How VA Rates Migraines

VA evaluates migraines under 38 CFR 4.124a, Diagnostic Code 8100. The criteria focus on the frequency and severity of attacks. Documented evidence should describe how often attacks occur, how long they last, what treatments are required, and their functional impact on daily life and work.

The rating heavily depends on whether migraine attacks are prostrating. Frequency matters: higher ratings often require more frequent prostrating attacks over a period of months. If the record does not clearly describe whether attacks are prostrating, VA may have less evidence to support a higher tier.

At the highest tier, VA looks for very frequent, completely prostrating, prolonged attacks that are productive of severe economic inadaptability. This does not necessarily require total unemployability, but the evidence should show serious work or economic impact, such as missed work, reduced reliability, major accommodations, or inability to maintain normal activity during attacks.

A diagnosis alone does not determine the rating. Helpful evidence includes a detailed headache log, treatment notes, medication history, and statements describing the functional and economic impact of the migraines.