motor or sensory disturbances. Jacksonian epilepsy, also known as focal aware seizures or focal onset aware seizures, is a type of epilepsy that starts in one specific part of the brain.

• DC 8913: Epilepsy, Diencephalic – Used for seizures originating from the diencephalon area of the brain, typically causing disturbances in consciousness or endocrine function. Diencephalic epilepsy, also known as hypothalamic or thalamic epilepsy, involves seizures originating from the diencephalon, a part of the brain that includes the thalamus and hypothalamus

• DC 8914: Epilepsy, Psychomotor – This code covers seizures that involve automatic behaviors or altered states of consciousness, which may not include the traditional convulsive movements. Psychomotor epilepsy, also known as temporal lobe epilepsy, is a type of epilepsy characterized by seizures originating in the temporal lobes of the brain.

• DC 8108: Narcolepsy – This code is used for a neurological disorder characterized by excessive daytime sleepiness and sudden attacks of sleep. Narcolepsy is rated as epilepsy, petit mal.

VA Rating Chart for Epilepsy and Seizures

Additional Notes:

Note (#1): If continuous medication is necessary for epilepsy control, a minimum evaluation of 10% is assigned. This rating does not combine with other epilepsy ratings.

Note (#2): When both major and minor seizures are present, the rating is based on the predominating type.

Note (#3): No distinction is made between seizures occurring during the day (diurnal) or at night (nocturnal).

Note (#4): Mental Disorders in Epilepsies: A nonpsychotic organic brain syndrome will be rated separately under the appropriate diagnostic code (e.g., 9304 or 9326). In the absence of a diagnosis of non-psychotic organic psychiatric disturbance (psychotic, psychoneurotic or personality disorder) if diagnosed and shown to be secondary to or directly associated with epilepsy will be rated separately. The psychotic or psychroneurotic disorder will be rated under the appropriate diagnostic code. The personality disorder will be rated as a dementia (e.g., diagnostic code 9304 or 9326).

Seizures and Unemployability Considerations

VA raters should remember that even if a veteran with epilepsy has controlled seizures, they may struggle to find employment due to employer biases.

If there is a history of unemployment, a thorough investigation should be conducted to determine if epilepsy is a major factor preventing the veteran from getting a job.

VA raters should conduct a survey to gather comprehensive information to understand the reasons behind the unemployment, including details about the claimant’s education, job history, places of work and reasons for leaving, wages, and number of seizures.

After the survey and a current medical examination, the case should be reviewed by a rating board.

If the board decides the veteran’s unemployability is due to epilepsy and if the case does not fall under their usual scope, it should be forwarded to the appropriate authority (either the Compensation Service or the Director, Pension and Fiduciary Service).

About the Author

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Brian Reese

Brian Reese is one of the top VA disability benefits experts in the world and bestselling author of You Deserve It: The Definitive Guide to Getting the Veteran Benefits You’ve Earned (Second Edition).

Brian’s frustration with the VA claim process led him to create VA Claims Insider, which provides disabled veterans with tips, strategies, and lessons learned to win their VA disability compensation claim, faster, even if they’ve already filed, been denied, gave up, or don’t know where to start. 

As the founder of VA Claims Insider and CEO of Military Disability Made Easy, he has helped serve more than 10 million military members and veterans since 2013 through free online educational resources.

He is a former active duty Air Force officer with extensive experience leading hundreds of individuals and multi-functional teams in challenging international environments, including a combat tour to Afghanistan in 2011 supporting Operation ENDURING FREEDOM.

Brian is a Distinguished Graduate of Management from the United States Air Force Academy, Colorado Springs, CO, and he holds an MBA from Oklahoma State University’s Spears School of Business, Stillwater, OK, where he was a National Honor Scholar (Top 1% of Graduate School class).