Migraine headaches are rated under 38 CFR §4.124a, Diagnostic Code 8100. The key to a good rating is documenting frequency and"prostrating" attacks—plus their impact on your ability to work.
Migraine Rating Criteria
| Rating | VA Criteria |
|---|---|
| 0% | Headaches diagnosed but no significant work impact |
| 10% | Characteristic prostrating attacks averaging one in 2 months |
| 30% | Characteristic prostrating attacks occurring on average once a month |
| 50% | Very frequent, completely prostrating and prolonged attacks productive of severe economic inadaptability |
What Does "Prostrating" Mean?
"Prostrating attack" = headache so severe you MUST lie down.
This is the critical phrase VA looks for. Use this exact word in all your statements and make sure your diary tracks which headaches were prostrating.
Getting the 50% Rating
For 50%, you must show:
- "Very frequent" prostrating attacks (multiple per month)
- "Prolonged" attacks (lasting hours or days)
- "Severe economic inadaptability" — Impact on ability to work/earn
"Economic inadaptability" doesn't mean you can't work at all. It means your migraines significantly impact your ability to work—missed days, leaving early, reduced performance, lost job opportunities.
Evidence That Wins
Evidence That Wins
- ✓Headache diary: date, duration, severity (1-10), prostrating (Y/N), medications taken
- ✓Lay statements about missed work, leaving early, reduced productivity
- ✓Employer statements: attendance records, performance issues, accommodations
- ✓Medication history: prescriptions and OTC medications, frequency of use
- ✓Treatment records: ER visits, neurology consultations, imaging
Evidence That Loses
- ✗Diagnosis only with no functional impact documented
- ✗No proof of prostrating attacks
- ✗Infrequent headaches (less than monthly)
- ✗Vague descriptions without frequency/severity
How to Keep a Headache Diary
For each headache, record:
- Date and time started and ended
- Severity (1-10 scale)
- Prostrating? (Did you have to lie down? Yes/No)
- Medications taken and effectiveness
- Impact (missed work, left early, couldn't function)
- Symptoms (nausea, light sensitivity, etc.)
Service Connection Paths
- Direct: Started in service or caused by service event
- Secondary to PTSD: Very common connection
- Secondary to TBI: Strong medical link
- Secondary to sleep disorders
- Secondary to cervical spine conditions
Secondary Conditions
Migraines may support claims for:
- Depression/anxiety — Chronic pain impact
- Sleep disturbance
- Nausea/GI issues
Filing Tips
- Start a headache diary NOW — This is your most important evidence
- Document work impact (sick days, leaving early, reduced performance)
- Get employer letter documenting attendance or performance issues if possible
- Claim as secondary to TBI or PTSD if applicable
- Use the word "prostrating" in all statements and diary entries