How Does VA Rate Migraine Headaches?

CCK Law: Our Vital Role in Veterans Law

VA disability ratings for migraines are based on the severity and frequency of migraine attacks, with possible ratings of 0, 10, 30, or 50 percent.

In this article, you will learn about the symptoms that may qualify you for VA disability compensation for migraines, the criteria VA uses to determine severity ratings, and what compensation is for each migraine rating.

Key points of this article include:

• VA disability ratings for migraines depend primarily on how serious and frequent the attacks are.
• A key term to understand about VA migraine ratings is “prostration,” which refers to when migraines force a veteran to stop all normal activities, lie down, and rest.
• If a veteran’s migraines are debilitating enough, they may also be able to earn total disability based on individual unemployability (TDIU) for their condition.

What Are the VA Disability Ratings for Migraines?

The possible VA disability ratings for migraines are 0, 10, 30, or 50 percent. VA assigns these based on how serious and frequent a veteran’s migraine attacks are. Veterans with more severe migraines will have a higher percentage rating and receive greater monthly compensation as a result.

These are the criteria for each migraine rating:

• 50 percent – With very frequent, completely prostrating, and prolonged attacks productive of severe economic inadaptability
• 30 percent – With characteristic prostrating attacks occurring on an average of once a month over the last several months
• 10 percent – With characteristic prostrating attacks averaging one in two months over the last several months
• 0 percent – With less frequent attacks

These VA disability ratings for migraines can be found under 38 CFR § 4.124a, Schedule of Ratings – Neurological Conditions and Convulsive Disorders, Diagnostic Code 8100.

Watch CCK Law Supervising Attorney Alyse Phillips discuss with colleagues how to earn the highest VA ratings for migraines:

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Terms to Understand for Migraine VA Claims and Appeals

What Is a “Prostrating” Migraine?

“A ‘prostrating’ migraine is specifically one that forces you to, for example, lie down in a dark room or take an extended rest period,” says Nick Scripter, reviewing attorney with CCK Law. “That’s a very important detail to tell VA about, because prostrating migraines can have a major impact on your ability to work.”

In other words, prostrating migraines are typically so severe and debilitating that they cause extreme exhaustion, physical weakness, or incapacitation that prevent the veteran from engaging in ordinary activities.

VA also sometimes uses the term “completely prostrating” to describe particularly severe examples of prostrating migraines. Migraines that are completely prostrating can fully incapacitate a veteran and may even require them to stop all activity and possibly take medication or seek medical attention.

Veterans should be sure to document how frequently they have episodes of prostrating migraines, as this can play a significant role in the VA disability rating for migraines that they ultimately receive.

How Can I Show That My Migraine Headaches Are Prostrating?

There are several ways veterans can show VA that their migraines are prostrating.

• Document migraine episodes – If a veteran can successfully document the number of prostrating migraine episodes they have over the course of several months, it may help prove the severity of their condition to VA.
• Submit lay statements – Lay statements are the personal accounts of a veteran or their friends or family attesting to a veteran’s symptoms. These offer veterans a chance to detail the impact of their migraines on their daily life or ability to work, including descriptions of what happens when they get a migraine and what activities they are not able to do when they experience one.
• Submit a medical opinion – Medical opinions can be provided by a personal physician and can be used to provide evidence of prostration. A veteran’s doctor can attest to the severity of their migraines and whether they can be considered prostrating. Veterans should consider speaking to their doctor to see if they would be willing to write a letter in support of the disability claim.

How Does VA Define “Severe Economic Inadaptability?”

“Severe economic inadaptability” is a term VA uses to describe serious impairment of a veteran’s ability to work due to the symptoms of their migraine headaches. This could take the form of frequent or sudden absences due to migraines, or a worsened capacity for the veteran to perform the functions of their job.

“This doesn’t mean that the veteran can’t work because of their migraine condition,” says Kevin Medeiros, reviewing attorney at CCK Law. “The court has interpreted that phrase to mean that the headaches could produce severe economic inadaptability. In other words, the migraines could actually cause that, or they could simply be capable of causing it.”

