Traumatic Brain Injury Financial Planning: Settlement Proceeds, SNT Strategy, and VA Benefits

Traumatic brain injury is the leading cause of acquired long-term disability in the United States. In 2020, there were 214,110 TBI-related hospitalizations — more than 586 every day — and TBI-related death and disability cost the U.S. approximately $76.5 billion annually in direct and indirect costs.¹ Unlike most of the conditions covered on this site, TBI is typically sudden: a car accident, a fall, a workplace incident, a combat injury. For the families affected, the financial planning emergency begins at the hospital — and the most consequential decisions must be made within weeks, before a settlement is finalized, before benefits are applied for, and often before the full extent of disability is known. This guide covers the financial planning considerations that matter most for TBI survivors and their families: protecting settlement proceeds through a first-party Special Needs Trust, qualifying for SSI and Medicaid under SSA Listing 11.18, coordinating VA disability benefits for veterans, managing cognitive capacity through the right legal tools, and structuring ABLE accounts and SNT distributions around TBI's specific cost profile.

Why TBI financial planning is different

Every condition covered on this site has nuances that generalist advisors miss. TBI has several that are entirely unique:

• The crisis starts before the diagnosis is complete. With a congenital condition like Down syndrome or spina bifida, families have years to build a financial plan. With TBI, a family may go from no disability planning to a multi-million-dollar settlement negotiation in six months. The decisions made in that window — how the settlement is structured, whether a trust exists before the check is written, whether benefits applications are submitted in the right sequence — have permanent consequences.
• Settlement proceeds are the most common funding event. Many TBI survivors have a legal claim — against a driver, an employer, a manufacturer, or a medical provider. The resulting settlement or jury award is often the primary asset that will fund the SNT. Structuring it correctly requires a three-way coordination between the personal injury attorney, the special needs attorney, and the financial advisor before the case resolves.
• Cognitive capacity may fluctuate. Unlike most physical disabilities, TBI often impairs the very capacity to manage financial decisions. A moderate TBI survivor may have intact capacity when well-rested, fatigued, or under emotional stress. A severe TBI survivor may have no meaningful financial decision-making capacity. The legal tools for managing this — guardianship, supported decision-making agreements, rep payee designation, SNT trustee — must match the actual capacity profile, not an assumed one.
• Veterans are disproportionately represented. Explosive blast injuries are the signature wound of post-9/11 combat. An estimated 15–20% of veterans who served in OEF/OIF experienced at least one TBI.² VA disability compensation, TSGLI benefits, and VA Aid and Attendance each interact with SSI and Medicaid in ways that require careful sequencing to maximize total income while preserving benefit eligibility.
• Recovery trajectory is unpredictable. Mild TBI often resolves with minimal permanent deficit. Moderate TBI may produce significant recovery over 1–2 years. Severe TBI frequently results in permanent disability with minimal improvement after the first year. A financial plan written at month three looks different than one written at month eighteen — and the settlement negotiation and trust structure must anticipate both recovery and non-recovery scenarios.

The TBI spectrum and financial planning implications

Not every person with a TBI needs a Special Needs Trust or SSI. The severity profile drives which tools apply:

The settlement proceeds emergency: first-party SNT mechanics

When a TBI survivor receives a personal injury settlement or jury award while receiving SSI or Medicaid, the structure of that payment determines whether those benefits survive. Here is exactly what happens and what must be done to protect them.

The $2,000 problem

SSI has a $2,000 individual resource limit. Countable resources above $2,000 cause SSI payments to stop; if resources remain elevated, SSI terminates. Medicaid eligibility for many programs is linked to SSI — losing SSI can mean losing Medicaid simultaneously. A $500,000 settlement received in the TBI survivor's personal bank account makes them instantly ineligible for both, and SSI is not reinstated until resources drop back below $2,000 — which means spending down the settlement on non-countable items or placing it in a properly-structured trust.

