What is the VA rating system used to determine disability for migraines?

Migraine headaches are recognized by the United States Department of Veterans Affairs (VA) as a service connected disability if you can prove that your military service caused or aggravated your headaches. When filing a claim, you need to show that an event or incident took place during your service that caused your migraines; that the migraines began while you were in service; or were caused by another condition that is service related.

In general, the VA rates migraines based on how often you experience them and their severity. Because headaches are difficult to assess because they’re not easily diagnosed like a cancer, high blood pressure, or an eye problem, the VA gives headaches four possible ratings to determine their seriousness and eligibility for compensation and benefits.

The VA Rating System for Migraines

When a VA ratings specialist examines your disability claim, he looks for evidence that your migraine is “prostrating”—a word used to characterize how serious your headache needs to be to be eligible for disability. A prostrating migraine means you Migraine headaches can qualify for disability benefits from the VA under certain circumstances.experience extreme weakness and you must lie down for an extended period of time. When assessing your condition, the VA assigns one of four possible ratings to your headache based on their frequency and severity.

To ensure that your migraine is properly rated, you need documentation that your headache is actually a migraine. Your medical records need to show a diagnosis of migraines from a qualified medical specialist—preferably a neurologist, an ophthalmologist, or a migraine specialist. However, you need to have more than a diagnosis. Your records must show evidence of the frequency and severity of your attacks. It’s a good idea to keep headache diaries and provide employment records that indicate how often you missed work due to a migraine.

In general, you’ll receive a 0 percent rating if your migraines are not prostrating, or they occur less than once every two months. Thus, if your migraines are infrequent and don’t cause you to lie down, leave work, or incapacitate you, you probably won’t be eligible for disability. A rating of 50 percent is the highest you can get for migraines.

When assessing your claim, the VA ratings specialist uses the following criteria to determine the severity of your migraines and rate them:

  • 50 percent. A veteran receives this rating with “very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability.”
  • 30 percent. A veteran receives this rating with “characteristic prostrating attacks occurring on an average once per month over last several months.”
  • 10 percent. A veteran receives this rating with “characteristic prostrating attacks averaging one in two months over last several months.”
  • 0 percent. A veteran receives this rating with “less frequent attacks.”

What If My Migraines Interfere With My Ability to Work?

Because 50 percent is the highest rating for migraines, it indicates that the VA may not feel migraines completely interfere with someone’s ability to maintain employment. However, if you feel you’re unemployable because of your condition, and your headaches debilitate you to the extent that you cannot sustain normal, regular employment, you may be eligible for Individual Unemployability (IU). IU is part of a disability compensation program through the VA that will award 100 percent compensation to a veteran, even if his service connected disability was not rated at 100 percent. The criteria for IU includes the following:

  • Due to his service connected disability, the veteran is unable to sustain “substantially gainful employment.” The VA does not consider minimal or minor jobs such as odd jobs under that term.
  • The veteran must have a service connected disability that was rated at 60 percent or higher.
  • The veteran must have two or more service connected disabilities, and at least one of them was rated at 40 percent or higher. Their combined rating must be 70 percent or higher.

What to Do If You Don’t Meet the Criteria for Individual Unemployability

It’s possible that you may not meet any of the listed criteria for IU eligibility. If so, special consideration may still be given to your claim if you can show that your disability demonstrates unusual or exceptional circumstances that interfere with your earning ability. For example, if your condition requires frequent hospitalization, and you’re unable to work in a consistent manner, this might be considered an exceptional situation. 

If you do receive IU compensation, you will be required to fill out an annual employment questionnaire in order for the VA to determine your continued eligibility.

The Importance of Documenting the Frequency and Severity of Your Migraines

When you visit your doctor about your migraines, it’s very important that you explain how often you’re experiencing them and if they are, in fact, prostrating. The more descriptive you can be about your symptoms and how you must respond to alleviate them, the better. If your medical report simply notes that you had two migraines each month, that doesn’t tell the VA ratings specialist much about your situation. But if your records detail your symptoms showing you had prostrating headaches requiring you lie in a dark, quiet room for days, you provide the ratings specialist with important information.

These details are critical because you will be rated based on what’s in your medical records. The VA specialist has more confidence and trust in what is printed in those records over what you may tell the VA administration directly.  

Our VA Disability Attorneys Can Help With Your Claim for Benefits 

If you suffer from migraine headaches you believe were caused by your military service, you may be eligible for benefits, and our VA disability attorneys may be able to help your claim. At Cuddigan Law, disability law is all we do, and we have over 50 years experience handling disability claims and appeals. We proudly represent veterans in Nebraska, Iowa, Minnesota, Colorado, Illinois, Missouri, and South Dakota. Contact us at 402-933-5405 to discuss your situation.

 

Sean D. Cuddigan
SSA and VA Disability Attorney in Omaha, Nebraska