Maximizing the VA Rating for Migraine Headaches

Migraines are more than just severe headaches: they can be debilitating conditions that significantly affect a veteran’s quality of life, ability to work, and capacity to engage in daily activities. For veterans experiencing migraines due to their military service, it’s essential to understand the VA disability ratings system and the steps required to secure the compensation they deserve. This guide outlines how the Department of Veterans Affairs (VA) evaluates migraine headache claims, discusses strategies to maximize your disability rating, and explains when higher-level compensation like Total Disability based on Individual Unemployability (TDIU) may be warranted.

Why Migraines Qualify for VA Disability Compensation

Migraines (and other severe headaches) can be recognized as service-connected disabilities if there is sufficient evidence showing a link between military service and the condition. The VA grants disability benefits based on how substantially these migraines affect a veteran’s earning capacity and quality of life. If you can demonstrate that your migraines began in service—or were made worse by a service-connected condition—you may be entitled to VA compensation.

Common migraine headache symptoms include:

• Throbbing head pain (often on one side)

• Sensitivity to light and sound

• Nausea and vomiting

• Visual disturbances (sometimes called an “aura”)

A medical nexus opinion is crucial in establishing the link between migraines and military service, as it provides the necessary medical evidence to support your claim.

Even if you are unsure whether your headaches meet the criteria for migraines, the VA will evaluate your symptoms and medical history to make this determination. You can also strengthen your claim by seeking medical opinions or submitting buddy statements that corroborate when and how your headaches began or worsened.

VA Rating Criteria for Migraine Headaches

The VA evaluates migraines under Diagnostic Code 8100 in the VA Schedule for Rating Disabilities (VASRD). The VA rates migraine headaches based on the frequency and severity of attacks and their impact on daily life and employment, with ratings ranging from 0% to 50%.

• 50% – Assigned for frequent, completely prostrating, and prolonged migraine attacks that cause severe economic inadaptability (e.g., preventing you from maintaining substantially gainful employment).

• 30% – Awarded for characteristic prostrating attacks occurring on average once a month over the past several months.

• 10% – Granted for characteristic prostrating attacks averaging once every two months over the past several months.

• 0% – Indicates the migraine condition exists but does not significantly impair work or daily life under VA criteria.

A key term in the migraine rating process is “prostrating.” A prostrating migraine is severe enough that you must lie down, rest, or otherwise be incapacitated to the extent that you cannot engage in normal activities.

Understanding “Prostrating” Migraine Attacks

Prostrating migraine headaches are a central focus in determining a VA disability rating. These attacks:

1. Require Rest or Isolation: You must rest in a dark, quiet room, often needing to avoid normal light or sound.

2. Significantly Impede Activity: You cannot perform daily tasks—such as cooking, caring for children, or working—during an attack.

3. Necessitate Medical Attention or Missed Work: Frequent missed days of work or emergency room visits can bolster evidence of the migraines’ severity.

If you experience prostrating migraines once a month, you may qualify for 30%. Less frequent attacks may lead to 10% or 0%. However, if your migraines occur very frequently—causing profound disruption to employment—you could be eligible for the highest schedular rating of 50%.

Proving Service Connection for Migraine Headaches

To establish a service connection for your migraines, you must demonstrate:

1. Current Diagnosis: You have a current medical diagnosis of migraines, specifically a migraine headache diagnosis, which can lead to significant disability benefits for veterans.

2. In-Service Event or Injury: Evidence (medical or lay) that your migraines began, or were aggravated, during military service.

3. Nexus Opinion: A medical opinion linking your migraines to that in-service event.

You can also pursue secondary service connection if your migraines stem from another service-connected condition (e.g., Traumatic Brain Injury, depression, or PTSD). Medical records, personal statements, and buddy statements from those who served with you can help prove the link between your headaches and your service.

Medical Evidence for Migraine Headaches

When seeking VA disability benefits for migraine headaches, providing comprehensive medical evidence is crucial. This evidence serves as the foundation of your claim and helps the VA accurately assess the severity and impact of your condition. Here’s what you need to include:

1. Clear Diagnosis: Ensure you have a definitive diagnosis of migraine headaches from a qualified medical professional. This diagnosis should be well-documented in your medical records.

2. Detailed Medical Records: Your medical records should thoroughly document the frequency, severity, and duration of your migraine attacks. Include notes from every medical visit related to your migraines.

3. Healthcare Provider Statements: Obtain statements from your healthcare provider that explain how your migraine headaches affect your daily life and ability to work. These statements should detail the functional limitations caused by your migraines.