What a first-party Special Needs Trust does

A first-party SNT (also called a d4A trust, referring to its statutory authority at 42 U.S.C. § 1396p(d)(4)(A)) holds assets that belong to the person with disabilities. Unlike a third-party SNT (funded with family money), a first-party SNT is funded with the beneficiary's own settlement proceeds. The trust is excluded from SSI resource counting, so settlement funds inside the trust do not count toward the $2,000 limit — and the trustee can make distributions for the TBI survivor's supplemental needs without destroying SSI or Medicaid eligibility.

Four requirements define a valid first-party SNT:³

1. Established for the benefit of an individual with a disability under age 65. If the TBI survivor is 65 or older at the time the trust is established, a d4A trust is not available. A pooled trust (d4C) has no age limit and is the alternative for older beneficiaries.
2. Established by a parent, grandparent, legal guardian, or court. The individual with the disability cannot establish their own d4A trust — even if they have full legal capacity. If no family member is available, a court can establish the trust.
3. The state must be named as remainder beneficiary to the extent of Medicaid paid on the beneficiary's behalf. This is the Medicaid payback provision. Upon the beneficiary's death, the trust pays back Medicaid before distributing to any other heirs. This is unlike a third-party SNT, where Medicaid payback is not required. The Medicaid payback is real but often smaller than families fear — it covers only Medicaid costs actually paid, which for a person with a large SNT and extensive private-pay distributions may be modest.
4. The trust must be irrevocable. Once established, it cannot be dissolved by the beneficiary. The trustee controls distributions.

The most common mistake: the settlement check is issued to the TBI survivor personally, deposited, and then the family tries to establish a trust after the fact. Once the funds touch the personal account — even briefly — they count as a resource during that month. The trust must be established and named as payee in the settlement agreement before the check is issued.

Structured settlement as an alternative

Instead of a lump sum, a personal injury settlement can be structured as an annuity — a series of payments over time. For SSI purposes, each periodic payment counts as income in the month received, not as a resource. A structured settlement combined with an SNT can minimize the income impact: payments flow into the trust (not to the individual directly), count as income only in the month received, and the excess over the SNT's monthly expenses sits as a trust asset excluded from the resource calculation. A special needs financial advisor should model both options — lump sum into SNT vs. structured settlement into SNT — before the case closes.

First-party vs. third-party: which does a TBI family need?

Many TBI families need both:

• First-party SNT for the settlement proceeds. Required if the TBI survivor is on SSI or Medicaid and receives any funds in their own name.
• Third-party SNT for family estate planning. Parents, grandparents, and siblings who want to leave assets for the TBI survivor's benefit should establish a separate third-party SNT that does not require Medicaid payback and does not affect the family's estate plan. Direct bequests to a TBI survivor on SSI/Medicaid destroy both benefits — the third-party SNT is the correct vehicle for all family transfers.

See the first-party vs. third-party SNT guide for full structural details and a comparison table.

SSI and disability benefits: SSA Listing 11.18 explained

The Social Security Administration evaluates TBI under Listing 11.18 (Traumatic Brain Injury) in the adult Blue Book. Note that SSA generally requires evidence from at least 3 months after the TBI before evaluating whether the Listing criteria are met — the evaluation window is not immediate, because TBI recovery is active in the early months.⁴

Listing 11.18 has two qualifying pathways:

• 11.18A — Disorganization of motor function in two extremities: severely limiting the ability to rise from a seated position, balance while standing or walking, or use the upper extremities. The limitation must persist for at least three consecutive months after the injury. This pathway covers TBI survivors with significant physical sequelae — hemiplegia, ataxia, spasticity, or tremor from direct motor pathway damage.
• 11.18B — Marked limitation in physical functioning plus a marked limitation in one mental area: The mental areas are: understanding, remembering, or applying information; interacting with others; concentrating, persisting, and maintaining pace; or adapting and managing oneself. Both the physical limitation and the mental limitation must persist for at least three consecutive months after the injury.

Listing 11.18B is the more commonly applicable pathway for moderate-to-severe TBI, because cognitive and behavioral dysfunction (executive function impairment, emotional dysregulation, memory loss) combined with even mild physical limitation often meets the "marked limitation in physical functioning plus marked mental limitation" standard. A neuropsychological evaluation documenting cognitive deficits is essential evidence for 11.18B claims.

