Migraines are one of the most under-rated VA disabilities. Veterans often receive 0% or 10% when their actual frequency and severity warrants 30% or 50%. The difference comes down to documentation and understanding exactly what the VA is measuring.
The Key Word: Prostrating
The VA’s migraine rating criteria hinges on the word “prostrating” — meaning attacks severe enough to prevent normal activity, requiring you to stop what you’re doing and lie down. A headache that hurts but lets you continue working is not a prostrating migraine in the VA’s definition. A migraine that forces you to stop working, close yourself in a dark room, and wait it out is.
If your migraines are prostrating, say so explicitly in your claim and your C&P exam. Don’t describe your migraines as “bad headaches.” Describe what they force you to stop doing.
The Frequency Thresholds
The gap between 10% and 50% in the migraine rating schedule seems small on paper — it’s the difference between “once a month” and “very frequent.” In practice, the 50% threshold requires documenting that your migraines are so frequent and severe they create economic inadaptability — meaning you regularly miss work, have reduced performance, or cannot maintain consistent employment because of them.
Keep a headache diary. Note the date, duration, severity, what you couldn’t do during the attack, and any medication taken. Six months of consistent diary entries is powerful evidence at a C&P exam.
Secondary to Service-Connected Conditions
Migraines are frequently successfully connected as secondary to PTSD, TBI, cervical strain, and sleep apnea. If you already have a service-connected condition that’s known to trigger migraines, a nexus letter from your treating physician can establish the secondary connection without needing to prove the migraines themselves occurred in service.
TDIU and Migraines
If your migraines are severe enough that they prevent you from maintaining substantially gainful employment, you may qualify for Total Disability Individual Unemployability (TDIU) — which pays at the 100% rate regardless of your combined rating. This is particularly relevant for veterans with 70%+ combined ratings where migraines are the tipping factor keeping them from work.
Do I need medical records showing in-service migraines?
Not necessarily. Many migraines begin after service as a result of service-connected conditions. If you can establish a nexus between your migraines and a service-connected condition, the in-service trigger doesn’t need to be documented.
What’s the difference between 30% and 50% for migraines?
The 50% rating requires very frequent completely prostrating attacks that produce severe economic inadaptability — meaning your migraines significantly impact your ability to hold steady employment. The 30% rating is for characteristic prostrating attacks averaging once a month without reaching that level of economic impact.