4. Diagnostic Tests: If you have undergone any diagnostic tests, such as MRI or CT scans, include the results. These tests can help rule out other conditions and support your migraine diagnosis.

5. Comprehensive Medical History: Provide a thorough medical history, including any previous treatments or medications you have taken for your migraines. This history helps the VA understand the progression and management of your condition.

The VA will carefully review this medical evidence when determining your disability rating for migraine headaches. Ensuring that your medical records are accurate, up-to-date, and comprehensive will strengthen your claim and increase your chances of receiving the appropriate disability benefits.

Lay Evidence and Migraine Headaches

In addition to medical evidence, the VA also considers lay evidence when evaluating claims for VA disability benefits for migraine headaches. Lay evidence consists of statements from individuals who have personal knowledge of your symptoms and their impact on your daily life. This type of evidence can provide a more complete picture of how your migraines affect you.

Examples of valuable lay evidence include:

1. Family and Friends Statements: Statements from family members or friends who have witnessed your migraine attacks can be powerful. They can describe the severity and frequency of your migraines and how they disrupt your daily activities.

2. Coworkers and Supervisors Statements: Statements from coworkers or supervisors can attest to the impact of your migraines on your work performance. They can provide insights into how often you miss work or need to leave early due to migraine attacks.

3. Personal Statements: Your own statements are also crucial. Describe your symptoms in detail, how they affect your daily life, and any challenges you face due to your migraines. Be specific about the frequency, duration, and intensity of your migraine attacks.

When submitting lay evidence, ensure that the statements are credible, detailed, and specific. The VA will consider this evidence alongside your medical records to determine your disability rating for migraine headaches. Well-documented lay evidence can significantly strengthen your claim and help you secure the disability benefits you deserve.

How to Get a 50% VA Disability Rating for Migraines

Achieving a 50% rating requires demonstrating that you suffer from very frequent, completely prostrating, and prolonged attacks leading to severe economic inadaptability. In other words, your migraines must be so intense and frequent that holding down a steady job or functioning normally is nearly impossible. Understanding the criteria used in VA disability ratings for migraines is crucial, as the United States Department of Veterans Affairs evaluates the frequency, intensity, and overall impact of migraine headaches to determine the level of disability benefits veterans may receive.

Here’s how to strengthen your case:

1. Maintain a Headache Journal: Record every migraine attack, including date, duration, severity, symptoms, and the work or personal activities you had to miss.

2. Collect Medical Evidence: Secure a comprehensive medical diagnosis, treatment records, and any specialist reports. Ask your doctor to complete a Disability Benefits Questionnaire (DBQ) that details the frequency, intensity, and functional limitations of your migraines.

3. Obtain Lay Statements: Statements from employers, coworkers, friends, or family can attest to how often migraines force you to leave work, miss shifts, or stop everyday tasks. This third-party evidence can be crucial in illustrating the full impact of your condition.

If you reach the 50% rating, but your migraines remain so debilitating that you cannot maintain substantially gainful employment, you may be eligible for higher-level compensation through TDIU or an extraschedular rating.

Case Example: Increasing a Migraine VA Rating from 30% to 50%

A veteran who served from 1996 to 1999 initially received a 30% rating for her migraine headaches. She believed that rating underestimated how debilitating her migraines were. After submitting an appeal to improve her VA ratings, the Board of Veterans’ Appeals examined:

• Frequent and Severe Migraine Attacks: Medical records showed migraines up to 20 times per month, often requiring emergency treatments and missed days of work.

• Employment Impact: Testimony and medical documentation indicated she could not maintain consistent employment due to frequent absences.

• Prostrating Nature of the Attacks: Her migraines were so severe she had to lie down in a dark room, often with nausea, vomiting, and extreme sensitivity to light and noise.

The Board found these attacks were “very frequent, completely prostrating, and prolonged,” meeting the criteria for a 50% rating. The veteran’s ability to document the severity and frequency of her migraines, plus their economic impact, proved key in her successful appeal.

Beyond 50%: TDIU and Extraschedular Ratings

Although 50% is the highest schedular rating for migraines under Diagnostic Code 8100, many veterans experience migraines that effectively make them unemployable. According to VA Attorney Patrick Sorsby:

“By offering a 50% rating as the highest for migraines, the VA is implicitly stating migraines do not fully prevent someone from working. But some veterans have weekly prostrating migraines, forcing them to miss one or two days of work per week. In a typical work setting, that’s simply not feasible, and those veterans are effectively unemployable.”

