DC 8100: Migraine headaches are a type of headache caused by the swelling of the blood vessels in the brain. They are often more severe than other kinds of headaches (stress, sinus, etc.), and so interfere more with the individual’s ability to work and function in daily life. If another kind of headache interferes significantly with daily life, it can also be rated here.
Documenting Migraine Symptoms (07/17)
| Frequency | Severity | Rating |
|---|---|---|
| 2 or more times per month |
(or with very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability) | Prostrating | 50% | | Once a month | Prostrating | 30% | | Once every 2 months | Prostrating | 10% | | Once every 3 months or less
(*If the condition does not make occupational activity impossible, then it cannot be rated more than 0%) | Prostrating | 0% |
Extraschedular
The ratings for migraines only go up to 50%. The Rating Authorities, however, can give a higher rating if the case is so severe that 50% doesn’t truly reflect the disability (extraschedular). To receive a proper rating, it is essential that the physician records the frequency (how often they occur) and severity (how bad they are) of the migraines clearly along with how they affect the individual’s ability to work and function. In cases where migraine headaches meet the criterion of severe economic inadaptability and, additionally, the evidence shows that the claimant is incapable of substantially gainful employment due to the headaches, referral for consideration of an extraschedular award of a total evaluation based on individual unemployability is appropriate.
<aside> 🔑 “Severe Economic Inadaptability” - Severe economic inadaptability denotes a degree of substantial work impairment. It does not mean the individual is incapable of any substantially gainful employment. Evidence of work impairment includes, but is not necessarily limited to, the use of sick leave or unpaid absence. See Pierce v. Principi*,* 18 Vet. App. 440 (2004).
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<aside> 🔑 "Prostrating" - The term “prostrating” means that the individual must stop all activity, take medication, and either seek medical attention or lie down and seclude himself for the rest of the day. The individual is unable to perform any occupational or daily activities either because of the migraine itself or because the migraine medication makes him too drowsy, etc.
Note: For VA purposes, the term prostrating means "causing extreme exhaustion, powerlessness, debilitation or incapacitation with substantial inability to engage in ordinary activities." Please complete both questions 4A and 4B — this is from the DBQ
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<aside> 📌 Pro Tip: Lay Statements About “Prostrating Attacks”
In order for the VA to consider an attack as “prostrating”, the veteran should include in his statement that he needs to lie down. A prostrating position refers to lying stretched out on the ground facing downward.
In a medical context, "prostrating" generally refers to extreme physical weakness or incapacitation, often due to illness or disease. A prostrating illness or condition is one that leaves a person extremely fatigued, weak, or unable to function normally.
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