How the VA rates migraines

The migraine schedule is four lines long and turns on a single word most veterans have never used to describe a headache. Learn the word, keep the log, and the rating follows.

Last reviewed August 2026 · Not legal advice, VA.gov always controls

Migraines are rated under diagnostic code 8100 in 38 CFR § 4.124a, the neurological section. Tension headaches, cluster headaches, and post-traumatic headaches after a TBI are generally rated by analogy to the same code, so this guide applies to most headache claims, whatever the diagnosis says.

The four tiers

Three things decide where you land: whether the attacks are prostrating, how often they happen, and at the top tier, what they do to your ability to work. Pain intensity on its own is not in the schedule. A veteran with daily moderate headaches who pushes through them can be rated 0%. A veteran with one attack a month that puts them in a dark room for six hours is at 30%.

What "prostrating" means

The regulation does not define it. The VA's adjudication manual and the courts have settled on the plain meaning: an attack that forces you to stop what you are doing and lie down, because you are physically unable to continue. Light and sound sensitivity, nausea, vomiting, and the inability to function until it passes are the markers. Taking a pill and carrying on at reduced speed is not prostration. Leaving work, closing the blinds, and losing the afternoon is.

The log is the evidence

Every tier is a frequency averaged "over the last several months." Nobody can reconstruct that from memory in a twenty-minute exam, and medical records rarely capture it either, because people do not go to the doctor for every migraine. That leaves one piece of evidence that actually answers the question the schedule asks: a headache log.

Keep it simple and keep it consistent. For every attack, record the date, how long it lasted, whether you had to lie down, what you missed because of it (work, a shift, a school pickup), and what you took. A log kept for six months before the exam is worth more than any letter, because it is contemporaneous and specific, and it converts directly into the "average once a month" language the rater needs.

Bring a copy to the C&P exam and submit a copy with the claim. Examiners are allowed to rely on it and frequently do. A log that shows fourteen prostrating attacks in six months is a 30% rating written in your own hand.

The 50% tier and "severe economic inadaptability"

The top tier adds two requirements beyond frequency: the attacks are completely prostrating and prolonged, and they are productive of severe economic inadaptability. The second phrase caused years of confusion, because raters read it as requiring that you be unemployed.

The Veterans Court rejected that in Pierce v. Principi (2004). "Productive of" means capable of producing, not has already produced. A veteran who is still employed, but only because an employer tolerates missed days, reduced hours, or a role that accommodates the attacks, can meet the standard. What the evidence has to show is that the migraines are severe enough to make holding ordinary employment seriously difficult. Employment records, a supervisor's statement, sick-leave balances, and the log all speak to this.

Service connection for headaches

Migraines are commonly claimed on three theories:

• Direct. Headache complaints in your service treatment records, even one visit, give the nexus something to attach to. Look for "HA," "cephalgia," or "tension headache" in sick-call notes; the diagnosis does not have to say migraine.
• Secondary. Migraines are frequently claimed as secondary to PTSD, anxiety, or depression, to neck conditions, to tinnitus, to sleep apnea, or to medications prescribed for a service-connected condition. Each needs a medical opinion explaining the mechanism in your case. The secondary conditions guide explains what that opinion has to say.
• TBI residual. Headaches after a documented head injury or blast exposure can be rated as a residual of TBI. When they are, they are often rated separately under DC 8100 rather than folded into the TBI rating, because the schedule's TBI note says residuals with their own code get their own rating.

Migraines in the combined rating

A 30% migraine rating added to an existing 70% combines to 79%, which rounds to 80%. A 50% rating added to 70% combines to 85%, rounding to 90%. Because headache ratings tend to be underrated on first decisions, this is one of the conditions where an increase claim most often changes the combined number. The combined rating guide shows the arithmetic, and the calculator does it for you.

The checklist

1. A current diagnosis of migraine or headache disorder from a treating provider, with the treatment plan (preventives, abortives) documented.
2. A headache log covering at least the last several months: date, duration, prostrating or not, what was missed.
3. In-service headache complaints from STRs, or a nexus opinion on a secondary theory.
4. Employment evidence if you are claiming 50%: leave records, a supervisor's statement, accommodations.
5. Your own statement describing a typical attack in functional terms: what it stops you from doing, for how long.