For TBI survivors who do not meet Listing 11.18 but whose TBI significantly limits work capacity, SSA also conducts a residual functional capacity (RFC) assessment. Relevant restrictions that appear in TBI RFC assessments include: inability to work at heights or around moving machinery (falls risk), no commercial driving, limited production-pace work (cognitive fatigue), limited public-contact roles (behavioral dysregulation), and need for rest breaks. An RFC-based claim is less predictable than meeting a Listing; a disability attorney or certified benefits counselor is valuable for these cases.

When TBI also causes a seizure disorder

Post-traumatic epilepsy affects an estimated 10–20% of people with severe TBI.⁵ If a TBI survivor develops a seizure disorder, SSA will evaluate both Listing 11.18 (TBI) and Listing 11.02 (Epilepsy). Meeting either Listing independently establishes disability. A claim for a TBI survivor with post-traumatic epilepsy should document both conditions — the seizure frequency documentation required for Listing 11.02 is separate from the TBI-specific motor and cognitive documentation required for 11.18. See the epilepsy financial planning guide for Listing 11.02 criteria.

SSI resource and income limits

SSI for 2026 pays up to $994/month (the Federal Benefit Rate) and requires countable resources below $2,000. A properly-structured first-party SNT holding settlement proceeds does not count toward the $2,000 limit. An ABLE account balance up to $100,000 also does not count. The $2,000 limit applies to the TBI survivor's personal countable assets — not to assets held by the trustee of an SNT established for their benefit.

VA benefits for veterans with TBI

For veterans, TBI is evaluated under VA Diagnostic Code 8045 (Residuals of Traumatic Brain Injury). Unlike SSA, which gives a single disability determination, VA assigns a percentage rating based on functional impairment using 10 facets of TBI residuals — cognitive impairment, emotional/behavioral dysfunction, vestibular dysfunction, headaches, visual impairment, and others — with the highest single-facet rating controlling the overall rating.⁶

2026 VA compensation rates for TBI

VA disability compensation is tax-free and paid monthly regardless of SSI or Social Security status. 2026 rates (effective December 1, 2025, with 2.8% COLA):⁷

• 10% rating: $175.51/month
• 30% rating: $508.05/month
• 50% rating: $1,075.16/month
• 70% rating: $1,808.45/month
• 100% rating: $3,737.85/month (veteran only, no dependents)

Veterans with severe TBI may also qualify for Special Monthly Compensation (SMC) at rates significantly above the 100% schedular rate — up to $10,000+/month for veterans requiring regular aid and attendance and who have loss of use of multiple extremities. SMC is evaluated separately from the schedular rating and requires specific medical documentation.

VA compensation and SSI: understanding the interaction

VA disability compensation is unearned income for SSI purposes. It reduces SSI dollar for dollar after the $20/month general income exclusion. Practically:

• A veteran receiving $1,808.45/month in VA compensation has $1,788.45 in countable unearned income for SSI — exceeding the $994 FBR. SSI = $0.
• A veteran receiving $175.51/month at 10% has $155.51 in countable unearned income. SSI = $994 − $155.51 = $838.49/month, plus the VA amount, for a total of $993.62/month.

Most veterans with moderate-to-severe TBI receiving VA compensation at 50% or above will have their SSI reduced to zero by the VA payment. However, losing SSI does not automatically mean losing Medicaid — many states have Medicaid programs for disabled individuals with income above the SSI level, and HCBS waiver programs often have higher income caps. A benefits counselor can map the specific state rules and identify whether Medicaid continues even when SSI is zero.

One planning strategy: if VA compensation eliminates SSI but the veteran still qualifies for Medicaid through another pathway, the first-party SNT may be less urgently needed for benefit preservation — but it remains valuable as a vehicle for settlement or inheritance funds that can supplement VA-funded care.

