Migraine claims: document episodes and their real-life effects

Start with the diagnosis and treatment history

Headache symptoms can have different explanations. A clinician should assess the condition rather than having you choose a diagnosis from a rating table. VA’s headache questionnaire distinguishes migraines, tension headaches, cluster headaches, and other diagnoses. Collect the relevant clinical history, including when headaches began, how they have changed, and what treatment has been tried.

A practical starting folder contains the clinician’s assessment, treatment notes, medication list, and any test reports the clinician considers relevant. Include records from outside VA as well as VA care. Explain where records are missing instead of reconstructing medical findings from memory. Describe what treatment helps and what difficulties remain. Treatment decisions belong with your health care professional, independently of how a benefits claim might be evaluated.

Sources: VA: Headaches, including migraines, questionnaire (PDF) · VA: Evidence needed for a disability claim

Explain why the headache condition relates to service

Current headaches and a difficult deployment are not, by themselves, a complete explanation of service connection. Identify relevant service events, symptoms, treatment, or injuries and the evidence connecting them to the present condition. An old clinical entry can help establish timing, but the medical significance of that entry may still need professional assessment.

If you believe another service-connected disability caused or worsened the headaches, identify that disability and explain the sequence of events to your clinician or representative. Causation and aggravation are different questions. Having two conditions at the same time does not automatically establish either relationship. Keep copies of earlier and later treatment records when a change in severity is part of the claim, and distinguish your own observations from a clinician’s conclusions.

Sources: 38 CFR 3.303: Principles of service connection · 38 CFR 3.310: Secondary causation and aggravation

Keep an episode record that captures more than a count

A diary can help you remember a pattern between appointments. Keep it in a format you can maintain, such as a notebook or a simple calendar. Record entries close to the episode when possible; clearly label anything reconstructed later. There is no benefit in filling gaps with invented dates or assuming every headache has the same effect.

For each episode, note when it started, how long the disabling portion lasted, what you could and could not do, and when you resumed ordinary activities. Include treatment taken and its observed effect. Distinguish an episode that required stopping activity from discomfort you worked through. This is a practical way to organize evidence, not a VA-required diary format or a substitute for medical evaluation.

Sources: VA: Headaches, including migraines, questionnaire (PDF) · 38 CFR 4.124a: Migraine criteria under code 8100

Explain the interruption and recovery in ordinary words

The migraine criteria use the term prostrating. In its headache questionnaire, VA describes substantial incapacity associated with extreme exhaustion or debilitation. Instead of trying to adopt that word, describe what actually happened. Could you continue the task? Did someone take over? How long did the interruption last? Was there a separate recovery period afterward?

For example, in a hypothetical account, a veteran may stop preparing dinner during an episode and rely on a family member to finish it. The useful evidence is the specific limitation, its duration, and how often it occurs. It is not a model every claimant should match. Include less severe episodes too, and distinguish symptoms observed by another person from details that only you can describe.

Sources: VA: Headaches, including migraines, questionnaire (PDF) · 38 CFR 4.124a: Migraine criteria under code 8100 · VA: Evidence needed for a disability claim

Connect the record to work and other responsibilities

Work effects can include missed shifts, interrupted tasks, reduced hours, or changes in duties. If those effects apply, keep relevant attendance records, accommodation correspondence, or a supervisor’s factual account. Explain how a headache episode caused the disruption rather than submitting a payroll total with no context. Separate headache-related absences from absences for unrelated reasons.

Diagnostic code 8100 considers the character, frequency, and duration of attacks; its highest schedular level also addresses serious effects on earning capacity. An episode count alone does not guarantee a percentage. People outside paid employment can still explain effects on ordinary activities, caregiving, or study. Record the responsibilities you actually have and what changes during an episode rather than inventing work losses to fit a formula.

Sources: 38 CFR 4.124a: Migraine criteria under code 8100 · VA: Headaches, including migraines, questionnaire (PDF) · VA: Evidence needed for a disability claim

Check that the evidence answers the right questions

Before submitting, separate the documents into diagnosis, service connection, and severity. A current diary may clarify severity while leaving the medical connection unanswered. A service record may support onset without explaining current limitations. Identifying that distinction helps you ask a focused question when speaking with a clinician or accredited representative.

The public headache DBQ is a medical questionnaire for an appropriate provider to complete. You can read it to understand the subjects considered, but do not fill in clinical findings on the provider’s behalf. Keep your personal record in your own words. Submit supporting material through the proper VA process, retain a copy, and follow any examination instructions. If a decision already exists, bring its stated reasons to your next discussion.

Sources: VA: Public Disability Benefits Questionnaires · VA: Headaches, including migraines, questionnaire (PDF) · VA: Find an accredited representative · VA: What to expect at a claim exam

Common Questions