One type of evidence veterans could use to potentially prove severe economic inadaptability is a vocational expert opinion. These are opinions produced by those who are experts on a veteran’s work and work requirements, who can potentially review the veteran’s symptoms to determine how exactly they might impair the veteran’s ability to carry out their duties at work.

Watch CCK Law attorneys Ethan Muckelbauer and Nick Scripter cover the types of evidence veterans can submit to support a VA migraine claim:

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How Do I Prove Service Connection for Migraine Headaches?

To establish service connection and earn a VA disability rating for migraine headaches, veterans need to prove both that they experience migraines and that the migraines are related to their military service.

“Typically, veterans need to meet the three following criteria to get service connected for migraines:” says Alex Cerrone, VA-accredited claims advocate with CCK Law.

• “The first is a current diagnosis of migraines from a medical professional;
• The second is an in-service event, injury, or illness;
• And the third is a medical nexus, or basically a link, between the in-service event or injury and the current diagnosis that the veteran has.”

If a veteran can prove each of the above, then they should consider applying for service connection by filling out VA Form 21-526EZ. In addition to the filled-out form, some forms of evidence veterans should submit to help establish the three factors above include:

• Medical records establishing an official diagnosis and symptoms.
• Service records detailing an in-service event that caused or aggravated the veteran’s migraines.
• A medical nexus opinion from the veteran’s doctor that connects the veteran’s condition and the in-service event or cause.
• Lay statements from a veteran or their friends, family, or fellow service members that attest to the severity of a veteran’s symptoms.

One example of how lay evidence may be used to support a claim for migraines is if the veteran’s spouse notices that the veteran experiences debilitating migraines at least five times per month that often prevent the veteran from leaving the house.

In this case, the spouse can write a lay statement describing how the veteran’s migraines affect them.

How Do I Prove Secondary Service Connection for Migraine Headaches?

If one service-connected condition leads to migraines, the migraines may also be eligible for VA compensation.

For a veteran to prove secondary service connection for migraine headaches (e.g., if their migraines developed secondary to a traumatic brain injury (TBI) or other service-connected condition), they will typically need to submit:

• A current diagnosis of migraines
• Medical evidence showing the relationship between the primary condition and migraines

Essentially, with secondary service connection, the veteran does not need to provide evidence of an in-service event or stressor, but rather only evidence that the secondary condition is linked to the primary one.

It is important to remember that migraines can be secondary service connected to another condition (e.g., an in-service TBI causing the migraines), or have a condition be secondary service connected to the migraines (e.g., the migraines causing a separate condition like depression or anxiety to develop).

Some migraine medications also have debilitating side effects that veterans may also be able to earn secondary service connection and compensation for, as long as their migraines are already service connected.

What Should I Expect During a Compensation & Pension (C&P) Exam for Migraines?

If a veteran pursues a VA disability rating for migraine headaches, VA will likely schedule them for a Compensation and Pension (C&P) exam.

Veterans should expect their C&P exam to be performed by either a VA examiner or a VA-contracted examiner. This examiner will use the exam to gather information about the veteran’s migraine headaches in order to render an opinion as to whether it is “at least as likely as not” that their current diagnosis is related to their service.

Some tips for attending a C&P exam for migraines include:

• When attending the C&P exam, veterans should thoroughly explain the severity of their symptoms to the examiner.
• The examiner will evaluate whether the veteran’s migraines are prostrating, so it is important for the veteran to detail any symptoms or limitations they experience during a migraine episode to ensure the examiner can accurately assess their condition.
• If a veteran receives an unfavorable opinion after their exam, there are ways to challenge it. Veterans should try to obtain a copy of their C&P exam results to see if any information discussed during the exam is missing or noted inaccurately.

If the VA examiner concludes there is no connection between a veteran’s condition and their military service, a second opinion from a treating physician may provide the positive nexus needed. It can also be helpful to submit lay statements because they are able to attest to the severity of a veteran’s symptoms and how they affect the veteran’s daily life.

Veterans should note that it is extremely important to attend any exams that VA requests. If a veteran fails to attend an exam, or fails to follow up with scheduling an exam, VA could deny their claim.

Watch VA-Accredited Claims Advocate Brandon Paiva and colleagues review strategies veterans can use to potentially win their VA migraine claim:

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Can I Receive TDIU for My Migraines?