TSGLI: the lump-sum TBI benefit most veterans don't know about

Traumatic Servicemembers' Group Life Insurance (TSGLI) provides a one-time payment of $25,000–$100,000 to service members who suffer a qualifying traumatic injury, including TBI. Specific TBI-related losses that qualify include: hospitalization for TBI lasting 15 or more consecutive days, and loss of activities of daily living (ADLs) due to TBI lasting specified periods.⁸

TSGLI coverage is automatic for service members enrolled in full-time SGLI. The benefit is paid to the service member (not a beneficiary), directly — meaning a veteran on SSI or Medicaid who receives TSGLI without an SNT in place faces the same resource-limit problem as with a personal injury settlement. Veterans and their families should check TSGLI eligibility promptly after a TBI qualifying event and coordinate the payment with the SNT structure before funds are received.

Cognitive capacity and money management tools

TBI creates a unique challenge for financial management tools: the person may have partial or fluctuating capacity, rather than the clear permanent incapacity typical of severe intellectual disability. The right tools depend on the specific capacity picture.

Representative payee for SSI and SSDI

SSA appoints a representative payee when a Social Security beneficiary cannot manage their own benefits. A rep payee receives the SSI or SSDI payment, manages it for the beneficiary's use, and reports annually to SSA on how funds were spent. Rep payee appointment does not require court involvement — SSA makes the determination based on medical and functional evidence. For TBI survivors with moderate to severe cognitive impairment, a rep payee is often appropriate even when full guardianship is not sought.

ABLE account authorized individual

If a TBI survivor cannot self-direct an ABLE account, a family member can be named as "authorized individual" to direct spending from the account — without guardianship. The authorized individual can manage contributions and qualified disability expense withdrawals on the beneficiary's behalf. This is a simpler, less expensive alternative to guardianship for the specific purpose of managing the ABLE account. See the ABLE account 2026 guide for how authorized individual designation works.

SNT trustee

The SNT trustee controls distributions from the trust — not the beneficiary. A well-chosen trustee is the most important protective mechanism for a TBI survivor with cognitive impairment: no ability for the beneficiary (or people around them) to misuse trust assets, no annual accounting burden on the beneficiary, and professional judgment applied to distribution decisions. For a large settlement-funded first-party SNT, a corporate trustee with experience in special needs trusts is often appropriate. For smaller trusts, a family member co-trustee with a trust protector for oversight may be cost-effective. See the SNT trustee guide for the full comparison.

Guardianship vs. supported decision-making

Guardianship transfers legal decision-making authority from the person with a disability to a guardian appointed by a court. For TBI survivors with severe impairment and no meaningful financial decision-making capacity, limited guardianship (covering financial decisions only) is often appropriate. For survivors with moderate impairment who retain some decision-making ability, supported decision-making agreements — where trusted supporters help the individual make and communicate decisions without overriding their legal authority — may better preserve autonomy while providing protection. See the guardianship vs. supported decision-making guide for the comparison and state-by-state legal status.

One TBI-specific nuance: cognitive capacity may improve significantly in the first 1–2 years after injury. A guardianship established during the acute phase may be more restrictive than necessary once recovery stabilizes. Courts can modify or terminate guardianship as capacity improves, but this requires another legal proceeding. Some families use a supported decision-making agreement initially and pursue guardianship only if capacity stabilizes at a level that makes independent financial decisions unsafe.

SSI work incentives for TBI survivors returning to work

Many TBI survivors want to return to work — some succeed fully, some succeed partially, and some find sustained competitive employment beyond reach. SSI work incentives make partial employment financially viable without immediately terminating benefits:

