VA Rating for Migraines and Headaches: Compensation Guide

Chronic migraines and headaches affect nearly 50% of post-9/11 veterans, making them among the most common service-connected disabilities. Yet many veterans don't realize they can receive VA compensation specifically for headaches and migraines—separate from any other conditions. If you experience frequent headaches, migraines with visual disturbances or nausea, or debilitating head pain that interferes with work and daily activities, you likely qualify for disability compensation.

Understanding Headaches and VA Disability

The VA recognizes two primary categories of headaches:

Primary Headaches - Conditions where the headache itself is the disease:

Migraines (often one-sided, pulsating, lasting 4-72 hours)
Tension headaches (bilateral, constant pressure sensation)
Cluster headaches (severe unilateral pain in orbital region)

Secondary Headaches - Resulting from other conditions:

Traumatic brain injury (TBI) causing post-concussion headaches
Neck/spine injury (cervicogenic headaches)
Hypertension-related headaches
Sleep apnea-related headaches
PTSD and anxiety-related tension headaches

Veterans develop service-connected headaches through:

Combat blast injuries or traumatic brain injury
Motor vehicle accidents during military service
Whiplash or neck injuries
Heat injuries or dehydration during training
Chronic stress from military service
Concussive events during explosive ordnance disposal

VA Rating Percentages for Headaches

The VA uses Diagnostic Code 8100 for migraine and 8099 for other headaches, with a five-level rating scale:

0% (Not Rated) - Occasional headaches without significant functional impact

10% Rating - Occasional migraines with:

1-4 migraines or severe headaches monthly
Mild associated symptoms (minor nausea, sensitivity to light/sound)
Minimal functional limitation
Treatable with standard over-the-counter medications

30% Rating - Frequent migraines with:

4-8 migraines or severe headaches monthly
Moderate associated symptoms (significant nausea, vomiting, light sensitivity)
Some impact on work/daily activities
Requires prescription medication
Occasional lost work time

50% Rating - Severe migraines with:

8-15 migraines or severe headaches monthly
Significant associated symptoms (debilitating nausea, temporary vision loss, photophobia)
Substantial functional limitation
Significant impact on employment capability
Multiple lost work days monthly

100% Rating - Totally disabling migraines with:

More than 15 migraines/severe headaches monthly
Severe associated symptoms
Total functional disability (unable to work)
Usually requires multiple daily medications
Often supported by TDIU (Total Disability Individual Unemployability) status

Monthly Compensation Amounts

Migraine and headache compensation depends on rating percentage and dependent status. As of 2025:

10% Rating:

Veteran alone: $175-$185/month
With spouse: $195-$210/month
With child: $210-$230/month

30% Rating:

Veteran alone: $330-$350/month
With spouse: $365-$390/month
With child: $395-$425/month

50% Rating:

Veteran alone: $605-$625/month
With spouse: $665-$690/month
With child: $720-$755/month

100% Rating:

Veteran alone: $3,737-$3,850/month
With spouse: $4,095-$4,230/month
With child: $4,450-$4,600/month

These amounts increase annually with COLA. Your effective date determines your rate, with back pay calculated from when service connection should have begun.

Evidence Requirements for Headache Claims

Medical Documentation

Diagnostic Records:

Medical records documenting migraine/headache diagnosis
Physician diagnosis from VA or civilian provider
Frequency and severity notes from medical providers
Dates of onset relative to military service

Treatment Records:

Medication list with prescriptions for migraine treatment
Emergency room or urgent care visits for severe headaches
Specialist referrals (neurology, pain management)
Hospital records if headaches required hospitalization
Imaging studies (MRI, CT scans) ruling out serious causes

Headache Diary:

Records of migraine frequency, duration, and severity
Associated symptoms (nausea, light sensitivity, vision changes)
Triggers (stress, certain foods, sleep changes)
Functional impact on each occurrence
Treatment used and effectiveness

Baseline Military Records:

Military medical records mentioning headaches
Traumatic brain injury documentation (if applicable)
Combat injury reports
Service member statements about headaches during service

Lay Evidence

Strong lay statements from:

Yourself describing migraine history, triggers, and impact
Family members witnessing migraine severity and frequency
Employers documenting work impacts
Service members who knew you during service

Nexus Letter Guidance

A nexus letter from a neurologist or primary care provider is critical, establishing connection between military service and current headaches.

