Migraines are neurological events, not just bad headaches, and they can be genuinely disabling. For veterans, they are often secondary to other conditions like PTSD, TBI, or neck trauma. This guide covers how the VA rates migraines and why the word "prostrating" matters so much.
How the VA rates migraines
Migraines are rated under diagnostic code 8100. The rating is based on the frequency and severity of "prostrating" attacks, meaning attacks so severe you must stop all activity and lie down. The levels are:
- 0 percent: less frequent attacks
- 10 percent: prostrating attacks averaging one every two months over the last several months
- 30 percent: prostrating attacks averaging once a month over the last several months
- 50 percent: very frequent, completely prostrating and prolonged attacks productive of severe economic inadaptability
The top schedular rating is 50 percent, which is high for what many people think of as "just headaches."
Why documentation is everything
The word "prostrating" is doing all the work. The VA is not just counting headaches. It wants to know how often an attack forces you to stop everything and lie down.
Many veterans undercount, mentioning only their worst episodes. That costs them. Keep a migraine log:
- Date and time of each attack
- How long it lasted
- Whether you had to stop all activity and lie down
- Whether it caused you to miss work or leave early
That log is some of the most useful evidence you can bring.
Migraines are often secondary
For veterans, migraines frequently connect to another condition:
- Secondary to PTSD or a mental health condition
- Secondary to a TBI or head injury
- Secondary to neck (cervical) trauma
If the related condition is already service-connected, a nexus letter can connect the migraines as secondary (38 CFR 3.310).
A real-world example
A veteran with service-connected PTSD had frequent migraines that forced him to lie down in a dark room and regularly cost him work hours. He had never logged them. Once he kept a detailed record and a provider connected the migraines as secondary to his PTSD, the claim had both the frequency evidence and the medical link.