How to Prove “Prostrating” Migraines for VA Disability Benefits: What Veterans Must Know!

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If you’re a veteran dealing with migraine headaches, you may be leaving thousands of dollars in monthly tax-free compensation on the table—simply because your migraines aren’t properly documented or clearly understood by the VA.

The good news?

The VA recently clarified its guidance for rating migraine headaches, especially when it comes to “prostrating” attacks.

These updates can help you understand better what it takes to get rated appropriately, especially at the 50% level.

In this article, VA disability expert Brian Reese reveals and explains what you need to know—and what evidence you’ll need to prove prostrating migraines to the VA.

Let’s begin!

Summary of Key Points

• VA migraine ratings range from 0% to 50%, with the highest rating reserved for veterans who suffer from very frequent, completely prostrating and prolonged attacks that cause severe economic inadaptability. You can still be employed and receive the 50% rating if your migraines significantly disrupt your ability to work.

• “Prostrating” migraines are defined by the VA as episodes that cause extreme exhaustion or incapacitation, while “completely prostrating” attacks leave you totally unable to function. These definitions help the VA determine the correct rating level based on symptom severity and impact on daily life.

• Medical and lay evidence are both critical. Medical records don’t need to use the word “prostrating,” but they must describe symptoms that meet the VA’s criteria. Lay statements from you, coworkers, or family members—combined with a detailed headache journal—can provide strong proof of frequency, severity, and functional impact.

• To prove “severe economic inadaptability,” veterans should document how migraines affect their ability to work: frequent sick leave, missed days, reduced productivity, or disciplinary action. Even if you’re still employed, credible documentation of work impairment can support a 50% VA rating.

What is the VA Rating for Migraine Headaches?

The VA rates migraine headaches under 38 CFR § 4.124a, Diagnostic Code (DC) 8100.

Your rating depends primarily on the frequency, severity, and duration of your migraine attacks and whether they cause prostration or interfere with your ability to work.

Here’s the VA rating schedule for migraines:

• 50% – Very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability

• 30% – Characteristic prostrating attacks occurring on average once a month over the last several months

• 10% – Characteristic prostrating attacks averaging one in two months over the last several months

• 0% – Less frequent attacks

The highest rating—50%—is reserved for veterans whose migraines significantly interfere with their ability to work.

Pro Tip: The 50% rating for migraines does not require a veteran to be unable to work. You can still be gainfully employed and get a 50% VA rating for migraines.

What’s the Difference Between “Prostrating” and “Completely Prostrating”?

The VA now defines these terms more clearly:

• Prostrating means the migraine attack causes extreme exhaustion or incapacitation with substantial inability to engage in ordinary activities. For example, you’re forced to stop everything and lie in a dark room for hours.

• Completely Prostrating means the attack causes total inability to function. You’re essentially unable to do anything at all—no walking, talking, reading, or eating—until the episode passes.

Here’s a real-world example:

Army veteran Mike suffers from migraines two to three times per week.

During these attacks, he experiences blinding head pain, vomiting, light sensitivity, and can’t move from bed for several hours.

He misses work at least once a week and has been written up for attendance issues.

This is a textbook case of completely prostrating migraines with severe economic inadaptability—and could qualify for the 50% VA rating.

Do You Need Medical Evidence for Prostrating Migraines?

Yes.

The VA needs medical evidence showing that your reported symptoms are linked to a formal migraine diagnosis.

However, medical records don’t need to use the exact word “prostrating.”

The key is that your medical documentation describes symptoms that meet the VA’s definition of a prostrating attack.

For example, your medical provider might write:

“Patient reports severe head pain, light sensitivity, nausea, and vomiting. During migraine attacks, the patient is unable to engage in any activity and must rest in a dark, quiet room for several hours. These symptoms are consistent with clinical presentations of migraines.”

That’s strong medical evidence—even if the term “prostrating” isn’t used.

Can Lay Evidence (Statements) Be Used?

Absolutely.

The VA accepts lay evidence—your personal testimony or statements from people who know you—as long as it’s credible and consistent with your medical diagnosis.

Let’s say you keep a headache journal, and your entries consistently describe the following:

• Migraine onsets with warning signs like flashing lights or tunnel vision

• You retreat to a dark room, unable to tolerate noise, light, or movement

• The pain lasts 4–8 hours and you can’t eat, talk, or engage in any activity

• You miss work the next day because of lingering symptoms

In addition, a coworker submits a written statement confirming that you’ve left work early or missed entire days due to migraine attacks.

This type of lay evidence, combined with medical records, can prove the prostrating nature of your migraines.

What is “Severe Economic Inadaptability?”

Severe economic inadaptability denotes a degree of substantial work impairment. 

However, it does not mean the individual is incapable of any substantially gainful employment. 

You can still be working and qualify for 50% if your migraines:

• Force you to use a significant amount of sick leave

• Cause frequent absences or leave early from work

• Impact your productivity or lead to disciplinary action

• Make it impossible to hold a consistent schedule

For example, Navy veteran Sarah works in healthcare but calls in sick at least 5 times a month due to migraines.

Her employer has issued warnings, and she’s worried about job security.

That’s severe economic inadaptability—and supports a 50% rating.

How Do You Prove Migraine Frequency, Severity, and Duration to the VA?

The frequency of your attacks is a factual determination and doesn’t require a trip to the ER every time.

In fact, many veterans don’t seek medical treatment for every attack, which is why a migraine journal is your best friend.

Include the following:

• Date and time of each migraine

• Symptoms experienced

• How long the episode lasted

• What activities you couldn’t do

• Whether it caused you to miss work or other responsibilities

You can also use migraine tracking apps or calendars.

Prescription refill history, supervisor letters, and even text messages to family or coworkers can further support your claim.

Conclusion & Wrap-Up

To win a VA disability rating for prostrating migraines, especially at the 30% or 50% level, you need to show how your condition affects your daily life and ability to work.

The VA wants to know about frequency, severity, duration, and negative impacts to your life and work.

Here’s what we recommend:

• Get a current medical diagnosis of migraines

• Track every attack using a headache log or mobile app

• Describe your symptoms and limitations clearly in a personal statement in support of a claim

• Include buddy letters from friends, family, or coworkers (first-hand witnesses only)

• Document how your migraines affect your work through leave records, HR reports, employer notes, or a supervisor statement

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