MIGRAINES

J. PARKER · 2026 · Case ID: A26037421

GRANTED

Summary

The veteran, who served from February 28, 2000, to April 5, 2021, appealed the denial of an initial disability rating for service-connected migraines. The veteran sought a higher rating for the period between February 28, 2000, and April 5, 2021. The Board reviewed medical evidence, including VA examination reports and the veteran's own statements detailing frequent and severe migraine attacks. The veteran reported migraines occurring two to three times per month, escalating to up to four times per week, characterized by throbbing pain, sensitivity to light and sound, dizziness, occasional blackouts, and fatigue. The Board found that these symptoms, including occasional staggering and inability to start a car due to migraines, constituted "prostrating attacks" as understood by VA guidance, meaning they caused extreme exhaustion or powerlessness. The evidence indicated these attacks occurred at least twice a month, meeting the criteria for a 30 percent rating under Diagnostic Code 8100. A higher 50 percent rating was not warranted as the evidence did not demonstrate severe economic inadaptability. Resolving reasonable doubt in the veteran's favor, the Board granted an initial disability rating of 30 percent for migraines for the period from February 28, 2000, to April 5, 2021.

Rationale

Veteran reported prostrating attacks occurring up to four times per week.; Migraine attacks met criteria for 30% rating under DC 8100.; Reasonable doubt resolved in veteran's favor.

Special Benefit

NO SPECIAL BENEFIT

Diagnostic Code

8100

Docket No.

230407-337619

Full Decision Text

Citation Nr: A26037421
Decision Date: 04/22/26 Archive Date: 04/22/26

DOCKET NO. 230407-337619
DATE: April 22, 2026

ORDER

An initial disability rating of 30 percent for the service-connected migraines from February 28, 2000, to April 5, 2021, is granted.

FINDING OF FACT

From February 28, 2000, to April 5, 2021, there were characteristic prostrating attacks occurring on average once a month over a three month period.

CONCLUSION OF LAW

Resolving reasonable doubt in the Veteran's favor, the criteria for an initial disability rating of 30 percent for migraines from February 28, 2000, to April 5, 2021, are met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.3, 4.7, 4.124a, Diagnostic Code (DC) 8100.

REASONS AND BASES FOR FINDING AND CONCLUSION

This matter comes to the Board of Veterans' Appeals (Board) on appeal from an April 2023 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO).

The Veterans Appeals Improvement and Modernization Act, also known as the Appeals Modernization Act (AMA) or modernized review system, created a new framework of review for veterans who disagree with VA's decision on their claim. In the April 2023 VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected the Direct docket.

In this AMA case, the Board may only consider the evidence of record at the time of the agency of original jurisdiction (AOJ) decision on appeal (April 6, 2023). 38 C.F.R. § 20.303. The Board cannot consider evidence submitted during the period after the AOJ issued the decision on appeal. 38 C.F.R. § 20.303.

In December 2024, the Board granted an initial disability rating of 10 percent from February 28, 2000, and assigned a staged rating of 50 percent from April 5, 2021. The Veteran appealed that Board decision to the U.S. Court of Appeals for Veterans Claims (CAVC).? A?September?2025 Order by CAVC adopted?a Joint Motion for?Partial Remand (JMPR) filed by the parties.? The parties agreed that the Board should have reconciled evidence showing severity of the headaches with the previous initial ratings assigned.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider for the issue granted in this decision, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

DISABILITY RATINGS LEGAL AUTHORITY

Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities (Rating Schedule) found in?38 C.F.R. Part 4. 38?U.S.C. §?1155. It is not expected that all cases will show all the findings specified; however, findings sufficiently characteristic to identify the disease and the disability therefrom and coordination of rating with impairment of function will be expected in all instances.? 38?C.F.R. §?4.21.

Where there is a question as to which of two disability ratings shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38?C.F.R. §?4.7. It is the defined and consistently applied policy of VA to administer the law under a broad interpretation, consistent, however, with the facts shown in every case. When after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding the degree of disability such doubt will be resolved in favor of the claimant. ?38?C.F.R. §?4.3.

In the April 2023 rating decision on appeal, the RO granted service connection for migraines and the Veteran submitted a substantive appeal in April 2023.