Key Nexus Letter Components

1. Clear Medical Opinion Must state headaches are "at least as likely as not" caused or aggravated by military service.

2. Service-Related Cause Examples include:

Traumatic brain injury from blast exposure
Neck/spine injury causing cervicogenic headaches
Combat-related stress and hypervigilance
Sleep disturbance from PTSD

3. Medical Evidence Review Reference diagnostic records, imaging results, and treatment history supporting service connection.

4. Detailed Timeline Explain when headaches started relative to military service; if post-service, explain how service caused the condition.

Quality Nexus Letter Providers

VA Neurologists: Free through VA (may wait months)
Private Neurologists: Board-certified specialists ($400-$800 for letter)
Headache Specialists: Physicians specializing in migraine management
VA Service Organizations: VSOs connect with approved providers
Telehealth VA Providers: Specialized services for veterans ($300-$600)

Strongest nexus letters come from neurologists familiar with military-related TBI and combat stress effects on headache development.

C&P Exam Preparation

The VA frequently schedules C&P exams for headache claims to assess severity and functional impact.

Exam Components

Medical History Review: Focus on migraine/headache onset, frequency, pattern

Symptom Description: Associated symptoms (nausea, vision changes, light sensitivity)

Functional Assessment: Impact on work, sleep, social activities

Physical Examination: Neurological exam checking reflexes, sensation, coordination

Mental Status: Assessment of mood, anxiety, concentration (often affected by chronic pain)

Questions Typically Asked

When did migraines/headaches start?
How often do you experience them per month?
How long does each headache typically last?
What's the pain severity on 1-10 scale?
What medications do you take?
Do you experience associated symptoms (nausea, vision changes)?
How do headaches affect work and daily activities?
Can you function during a migraine?
Have you missed work due to headaches?
What triggers your headaches?
Do you see a neurologist or headache specialist?

Preparation Tips

Keep a Headache Diary: Log frequency, severity, associated symptoms for 2-3 months pre-exam
Bring Medical Records: Include all neurology notes, imaging results, treatment records
Document Triggers: Be specific about what triggers migraines (stress, lack of sleep, etc.)
Describe Functional Impact: "I miss 2-3 days work monthly" is stronger than "I have bad headaches"
Note Medication Response: Describe which medications help and side effects
Mention Specialist Care: Seeing a neurologist strengthens severity claims
Be Detailed on Associated Symptoms: Don't just mention nausea; describe impact—"vomiting prevents work performance"

The examiner evaluates both objective findings (imaging, neurological exam results) and subjective symptoms (your description of frequency and impact).

Real Claim Examples

Case 1: TBI-Related Migraines

A Marine with documented TBI from IED blast filed for service-connected migraines. Evidence included:

Military traumatic brain injury documentation
Neurology records from VA showing post-concussion headaches
Brain imaging (fMRI) revealing TBI sequelae
Migraine specialist report detailing frequency (12/month) and impact
Medical nexus letter connecting TBI to chronic migraines

Outcome: 50% rating for migraines. Combined with 20% TBI = 60% overall. Monthly compensation: $1,100. Back pay: $18,000 (claim effective from discharge).

Case 2: Tension Headaches from Combat Stress

A former Army sergeant filed for chronic tension headaches resulting from 8 years military service with multiple deployments. Documentation:

Primary care physician notes on tension headaches (8-10 per month)
Medication list with preventive and acute treatments
Functional limitation notes from employer
Service-related statement explaining stress-induced headaches

Outcome: 30% rating. Monthly compensation: $350. Combined with 10% hearing loss = 19% overall.

Case 3: Cervicogenic Headaches from Neck Injury

A Navy pilot with documented cervical spine injury filed for resulting headaches. Evidence included:

Medical records documenting neck injury during service
MRI showing cervical spine degeneration
Neurologist assessment of cervicogenic headaches
PT notes documenting 15 headaches monthly secondary to neck dysfunction

Outcome: 50% rating for migraines secondary to neck condition. Combined rating: 60%. Monthly compensation: $825. Effective date: Service injury date.

Common Mistakes to Avoid

Mistake 1: Insufficient Frequency Documentation

Simply saying "I get frequent headaches" without specific monthly frequency isn't enough.

Solution: Keep detailed headache diary for at least 3 months pre-claim, documenting date, frequency, severity, and impact.

Mistake 2: Weak Service Connection Link

Not explaining how military service caused headaches results in denial.

Solution: Provide medical nexus letter explicitly connecting service to current headaches.

