Did you know you can claim migraines secondary to anxiety for VA benefits?
Here at VA Claims Insider, we refer to secondary claims as “the Overlooked Claim” because so many veterans overlook this opportunity to file for more benefits.
According to the American Migraine Foundation, about 20% of people with episodic migraines have anxiety, and somewhere between 30-50% of people with chronic migraines also have anxiety. Those are huge numbers!
Dawn Buse, Ph.D., the director of behavioral medicine at the Montefiore Headache Center and an associate professor in the Department of Neurology at Albert Einstein College of Medicine in New York states that “It’s very logical when you’re living with a chronic disease like migraine, which is affecting your life in such a big way, that you’re going to feel sad, down and frustrated about how it’s affecting your life.”
Although the medical field is still not sure what the link is between the two, there is no doubting the connection. For instance, no one knows yet if migraines cause anxiety or vice-versa. However, there is simply no ignoring the substantial evidence pointing to them being linked. This is powerful information for a veteran, considering the large amount of people who suffer in our population. Understanding this connection can assist you with filing primary and secondary claims.
Dr. Buse continues, “We think there might be some underlying reason, maybe a genetic reason, or the fact that both depression and migraine act off similar biochemicals in the brain and in the body that predisposes someone to have one, and then the other.”
Some believe that it has to do with how the brain works, especially with regard to serotonin levels.
So what does this mean for veterans looking to claim migraines as secondary to anxiety in their VA claims?
Getting Rated for Veteran Anxiety
First of all, you must already be rated for anxiety. It’s estimated that around 20% of current veterans struggle with anxiety, stress or depression, meaning that the VA already grants many different claims for these disorders.
In fact, from 2000 to 2012 the reports of anxiety disorders from service members increased by 327%! (report)
So if you have a diagnosis of anxiety and need to get rated, you are definitely not alone.
Anxiety can be rated all the way from 0 to 100%. To have an idea of what to expect for your anxiety rating, here is a breakdown of how the VA determines which rating to give anxiety:
- 0%: No compensation is awarded due to symptoms not being considered severe enough to interfere with social or occupational functions. At this rating, continuous medication is not considered to be needed. However, a medical condition is formally diagnosed.
- 10%: It is recognized that mild or transient symptoms are contributing to a decrease in working tasks during periods of significant stress; or, that symptoms can be controlled by continuous medication.
- 30%: The VA recognizes social and occupational impairment due to symptoms such as depressed mood, mild memory loss, anxiety, panic attacks, or suspiciousness.
- 50%: There is considerable reduced reliability and productivity because of regular panic attacks, impaired judgment, difficulties with abstract thinking, lack of motivation, mood swings, difficulty maintaining healthy relationships, or trouble understanding anything more than most basic instructions.
- 70%: Major occupational and social deficiencies being experienced due to suicidal thoughts, obsessive rituals interfering with basic activities, frequent panic attacks, depression, neglect of hygiene, inability to deal with stressful situations, inability to establish or maintain effective relationships, or illogical speech.
- 100%: Complete occupational and social impairment due to; disorientation of time or place, frequent inability to perform daily activities, delusions or hallucinations, grossly inappropriate behavior, major impairment of thought process and communication, and memory loss of close relationships, current occupation, and personal attributes.
These are the standard ratings applied to any mental health condition recognized by the VA. The VA currently has no set guidelines for mental health ratings based on specific diagnoses. Therefore your rating could be extremely difficult to predict.
Generally speaking, the VA tends to provide low ratings for mental health issues. This means you should take your time in filling out a strong claim in order to get the best rating possible. You can do this by taking detailed notes of what your daily life looks like with anxiety.
Track your symptoms and explain what life was like for you before and now with the condition. Also we recommend to include buddy letters from your family, friends, and fellow service members as these help substantiate your claim. They are the people in your daily life who have witnessed how your condition affects you!
Finally, be well prepared for your C&P exam. Be straightforward in your answers but also be detailed. Do not stick to simple, “Yes” and “No” answers; be descriptive. Understanding how to put your symptoms into descriptive words prior to your exam will help ease your nerves on the actual day.
If you receive a 100% rating for anxiety, applying for a secondary rating will not provide any additional benefits to you. This is true even if you are also suffering from debilitating migraines.
But if your rating for anxiety is 70% or less, then it is time to seriously consider filing for a secondary claim if you have appropriate diagnoses connected with anxiety, like migraines.
Getting a VA Rating for Migraines
It’s been found that nearly 36% of veterans who went to Iraq were either diagnosed as having migraines or showed signs of it. The VA has noted that, by comparison, only 12 percent of the general population is affected by migraines.
In other words, veterans can experience migraines at a rate of 3x higher than everyone else!
Despite these numbers, it still can be difficult to have a claim granted for migraines since they are notoriously difficult to test for. Objective tests by doctors and medical experts can fall short, which means that you will need a lot of subjective evidence in order to file a strong claim.
This means having detailed medical records as well as your own logs and records of life before your migraines and what it’s like living with them. On top of that, you will want to have friends, family, and fellow service members write detailed buddy letters to describe what they have witnessed in regard to your migraine condition.
If your claim is granted, then you can expect to receive a rating in the range of 0 to 50%. The VA determines the ratings by using the following criteria:
- 50% – If you suffer from frequent, prolonged attacks that are fully prostrating (meaning you have to lie down), leaving you unable to work
- 30% – Prostrating attacks occur at an average of at least once per month over the course of a few months
- 10% – One prostrating attack for every two months
- 0% – Attacks are infrequent
The main effect the VA will be looking for in determining your rating is “prostrating.” Prostrating is when you are basically incapacitated during the duration of your migraines, forcing you to lie down until they pass.
At this time the VA will not rate the condition of migraines higher than 50%, although there are some ways to increase your benefits outside of the disability rating. For more info on that, you can check out How the VA Rates Chronic Migraines.
How Secondary Disability Ratings Work
Because migraines cannot receive as high a rating on their own as anxiety, your path to 100% disability compensation benefits is made easier by being rated for anxiety first.
This is because, with the system the VA uses, simple math doesn’t apply. For instance, if you received a 70% rating for anxiety, you would hope that a 30% rating would get you to 100%. And in most cases, that math adds up. But not with the VA.
With the VA’s complicated math the combination of 70% and 30% would get you to 80% disability compensation.
In fact, 70% for anxiety and 50% for migraines would still only get you to 90% total disability compensation!
“How is this possible?” you might be asking.
It’s because the VA doesn’t use a simple formula, but rather something called a “descending efficiency scale.” How it works is extremely complicated, which is why VA Claims has its own calculator for figuring out how your various disabilities can add up.
You can check it out HERE.
Getting Rated for Migraines Secondary to Anxiety
While there is enough evidence to know that migraines and anxiety are often connected, it can still be difficult to prove the connection for your VA claim since the connection is not obvious.
In preparing your secondary claim for migraines secondary to anxiety, you will want to gather as much subjective evidence as possible.
Go through your medical records to make sure they are detailed and accurate.
Then take your time to detail when you first began to experience the migraines after having anxiety. Do your best to explain how you believe they are linked because you will need to convince the VA that your anxiety led to the migraines occurring.
Remember, both anxiety and migraines, while disabilities recognized by the VA, are conditions that can be difficult to prove. Be sure to treat your secondary claim with the same care you gave to your first claim, and you should be fine.
If you feel like you could use some help, we have a great team here at VACI, full of VA Insiders ready and excited to help you get the most out of your claim!
*Quotes from Dr. Buse were pulled from the story, Understanding the relationship between migraine and mental health on www.americanmigrainefoundation.org