Veterans: How to Provide Evidence That Your Migraines Are “Prostrating”

Migraines are a serious issue for military personnel and veterans, and studies suggest that they are especially common in those deployed in Iraq. These migraines were found to negatively impact a soldier’s ability to perform military duties, and after returning home, they continued to be problematic.

The United States Department of Veterans Affairs (VA) recognizes that migraines may be a service connected disability. If you can prove that an event or incident during military service caused or aggravated your headaches, you may be eligible for VA Disability.

If you submit a claim to receive benefits for migraines, a VA ratings specialist will rate your headaches based on their severity and frequency using a ratings chart with four possible percentages: 0 percent, 10 percent, 30 percent, and 50 percent. A 50 percent rating is the highest rating given for migraines. This rating is only given if the migraine causes “very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability.”

The Significance of the Term “Prostrating” When Rating Migraines

In general, the term “prostrating” means that a person experiences extreme weakness due to his migraines and must lie down for a long period of time. The VA uses this word to characterize how severe the headache needs to be. Some claims for migraine disability have used the phrase “extreme exhaustion or powerlessness.” Basically, the VA will grant a 50 percent rating if you are incapacitated enough that your headaches disrupt your work, making you unemployable.

A VA ratings specialist examines your disability claim looking for evidence that your migraine is “prostrating”—that it forces you to stop what you’re doing and get medical attention. In the past, the VA required documentation that you left work and went to the emergency room. However, the obvious issue was that your doctor likely gave you a prescription for your migraines, and you would go home to take the medicine rather than visit the ER every time you suffered one.

Although documented trips to the ER are helpful in your case, the Army Physical Disability Agency (APDA) acknowledged that migraines were not treated in this manner. Thus, they established an exception to the necessary criteria for proving a prostrating migraine. It is no longer necessary for a veteran to visit the ER, as long as these conditions are met:

  • The veteran must have a valid diagnosis of migraines and a description of these migraines as they occurred in the past and occur in the present.
  • Evidence must show that the headache episodes meet the definition of “prostrating.”
  • The veteran must have tried to control his migraines through a “rational medical treatment program.”
  • The veteran must show compliance with treatment in the past and currently.
  • The veteran’s doctor must provide a written instruction plan that defines what the veteran must do when suffering from a migraine. This set of instructions must be included in the veteran’s health record. It’s best if a neurologist writes this plan.
  • The doctor’s plan must require the veteran to stop all activities and use the prescribed medication. This break in activity must interfere with the veteran’s work performance and be documented. If the veteran only needs to take a short rest period once a week, this will likely not meet the requirements.
  • Evidence must show that the veteran’s doctor reviewed the plan at least every six months.

If all of the conditions are met, you can get your migraine rated. The evidence that is helpful is a diary created by the veteran that shows the frequency and severity of the migraines. The veteran should report the same information to his physician.

Tell Your Doctor How Often Your Migraines Are “Prostrating”

It’s not only important to let your doctor know the frequency of your migraines, but also how often they are prostrating. The more detail you can provide about this, the better your chances are of receiving benefits. If your medical records indicate that you have a couple migraines a month, that doesn’t give the VA ratings specialist enough information to make a determination in your favor. But if your doctor documents that you had to lie down in a quiet, dark room for an extended period of time—perhaps for days—he provides evidence that your migraines were prostrating. And because a VA ratings specialist will rely more on what is in your medical records than what you tell the VA administration, these details are very important.

If you’re a veteran suffering from prostrating migraines due to an incident or event during your military service, you may be eligible for VA Benefits. Contact us at 402-933-5405 to discuss your case.

 

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