VA Migraine Claim Guide: Get the 50% Rating (DC 8100)

Key takeaways

• Migraine ratings under DC 8100: 50% for very frequent prostrating attacks with severe economic inadaptability, 30% for monthly prostrating attacks, 10% for attacks every 2 months.
• "Prostrating" means total incapacitation—you must lie down in a dark room, unable to function, often for hours or days. Document this clearly.
• Secondary connection is common: migraines often develop from service-connected tinnitus, PTSD, TBI, or neck injuries. A nexus letter is essential.

Situation Brief

Migraines rank among the top 10 most common VA disability claims, yet many veterans settle for lower ratings because they don't understand the criteria or fail to document attack severity. The difference between 30% and 50% often comes down to evidence quality—specifically, proving your attacks are "completely prostrating" and cause "severe economic inadaptability."¹

Prep Checklist

Before you file or reopen, stack the evidence that proves your migraines are service-connected, frequent, prostrating, and economically impactful.

• File an Intent to File (VA Form 21-0966) to lock in your effective date while you gather migraine evidence.
• Start a detailed migraine diary: date, time, duration, symptoms, triggers, medications taken, and activities disrupted. Use a notes app or printable template.
• Obtain a formal migraine diagnosis from a neurologist or primary care physician—ensure the records use specific diagnostic language.
• Request a completed Migraine Disability Benefits Questionnaire (DBQ) from your treating physician describing frequency and severity.
• Collect prescription records: triptans, preventives (topiramate, propranolol), anti-nausea medications, and any emergency room visits for migraines.
• Gather employer documentation: sick leave records, FMLA paperwork, performance reviews mentioning attendance, or termination letters citing health.
• For secondary claims: obtain a nexus letter from your provider stating migraines are "at least as likely as not" caused or aggravated by your service-connected condition.
• Prepare lay statements from family or coworkers who have witnessed your incapacitation during migraine attacks.

If claiming secondary to tinnitus, review the tinnitus playbook for evidence strategies that support both conditions.

Step-by-step playbook

1. Document migraine frequency and severity: Start a migraine diary tracking every attack: onset, duration, symptoms (photophobia, nausea, aura), triggers, and exactly what you couldn't do. Note if you had to lie down, leave work, or cancel plans.
2. Establish service connection: For direct claims, link migraines to an in-service event (blast exposure, head injury, stress). For secondary claims, connect them to an already service-connected condition like tinnitus, PTSD, or TBI with a nexus letter.
3. Get the diagnosis documented: Obtain a formal migraine diagnosis from a neurologist or physician. Ask them to describe attacks as "prostrating" if accurate. Request a completed Migraine DBQ before filing.
4. Compile employment impact evidence: Gather sick leave records, FMLA documentation, emails about leaving work early, and any performance issues tied to migraines. The 50% rating requires "severe economic inadaptability."
5. Write your lay statement: Describe your worst migraine days in vivid detail: lying in bed for hours, unable to tolerate light or sound, vomiting, missing important events. Use the word "prostrating" if it accurately describes your incapacitation.
6. Prepare for the C&P exam: Bring your migraine diary, medication list, and work impact documentation. Describe frequency precisely (e.g., "15-20 days per month"). Don't minimize symptoms or describe an average day—describe your worst.

Keep your migraine diary current and aligned with treatment records. Inconsistencies between your diary, medical records, and C&P exam statements can undermine your claim.

Evidence Arsenal

Organize your proof so the rater can trace migraine frequency, severity, and work impact without guessing.

Key terminology: "Prostrating" means total incapacitation—you must lie down, often in a dark/quiet room, unable to perform any activities. "Economic inadaptability" means your migraines interfere with your ability to maintain employment. Use these terms accurately in your evidence.

Intel & Tools

Migraine ratings hinge on frequency, severity, and documented work impact. Consistency is everything.

• Use "prostrating" precisely: the VA looks for this word when assigning 30% and 50% ratings. If your migraines truly incapacitate you, use it in your diary, lay statement, and at the C&P exam.
• Quantify frequency: "I get migraines 15-20 days per month" is more compelling than "frequent migraines." Track exact numbers in your diary.
• Document "severe economic inadaptability": the 50% rating specifically requires proof that migraines interfere with your ability to work. Sick leave, FMLA, and termination records are powerful evidence.
• Secondary connection is common: the American Migraine Foundation recognizes links between migraines and tinnitus, PTSD, and TBI. Get a nexus letter citing medical literature.
• Don't minimize at C&P: describe your worst days, not an average day. Examiners sometimes use minimized statements to justify lower ratings.
• Consider secondary conditions: chronic migraines can lead to depression, anxiety, or insomnia. File secondary claims for additional compensation if applicable.

Update your migraine diary consistently and bring it to every medical appointment. Treatment records that align with your diary strengthen your claim significantly.

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