• The earned income formula: SSI excludes the first $65/month in earned income plus half of everything above that. A TBI survivor working part-time at $800/month retains SSI of approximately $994 − $367.50 = $626.50, for total monthly income of $1,426.50. Working part-time almost always increases total income relative to SSI alone.
• Impairment-related work expenses (IRWE): Costs directly related to the TBI and necessary for the person to work are deducted before calculating countable income for SSI. For TBI survivors, common IRWEs include: attendant care for job-site assistance, cognitive prosthetics and assistive technology used at work, transportation costs when the survivor cannot drive due to TBI, and medication costs that affect work capacity. IRWEs can meaningfully increase the break-even income level.
• Plan to Achieve Self-Support (PASS): A PASS plan allows a TBI survivor to set aside income and resources for a vocational goal — such as vocational training, education, or self-employment startup costs — without those set-aside amounts counting toward SSI resource or income limits. PASS plans are approved individually by SSA and require a specific vocational objective.
• Section 1619(b) Medicaid protection: If earned income rises above the SSI break-even level and SSI payments stop, Medicaid continues under Section 1619(b) as long as the person continues to meet the medical definition of disability, earnings don't exceed a state-specific threshold (typically $30,000–$50,000/year), and the person would otherwise be eligible for SSI but for earnings. This makes the transition from SSI to full employment less risky — Medicaid doesn't evaporate the day SSI stops.
• ABLE-to-Work: A TBI survivor who works can deposit earned income into an ABLE account in addition to the standard $20,000/year limit — up to an additional $15,650/year (2026 limit, equal to the federal poverty level for an individual). This shields earned income from SSI resource counting and preserves benefits while building assets.

SNT distributions specific to TBI

SNT distribution language for TBI should explicitly authorize expense categories that generalist SNT drafts commonly omit. The trustee can only distribute for what the trust document permits:

• Cognitive rehabilitation: Neuropsychological therapy, cognitive training programs, speech-language therapy for cognitive-communication deficits. Not covered by standard Medicaid in many states; a specific distribution authorization prevents the trustee from declining on ambiguity grounds.
• Assistive technology for cognitive support: Reminder systems, scheduling apps and devices, GPS trackers for elopement risk, simplified phones and tablets. These fall in a gray zone between "electronics" (often excluded in generic SNTs) and "health equipment" — explicit authorization prevents disputes.
• Transportation when driving is medically prohibited: Rideshare, paratransit, and accessible vehicle modifications. TBI survivors with post-traumatic seizures, significant vestibular dysfunction, or cognitive impairment that affects driving safety may be medically prohibited from driving — yet most care needs require transportation. Budget this explicitly.
• Home modifications for TBI safety: Fall-prevention modifications (grab bars, non-slip flooring, stair safety), locks for wandering prevention, accessible bathroom design for physical deficits. These are health-related expenses distinct from "home improvements" that some SNTs restrict.
• Behavioral health and psychiatric care: Post-traumatic stress, depression, anxiety, and personality changes are extremely common after TBI — affecting an estimated 25–50% of moderate-to-severe TBI survivors.⁹ Psychiatric medication, therapy, and crisis services should be explicitly authorized, particularly if a co-occurring substance use disorder is present (also common after TBI).
• Caregiver respite and family support: Family caregiver burnout is a major risk for TBI families, particularly in the first 1–3 years of recovery when care intensity is highest. Respite care services, caregiver training, and family therapy are appropriate SNT distributions and should be named.
• Vocational rehabilitation and supported employment: Job coaching, supported employment programs, and assistive workplace technology costs not covered by vocational rehabilitation agencies. For TBI survivors pursuing return to work, these investments produce independence that reduces long-term SNT depletion.

See the SNT distributions guide for the full list of safe expense categories and ISM rules.

SNT funding targets for TBI

SNT sizing for TBI depends on severity and the availability of public funding through Medicaid HCBS waivers and VA benefits. As a general framework:

• Severe TBI with no VA benefits, no structured settlement, living in the community: The SNT must fund the gap between Medicaid-covered services and actual care costs over a projected lifespan. Using the Lifetime Care Cost Calculator with a supported-living setting assumption — approximately $30,000/year in 2026 dollars — a 30-year-old with a 50-year planning horizon has a present-value care cost of $700,000–$1,200,000 before accounting for cognitive rehabilitation, assistive technology, transportation, and extraordinary medical costs. SNT targets for severe TBI typically run $1M–$2.5M.
• Severe TBI veteran with 70%+ VA compensation: VA compensation covers a significant portion of monthly living costs. The SNT supplements VA benefits and covers gaps — primarily medical copays, assistive technology, transportation, and behavioral health services not covered by VA. SNT targets are lower but still substantial: $500,000–$1,500,000 depending on the care model and VA service level.
• Moderate TBI with partial employment potential: The SNT serves primarily as a safety net for depletion scenarios — job loss due to cognitive decline, extraordinary medical costs, or behavioral health crises. Smaller SNT targets ($250,000–$750,000) combined with strong ABLE account use and employment support may be appropriate, but the plan should be stress-tested against a non-employment scenario.

