Rating Criteria for Migraines
How VA Assigns Migraine and Headache Ratings
When VA awards service connection for migraines, or headaches as they are treated the same for VA compensation purposes, the condition is rated under diagnostic code 8100, under the schedule of ratings for neurological conditions and compulsive disorders. The rating criteria is as follows:
50% : With very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability
30% : With characteristic prostrating attacks occurring on an average once a month over last several months
10% : With characteristic prostrating attacks averaging one in 2 months over last several months
0% : With less frequent attacks
The ratings for 0, 10, and 30-percent evaluations are straight forward. How often is the Veteran experiencing a prostrating, or debilitating, headache? For VA purposes, the term prostrating means “causing extreme exhaustion, powerlessness, debilitation or incapacitation with substantial inability to engage in ordinary activities.” Examples include lying down in a dark room, requiring the use of blackout shades or cold compress, or being in complete silence when experiencing a migraine.
Importantly, the criteria for VA ratings for migraines are “successive,” meaning that to establish the next level rating, a veteran must establish each of the lower ratings levels for migraines.
If a veteran exceeds the threshold of “prostrating attacks occurring on an average once a month over last several months” (30% criteria), the next higher evaluation is warranted.
However, the 50-percent criteria is less clear, and in fact, the vagueness of the language required the Court to get involved to detail out what the 50-percent criteria actually means, “Productive of” can either have the meaning of “producing” or “capable of producing.” Thus, migraines need not actually “produce” severe economic inadaptability to warrant the 50 percent rating. Further, “economic inadaptability” does not mean unemployability, as that would undermine the purpose of regulations pertaining to a TDIU. Pierce v. Principi, 18 Vet. App. 440, 445 (2004).
How to Support Your Claim for an Increased Rating
Oftentimes, gathering and submitting additional information will help support your claim for an increased rating. When only relying on VA examinations, VA only sees a snapshot of the headache disability on that day, at that time. Additional information such as a statement, or journal of migraines can be a powerful tool in helping VA better understand the frequency and severity of the condition. Elements to address in a statement include:
How often does the Veteran experience headaches?
What symptoms does the Veteran experience? For example, nausea, light/sound sensitivity, pain. How often does the Veteran experience a migraine episode? How long does it last?
How does the Veteran treat their migraines? For example, pain medication, cold compress, lying down in a dark room.
How do migraines affect their ability to work? For example, having to call out from work or leave early. Office job often involve staring at a screen, which can trigger migraines; physical jobs often involve exertion or loud noises, like on a construction site, which can also trigger migraines.
Additionally, keeping a journal or log of migraine attacks and their duration can help further support the claim for an increased rating. Information like the date of an attack, the duration, and severity can all help support entitlement to an increased rating. Below is an example:
If you believe your headache disability is underrated, or are seeking assistance in pursuing a claim, please contact our office at 844-483-8737.