Yes, if a service-connected migraine headache condition contributes to a veteran’s inability to obtain and maintain substantially gainful employment, they may be eligible for total disability based on individual unemployability (TDIU).

TDIU is a monthly VA benefit that compensates veterans at the 100 percent level if they are prevented from working because of their conditions, even if their schedular VA rating is below 100 percent.

VA requires that veterans fill out a Veteran’s Application for Increased Compensation Based on Unemployability for all TDIU claims.

To be eligible for schedular TDIU, veterans must have:

• One condition rated at 60 percent minimum; OR
• Two conditions that can be combined to reach 70 percent, where one condition is at minimum 40 percent.

Secondary service connection can be extremely helpful in boosting veterans to the 70 percent minimum needed for multiple conditions to achieve TDIU. This is because, if a veteran’s migraines are secondarily service connected to another condition, both their VA disability rating for migraines and the rating for their primary service-connected condition can contribute toward their schedular TDIU eligibility.

Veterans who do not meet the necessary criteria for schedular TDIU may still be eligible for extraschedular TDIU. For this form of TDIU, veterans must prove:

• That their condition(s) uniquely hinder their ability to maintain substantially gainful employment.

The criteria for schedular TDIU are outlined under 38 CFR § 4.16(a), while extraschedular TDIU is rated under 38 CFR § 4.16(b).

Denied Compensation for Migraine Headaches? CCK May Be Able To Help

Frequently Asked Questions

What common migraine symptoms does VA recognize?

Per VA’s disability benefits questionnaire (DBQ) for headaches (including migraines), if a veteran is pursuing a claim for migraine headaches, VA will evaluate them for common migraine symptoms such as:

• Severe head pain
• Nausea
• Vomiting
• Sensitivity to light and sound
• Changes in vision
• Sensory changes (such as a feeling of pins and needles in extremities)

Can VA assign a rating higher than 50 percent for migraines?

Except in very rare circumstances, 50 percent is the highest schedular rating available for migraines under 38 CFR § 4.124a, Diagnostic Code 8100.

However, veterans whose migraines prevent them from maintaining substantially gainful employment may still qualify for TDIU, which pays benefits at the 100 percent rate regardless of the underlying schedular rating.

Is a 0 percent rating for migraines useful for anything?

While a 0 percent rating does not grant monthly compensation, a 0 percent rating confirms that migraines are service connected. This designation can matter later, since a veteran can file for an increased rating if migraines become more frequent or severe, without having to reestablish service connection from scratch.

Also, if migraines lead to secondary conditions, such as medication side effects or depression, then those may be eligible for VA compensation.

Can migraines and TBI receive separate VA disability ratings?

Migraines and TBI can sometimes be rated separately. VA generally does not compensate the same symptoms twice under different diagnostic codes, a rule known as pyramiding. But a reviewing attorney or claims advocate may be able to help determine whether a veteran’s migraine symptoms are distinct enough from TBI symptoms to warrant filing for two ratings.

What should I do if VA denies my migraine claim or assigns a low rating?

Veterans who disagree with a VA decision on their migraine claim can take one of several appeal options, including:

• Filing a Supplemental Claim with new evidence; OR
• Requesting a Higher-Level Review; OR
• Appealing to the Board of Veterans’ Appeals (BVA).

Each of these options involves different evidence requirements and deadlines, so veterans should review their decision letter carefully before choosing a path forward.

Does keeping a migraine diary actually help my VA claim?

Yes, a migraine diary that tracks the date, duration, and severity of each attack, including whether it was prostrating, can serve as credible lay evidence of frequency and impact. This kind of record often carries weight because it is documented close in time to when symptoms occurred.

Does VA rate tension headaches the same way as migraines?

No. While VA rates all headache conditions under 38 CFR § 4.124a, Diagnostic Code 8100, tension headaches do not have their own diagnostic code.

Therefore, instead of following the same rating criteria as for migraines, VA rates tension headaches “by analogy.” This means a veteran’s tension headache rating may differ from the rating criteria for migraines. VA will only use the migraine rating criteria as a general guide, rather than strict requirements.