The Department of Veterans Affairs (VA) recognizes chronic migraines as a compensable disability, providing monthly financial benefits to service members who have illnesses or injuries incurred or aggravated during active military duty. The rating system assesses the degree of functional impairment caused by a service-connected condition, which determines the level of compensation a Veteran receives. The severity and frequency of a Veteran’s symptoms are the factors used to determine the final disability percentage.
The Maximum Disability Rating for Migraines
The highest standard percentage a Veteran can be assigned specifically for migraines is fifty percent. This is the maximum schedular rating available under the VA’s rating schedule for headaches, assigned when the condition causes a high degree of functional limitation.
A fifty percent rating for migraines alone does not represent the absolute highest possible compensation rate a Veteran can receive. If the service-connected migraines are so debilitating that they prevent the Veteran from maintaining substantially gainful employment, they may qualify for Total Disability based on Individual Unemployability (TDIU). TDIU is a benefit that pays at the one hundred percent disability rate, even if the schedular rating for the condition is lower. For migraines to qualify for TDIU, the evidence must show the Veteran cannot work due to the frequency and severity of the headache attacks.
Criteria for Rating Migraines (Diagnostic Code 8100)
Migraines are evaluated under Diagnostic Code 8100 within the VA Schedule for Rating Disabilities, which defines four possible percentage ratings based on the frequency and severity of attacks. The key determinant is the presence of “prostrating attacks,” which describes a migraine so severe that it forces the individual to stop all activity and lie down for a period of time. The lowest compensable rating is ten percent, assigned for characteristic prostrating attacks that occur on average once every two months.
A thirty percent rating requires characteristic prostrating attacks occurring on average of once a month. The attacks at this level generally include symptoms like severe pain, nausea, and sensitivity to light and sound, often requiring rest. A zero percent rating is assigned when the headaches are diagnosed as service-connected but are less frequent or non-prostrating, meaning they cause minimal impairment.
The maximum fifty percent rating is reserved for cases involving very frequent, completely prostrating, and prolonged attacks. The term “completely prostrating” suggests a total inability to engage in normal daily activities during the migraine episode. To qualify for the fifty percent rating, the condition must be productive of “severe economic inadaptability,” meaning the migraines significantly interfere with the Veteran’s ability to maintain a steady work schedule or hold employment.
Establishing Service Connection and Required Evidence
Receiving any VA disability rating for migraines requires establishing a “service connection,” which links the current diagnosis to military service. Three specific elements are necessary to prove a direct service connection:
- A current medical diagnosis of migraines from a qualified healthcare professional.
- Evidence of an in-service event, injury, or illness that occurred during military service.
- The “Nexus,” which is a medical opinion linking the current migraine diagnosis to the in-service event.
The nexus is typically established by a medical professional, often the Compensation and Pension (C&P) examiner, who must state that the current condition is “at least as likely as not” caused by or related to military service. Veterans can significantly strengthen their claim by providing thorough and specific evidence, particularly a detailed headache log or journal. A headache log should document the date, time, duration, and severity of each attack, noting whether it was prostrating and how it impacted the ability to work or perform daily tasks.
The C&P examination is a crucial part of the process, as the examiner uses the information presented to complete a Disability Benefits Questionnaire (DBQ). During this exam, it is important for the Veteran to accurately describe the frequency of prostrating attacks and the functional limitations they cause. Medical records, headache logs, and statements from family or employers can provide supporting evidence that substantiates the severity and frequency of the migraines.