A personal injury settlement should be sized with the life-care plan as the anchor. A rehabilitation physician or life-care planner (a credentialed professional who projects lifetime medical costs) typically produces the life-care plan used in litigation. The special needs financial advisor translates the life-care plan into an SNT funding target, accounting for investment returns, inflation, and the interplay of public benefits.

ABLE accounts for TBI survivors

ABLE accounts are particularly well-suited for TBI survivors with moderate impairment who maintain some independence and employment capacity. 2026 parameters:

• Age eligibility expanded to 46 (ABLE Age Adjustment Act, effective January 1, 2026). TBI can occur at any age — but the working-age adults most affected by car accidents, falls, and combat injuries are overwhelmingly under 46 at the time of injury. Most TBI survivors now meet the age requirement.
• $20,000/year contribution limit (2026). Parents, siblings, employers, and the beneficiary can all contribute. For a TBI survivor who is unable to self-direct the account, an authorized individual manages spending without requiring guardianship.
• Qualified disability expenses relevant to TBI: prescription medications (including psychiatric medications common after TBI), cognitive prosthetics and assistive technology, rideshare and transportation (particularly when driving is medically prohibited), home modifications for TBI safety, and employment-related expenses for survivors in supported employment.

Recommended structure: the ABLE account handles routine monthly costs within the $20,000/year limit — transportation, medication co-pays, adaptive equipment, medical appointments. The SNT holds the long-term corpus and handles extraordinary costs — major medical episodes, equipment replacement, residential transitions. This split minimizes administrative burden on the trustee while keeping routine transactions flexible.

The three-professional team

1. Personal injury attorney (if a legal claim exists). Maximizes the settlement and structures it correctly — particularly the allocation between economic damages (medical costs, lost wages) and non-economic damages (pain and suffering), which affects how the settlement is taxed. The PI attorney must coordinate with the special needs attorney on SNT establishment timing before the case closes. Never let the PI case resolve without a special needs attorney in the room.
2. Estate attorney specializing in special needs. Establishes the first-party SNT before settlement funds transfer; establishes a separate third-party SNT for family estate planning; amends parental wills and audits all beneficiary designations; advises on guardianship or SDM appropriate to the TBI survivor's capacity level.
3. Fee-only financial advisor specializing in special needs. Models the SNT funding target from the life-care plan; structures life insurance to fund the third-party SNT (survivorship or single-life depending on family structure); coordinates ABLE and SNT contributions; models the VA benefits + SSI interaction for veterans; advises on structured settlement vs. lump sum; and produces a long-term financial plan that accounts for recovery scenarios ranging from partial improvement to permanent severe disability.

For veterans, a VA-accredited attorney or claims agent is often a fourth team member — particularly for TSGLI claims, SMC claims, and TDIU applications that require specialized VA appeals knowledge.

What to do first

1. If a settlement is being negotiated: stop and get a special needs attorney on the call before anything is signed. The settlement structure — lump sum vs. structured, SNT as payee vs. individual as payee — must be decided before closing. Once the check clears in the wrong account, the damage is done.
2. Apply for SSI and Medicaid. Many TBI families don't apply because they assume the settlement will make their family member "too rich" for benefits. A properly-structured first-party SNT means the settlement doesn't count as a resource. Apply while the trust is being established; SSA can backdate SSI to the application date.
3. For veterans: file VA disability claim promptly. VA compensation is not retroactive beyond the date of claim — every month without a filed claim is a month of benefits lost. TSGLI claims have a separate claim process and filing deadline.
4. Enroll on HCBS Medicaid waiver waitlist. For TBI survivors who will need residential support or intensive day programming, the waitlist — often 5–15 years — should be started immediately regardless of the beneficiary's current living situation. There is no obligation to accept services when offered. See the HCBS Medicaid Waiver guide.
5. Open an ABLE account. Begin making contributions for transportation, medical appointments, assistive technology, and cognitive rehabilitation costs not covered by Medicaid. The authorized individual provision means a family member can manage the account if the TBI survivor cannot self-direct.
6. Audit all beneficiary designations. Every IRA, 401(k), and life insurance policy owned by parents, grandparents, or the TBI survivor themselves should be reviewed. Direct designations to a TBI survivor on SSI destroy benefits; the SNT should be named instead. See the retirement accounts and special needs planning guide.

