The VA updated rating for headaches, and we have the details you need to know. Instead of reading through the VA's lengthy web page about neurological and convulsive disorders, keep reading this blog for our simple breakdown of what this means for your VA disability claim.
Here's what Veterans with migraine headaches need to know:
What are the evaluation criteria for migraine headaches?
The VA evaluates migraine headaches based on the criteria of 38 CFR 4.124a, DC 8100. Simply put, migraine headaches are evaluated based on the following:
The frequency of attacks
The degree to which symptoms are prostrating (read on for details)
All other symptoms experienced as a result of migraine attacks
Economic impact of the migraine attacks
The updates are based on the precedent case Holmes v. Wilkie, 33 Vet.App. 67 (2020), where the VA MUST contemplate more than merely headache symptoms and provide clarification on key terms in the rating criteria.
What does "prostrating" mean in regards to migraine headaches?
In the context of migraine headaches for VA disability benefits, "prostrating" means "causing extreme exhaustion, powerlessness, debilitation or incapacitation with substantial inability to engage in ordinary activities."
A Veteran's migraine headaches might be severe enough to be classed as "completely prostrating", which means: "extreme exhaustion or powerlessness with essentially total inability to engage in ordinary activities."
Veterans typically fail to show prostration because they rely solely on lay evidence, but that evidence is not considered “credible”. The VA requires medical evidence to establish that the reported symptoms are due to the SC migraine headaches.
What does "economic impact" mean in regards to migraine headaches?
“Severe economic inadaptability” is how the VA talks about economic impact and it is defined as a degree of substantial work impairment. It does not mean the individual is incapable of any substantially gainful employment.
This can be demonstrated by lay statements, but like proving prostration, you need medical evidence to support the statement to make it credible. This is easier than you think. It can be as easy as showing use of sick time, evaluation reports from work showing the impact of your headache condition, or even a statement from your employer.
Frequency as a qualifier for migraine headaches
The VA splits migraine headaches into two categories for rating purposes: Less Frequent and Very Frequent. The difference between those two categories is as follows:
Less Frequent: "Characteristic prostrating attacks, on average, are more than two months apart over the last several months."
Very Frequent: "Characteristic prostrating attacks, on average, are less than one month apart over the last several months."
Keeping a Headache Journal for VA disability claim purposes
The VA accepts self-written "headache Journals" as credible lay testimony regarding frequency, prostration, and occupational impairment – such as the need to leave one's work day due to a headache. Keeping a record of the days you experience headaches, and their intensity, is a great way to build evidence for your VA disability benefits claim. Just make sure you have the necessary medical evidence to accompany your claim, too.
Start by organizing your Nexus Letter or DBQ today
Filing a claim for VA disability benefits is much easier and efficient when you're prepared with expert documentation. We can help you with private medical opinions that make a difference. Ready to get started? Schedule an appointment for a chart review with one of our experts, or view our other services. Help is just a call away.