If you can show that your migraines alone make it impossible for you to work, you may qualify for Total Disability based on Individual Unemployability (TDIU) . While TDIU generally requires a minimum combined rating (e.g., 70%), exceptions exist. The VA must consider an extraschedular TDIU if your service-connected migraines, regardless of the rating, prevent you from securing and following substantially gainful employment.

Using a vocational expert to evaluate your work limitations can be instrumental. The expert can provide a detailed analysis of your job requirements, absenteeism, and the effects of migraines in a workplace context—making the case that you are unemployable due to migraines.

Navigating the VA Appeals Process

If you receive a denial or a rating you believe is too low, you have the right to appeal. The typical appeals process includes:

1. Filing a Notice of Disagreement (NOD) – Submit this formal notice to the VA, stating your intention to challenge the decision.

2. Statement of the Case (SOC) – The VA issues an explanation of the evidence reviewed and the reasons for the decision.

3. VA Form 9 – Appeal to the Board of Veterans’ Appeals, requesting the Board’s review of your case.

4. Board Decision – A Veterans Law Judge reviews your file, holds a hearing (if requested), and renders a decision.

Working with a VA-accredited attorney can be invaluable. Experienced legal counsel helps with gathering additional evidence, preparing for hearings, and crafting a compelling argument for higher ratings or service connection.

Working with a VA Disability Attorney

Navigating the VA disability benefits process can be complex and overwhelming, especially when dealing with a condition like migraine headaches. Working with a VA disability attorney can provide invaluable assistance in ensuring that your claim is thoroughly prepared and presented to the VA.

A VA disability attorney can help you in several ways:

1. Gathering Medical Evidence: An attorney can assist you in collecting and organizing all necessary medical evidence to support your claim. They can ensure that your medical records are comprehensive and accurately reflect the severity of your migraine headaches.

2. Preparing Lay Evidence: Your attorney can help you prepare and submit lay evidence statements from family members, friends, and coworkers. They can guide you on what information to include to make these statements as effective as possible.

3. Filing Your Claim: Ensuring that your claim is filed correctly and on time is crucial. An attorney can handle the paperwork and ensure that all necessary documentation is included.

4. Representation at Hearings and Appeals: If your claim is denied or you receive a lower rating than expected, an attorney can represent you at hearings and appeals. They can advocate on your behalf and present a compelling case for a higher disability rating.

5. Maximizing Your Rating: An experienced VA disability attorney understands the VA’s rating criteria and procedures. They can help you navigate the process and increase your chances of receiving the maximum disability rating for which you are eligible.

When selecting a VA disability attorney, look for someone with experience handling migraine headache claims and a deep understanding of the VA’s rating system. A skilled attorney can make a significant difference in the outcome of your claim, helping you secure the disability benefits you deserve.

Tips for Veterans Seeking Higher Migraine Ratings

• Keep a Detailed Headache Journal: Track frequency, duration, symptoms, and missed workdays.

• Gather Medical Evidence: Collect and organize all treatment records, specialist evaluations, and emergency room documentation.

• Leverage Lay Evidence: Ask friends, coworkers, or family members for statements that outline how migraines disrupt your life.

• Highlight Economic Impact: Show proof of lost wages or difficulty maintaining employment.

• Get Legal Guidance: A VA-accredited attorney or representative can ensure no critical evidence is overlooked.

By thoroughly documenting your migraines’ impact on your day-to-day activities and your earning capacity, you increase your likelihood of receiving the comp

Underrated? We Can Help

If your migraine claim has been denied or you feel your rating is too low, you have options. Our legal team specializes in VA appeals and offers free evaluations. Even if we do not take your case, we can guide you toward resources that will help. Don’t settle for an inadequate rating—if migraines are keeping you out of work or drastically altering your life, the VA should compensate you accordingly.

Contact Sorsby Law nationwide at (518) 456-4529 or via our contact form. Our experienced team is dedicated to helping veterans navigate the complexities of the VA disability benefits system, particularly for conditions like migraine headaches that can significantly impact daily life and employment.

Understanding the nuances of VA disability ratings for migraine headaches is crucial to securing the compensation you deserve. Our legal experts will work closely with you to gather comprehensive medical evidence, including detailed headache journals and lay statements, to build a strong case for your claim. We know the importance of demonstrating the frequency and severity of your migraine attacks, as well as their economic impact on your ability to maintain substantially gainful employment.

If you've been denied a claim or feel your rating is too low, our team is equipped to guide you through the appeals process, ensuring that no detail is overlooked. We offer free evaluations to assess your case and provide strategic advice.