VA Disability for Migraines: How Medical Evidence Makes the Difference 

Migraines are much more than a bad headache. They are a serious medical condition that can cause intense pain, nausea, and sensitivity to light and sound. For Veterans, these attacks can make it difficult to go about daily life or maintain steady employment.  

If your migraines began or worsened during your service, or if they are linked to a service-connected condition like TBI or PTSD, having strong medical evidence is the key to pursuing the disability benefits you may be medically, legally, and ethically eligible for. 

Connecting Your Migraines to Your Service 

If you believe your migraines are linked to your military service, Trajector Medical is here to support you in gathering the medical evidence that tells the true story of your condition. This evidence is essential as you move forward on your benefits journey. 

Direct Service Connection 

A direct service connection means your migraines began or got worse because of a specific event, injury, or exposure during your military service. Your medical evidence may include: 

• In-Service Notes: Documentation in your military medical records about a diagnosis of migraines or frequent headaches while in uniform. 

• A Specific Event: Medical notes or records linking your migraines to an event such as a head injury, blast exposure, or extreme stress during service. 

• Aggravation: Evidence that you had migraines before joining, but they became significantly worse during your service. The VA will look for proof that your service aggravated your condition beyond its natural progression. 

Secondary Service Connection 

Migraines can also be a secondary condition, meaning they are caused or aggravated by another service-connected condition. Common medical links include: 

• Traumatic Brain Injury (TBI): Many Veterans with a TBI also experience migraines. A 2018 study found that over 60% of service members with a history of TBI reported headaches afterward  

• PTSD and Other Mental Health Conditions: Research shows that conditions like PTSD, depression, and anxiety can trigger or worsen migraines. 

• Tinnitus: This condition, which causes ringing in the ears, can be linked to migraines. 

Building a Strong Medical Evidence Portfolio 

No matter how your migraines are connected to your service, the foundation of your medical evidence should include: 

• A recent diagnosis of migraines from a doctor. 

• Medical records that show the connection between your migraines and either a service event or another service-connected health issue. 

• A medical nexus letter. This is a professional medical opinion that explains how your migraines are linked to your service. 

How the VA Rates Migraines 

The VA uses a specific guide to rate migraines (38 CFR § 4.124a). Your rating depends on how often you have attacks, how severe they are, and whether they are “prostrating.” Here’s how the VA rates migraines: 

• 0% Rating: Service-connected migraines, but attacks occur less than once every two months. 

• 10% Rating: Prostrating attacks about once every two months. 

• 30% Rating: Prostrating attacks about once a month. 

• 50% Rating (Highest): Very frequent, prolonged, completely prostrating attacks that severely affect your ability to work 

What “Prostrating” Means 

A prostrating attack is a migraine so severe that it forces you to stop all activity. It often means you must lie down in a dark, quiet room because the pain and symptoms are overwhelming. For a 50% rating, the VA also looks for evidence that your migraines make it difficult to maintain steady employment. This does not mean you must be unemployed, but your migraines may cause you to miss work or struggle with productivity and reliability.  

Your medical records should document extreme exhaustion, powerlessness, debilitation, or incapacitation that results in substantial inability to engage in ordinary activities. 

Your Medical Evidence Checklist 

To assemble the strongest possible medical evidence, you can use the checklist below: 

• Recent diagnosis from a doctor or neurologist 

• All relevant medical records: 

• Military medical records showing headaches, TBI, or PTSD 

• Civilian medical records describing how your migraines have changed over time 

• Migraine journal (dates, duration, severity, symptoms, coping methods) 

• Medical nexus letter (doctor’s opinion explaining the connection) 

• Personal statements (from you and those who have witnessed your migraines)
  
  

Secondary Conditions and TDIU for Migraines 

Migraines, especially at the 50% rating, can significantly impact your ability to maintain employment. If your service-connected migraines—alone or combined with other disabilities—prevent you from keeping a steady job, you may be eligible for Total Disability Individual Unemployability (TDIU). TDIU can pay you at the 100% disability rate, even if your total rating is less than 100%. 

Migraines can also lead to other health problems that may be considered secondary service-connected conditions, such as depression, anxiety, or sleep disturbances. Understanding these connections is key to pursuing the benefits you are medically, legally, and ethically eligible for. 

“Understanding VA Secondary Conditions: A Guide for Veterans.” 

Your Pathway to Stronger Evidence  

Migraines are often misunderstood and under-recognized. As a Veteran, your experiences deserve acknowledgment, and the right medical evidence is your most powerful tool. 

Clear and concise medical documentation is crucial for the success of any disability case. If you’re unsure about your documentation, talk to one of our licensed medical experts for FREE.