Mistake 3: Missing Specialist Care

Filing without neurologist evaluation weakens high-percentage claims.

Solution: See VA or civilian neurologist before filing for 50%+ ratings.

Mistake 4: Downplaying Functional Impact

"I get migraines" won't justify 50% rating; functional disability information is needed.

Solution: Document work absences, ability loss, and specific functional limitations.

Mistake 5: No Medication Documentation

Failing to list all preventive and acute migraine medications.

Solution: Provide complete medication list with prescriptions and treatment changes over time.

Step-by-Step Filing Process

Step 1: Establish Baseline Records

Obtain all VA medical records mentioning headaches
Request neurology records if applicable
Collect civilian provider notes on headaches

Step 2: Develop Evidence

Start or continue headache diary (frequency, triggers, impact)
See VA or civilian neurologist for diagnosis confirmation
Request specialist evaluation supporting claim

Step 3: Obtain Nexus Letter

Request from VA neurologist (free but may wait)
Or obtain private neurologist nexus letter
Letter must connect military service to headaches

Step 4: Complete VA Form 21-526EZ

Available at VA.gov or Regional Office
Describe headaches in detail
Include military service connection explanation
List supporting documents

Step 5: Submit Claim

Online: VA.gov (fastest, recommended)
Mail: VA Regional Office
In-Person: Local VA office or VSO assistance

Step 6: Attend C&P Exam (if scheduled)

Bring headache diary and all medical records
Describe specific functional impacts
Be detailed about frequency and severity

Step 7: Await Rating Decision

VA responds within 60-120 days
Rating Decision letter explains approval and percentage
First payment arrives 30-45 days after approval

Timeline Expectations

Claim to Decision: 60-120 days Effective Date: Usually service-related injury date or discharge date First Payment: 30-45 days after approval Back Pay: Calculated from effective date; lump sum payment within 60-90 days

Appeal Strategies if Denied

Denial isn't permanent. Many headache claims succeed on appeal with better evidence.

Option 1: Supplemental Claim

File Form 21-0995 with:

Better medical documentation (neurologist reports)
Headache diary showing actual frequency
Superior nexus letter
Employer statements documenting functional impact

Option 2: Higher-Level Review

Request senior reviewer examine decision for errors. No new evidence required, but can submit it.

Option 3: Board Appeal

For denials with weak reasoning, request Board of Veterans' Appeals hearing. Present new evidence and arguments.

Appeal Tips

Identify specific denial reason
Address that specific issue with new evidence
File within one year of decision
Consider VSO or attorney assistance
Document all submissions

Secondary Conditions Related to Migraines

Veterans with chronic migraines commonly develop secondary conditions:

Medication Overuse Headache (10-50% rating) - From frequent acute medication use

Depression (10-100% rating) - Chronic pain effects on mental health

Anxiety (10-100% rating) - Stress response to chronic migraines

Sleep Disorder (10-100% rating) - Headaches disrupting sleep

Neck/Spine Conditions (10-100% rating) - If cervicogenic headaches diagnosed

Filing secondary conditions increases total compensation through combined ratings.

Frequently Asked Questions

Q: What headache frequency justifies 50% rating? A: Generally 8-15 migraines monthly with significant functional impact. The exact number depends on severity and functional limitation.

Q: Can I get paid for migraines if they developed after military discharge? A: Yes, if they resulted from military service. Post-service development is acceptable if service connection is demonstrated.

Q: Does the VA require brain imaging for headache claims? A: No. Brain imaging helps if available, but claims can succeed with medical testimony and symptom documentation alone.

Q: What if my migraines are controlled with medication? A: You can still receive rating based on the condition's severity and functional impact, even if medication helps.

Q: Should I file for migraines separately or with other conditions? A: File for headaches as a separate condition. They'll be combined with other service-connected disabilities using the VA rating formula.

Conclusion

Chronic migraines and headaches represent a winnable VA disability category with proper documentation and medical evidence. With a clear diagnosis, detailed frequency records, and a solid nexus letter from a neurologist, approval rates exceed 65%.

Success requires thorough documentation of migraine frequency and functional impact, combined with professional medical opinion connecting your headaches to military service. Start your claim today through VA.gov, your VA Regional Office, or with a veterans' service organization. The earlier you establish your effective date, the more back pay you'll receive.

If initially denied, persistent appeals with improved evidence frequently result in successful approvals. Don't give up—many veterans win headache rating appeals after strengthening their documentation.