Sources

1. CDC — Facts About Traumatic Brain Injury. In 2020, there were 214,110 TBI-related hospitalizations (more than 586 per day) and 68,663 TBI-related deaths in 2023. TBI is a major cause of death and disability in the United States.
2. NCBI Bookshelf — The Scope and Burden of Traumatic Brain Injury. Post-9/11 military service, particularly in Iraq and Afghanistan, produced high rates of blast-related TBI. Estimates of OEF/OIF veterans with at least one TBI range from 15–20% across studies.
3. Special Needs Alliance — Special Needs Trusts and Personal Injury Settlements. First-party d4A SNT requirements: beneficiary under 65, established by parent/grandparent/guardian/court, Medicaid payback provision required, irrevocable. Settlement proceeds must be directed to the trust before or at the time of distribution to avoid resource-counting issues.
4. SSA Blue Book — 11.00 Neurological Disorders (Adult). Listing 11.18 criteria for traumatic brain injury: 11.18A (disorganization of motor function in two extremities, 3 months) or 11.18B (marked physical limitation plus marked limitation in one mental area, 3 months). SSA evaluates TBI at least 3 months post-injury to allow for recovery assessment.
5. Epilepsy Foundation — Traumatic Brain Injury and Epilepsy. Post-traumatic epilepsy affects an estimated 10–20% of patients with severe TBI. The risk is highest in the first year after injury but persists for many years; overall risk is proportional to injury severity.
6. CCK Law — How the VA Rates Traumatic Brain Injury. TBI is rated under Diagnostic Code 8045 using 10 facets of residuals (cognitive, emotional/behavioral, vestibular, headache, visual, others). The highest single-facet rating controls the overall rating. SMC may be available for severe TBI requiring aid and attendance.
7. VA Disability Group — 2026 VA Disability Pay Rates. 2026 VA disability compensation rates effective December 1, 2025 (2.8% COLA): 10% = $175.51/mo; 30% = $508.05/mo; 50% = $1,075.16/mo; 70% = $1,808.45/mo; 100% = $3,737.85/mo (veteran only, no dependents).
8. VA — Traumatic Injury Protection (TSGLI). TSGLI provides $25,000–$100,000 in one-time financial support to service members who suffer a qualifying traumatic injury. TBI-related losses include hospitalization for TBI lasting 15+ consecutive days and loss of ADLs due to TBI. Coverage is automatic for SGLI enrollees.
9. Disability Secrets — Using Special Needs Trusts for SSI Eligibility. Assets in a properly-structured SNT do not count toward SSI's $2,000 resource limit. First-party SNTs must include a Medicaid payback provision; third-party SNTs do not. The trust must be established before settlement funds are received in the beneficiary's name.

SSI and benefit rules verified against 2026 SSA standards. SSI FBR $994/month (2026). SSI individual resource limit $2,000. SGA limit $1,690/month (2026, non-blind). ABLE age limit expanded to 46 effective January 1, 2026 (ABLE Age Adjustment Act). ABLE annual contribution limit $20,000; ABLE-to-Work additional $15,650 (2026). VA disability rates effective December 1, 2025 (2.8% COLA confirmed). TSGLI benefit range $25,000–$100,000 (unchanged for 2026). SSA Listing 11.18 criteria current as of SSA Blue Book neurological listings. SNT sizing estimates are illustrative ranges; individual plans require a licensed special needs financial advisor and life-care planner.