In Fenderson?v. West, 12?Vet. App.?119, 125-26 (1999), the Court addressed a similar appeal and directed that such appeal of the?initial?rating
defined and consistently applied policy of VA to administer the law under a broad interpretation, consistent, however, with the facts shown in every case. When after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding the degree of disability such doubt will be resolved in favor of the claimant. ?38?C.F.R. §?4.3.

In the April 2023 rating decision on appeal, the RO granted service connection for migraines and the Veteran submitted a substantive appeal in April 2023.

In Fenderson?v. West, 12?Vet. App.?119, 125-26 (1999), the Court addressed a similar appeal and directed that such appeal of the?initial?rating assigned following a grant of service connection was specifically not a claim for an increased disability rating.? Separate ratings may be assigned for separate periods of time based on the facts found, a practice known as "staged" ratings. A 50 percent "staged" rating from April 5, 2021, was assigned for the migraines in the December 2024 Board decision. 38?C.F.R. §?4.2.

From February 28, 2000, the migraines have been rated under 38?C.F.R. § 4.124a for neurological conditions and convulsive disorders and DC 8100 for migraines. Under DC 8100, a noncompensable rating is warranted for migraines with less frequent attacks. A 10 percent rating is warranted for migraines with?characteristic prostrating attacks?averaging one in two months over the last several months. A 30 percent rating is warranted for migraines with?characteristic prostrating attacks occurring on an average once a month over the last several months. A 50 percent rating requires very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability.? 38?C.F.R. §?4.124a. The rating criteria of DC 8100 are considered successive, meaning that a claimant cannot fulfill the criteria of the higher rating without fulfilling those of the next lower ratings. This renders 38?C.F.R. §§?4.7?and 4.21 inapplicable. Johnson v. Wilkie, 30?Vet. App.?245, 252?(2018).

The phrase "characteristic prostrating attacks" is used in the criteria corresponding to 10 percent and 30 percent ratings under DC 8100 to describe the nature and severity of migraines, but it is not defined in the regulation. Pursuant to Dorland's Illustrated Medical Dictionary 1531 (32d ed. 2012), prostration is defined as "extreme exhaustion or powerlessness." Thus, the phrase "characteristic prostrating attacks" is understood to describe migraine attacks that typically produce extreme exhaustion or powerlessness. Further, in Johnson, the Court held that the phrase "characteristic prostrating attacks" plainly describes migraines that typically produce powerlessness or a lack of vitality. Similarly, "prostrate," as an adjective, is defined as completely overcome and lacking vitality, will, or power to rise. See Merriam-Webster Dictionary, merriamwebster.com/dictionary-/prostrating, (last visited Dec. 11, 2024). Although prostrating attacks are not defined in the rating criteria, medical guidance used by the VA Compensation Service suggests that such an attack causes one a lack of strength to the point of exhaustion. See VA Compensation Service's Medical Electronic Performance Support System.

The Veteran appeals for a higher initial disability rating for the service-connected migraines from February 28, 2000, to April 5, 2021. See April 2023 substantive appeal to the Board.

After a review of all evidence, lay and medical, the evidence is at least in relative equipoise on the question of whether the symptoms and functional impairment of the service-connected migraines more nearly approximate the criteria required for a 30 percent rating under DC 8100. For the rating period on appeal from February 28, 2000, to April 5, 2021, there is some evidence to support a finding of characteristic prostrating attacks occurring on an average once a month over a several month period.

The Veteran reported migraines that began slowly and dull in the occiput area and then radiated to the temporal and frontal area that occurred two to three times per month preceding other neurological symptoms. The Veteran reported ongoing and "regular episodes" of intense migraines, sensitivity to light and sound, tired eyes, dizziness, occasional staggering, nausea, spells of lightheadedness, and fatigue up to four times per week. The Veteran reported taking Topamax. See February 2001 VA examination report; July 2007, August 2007, January 2009, April 2009, and January 2017 correspondence to VA; September and November 2008 submissions to VA; March 2013 Disability Benefits Questionnaire (DBQ). VA treatment records show the Veteran reported worsening migraines of throbbing pain with episodes that lasted 20 to 30 minutes with occasional "black outs" such as in September 2009 when attempting to start a car. See March 2006 to December 2008 VA treatment records; February 2017 submission to VA.

The Board finds that the lay and medical evidence more nearly approximates the requirements for a 30 percent initial disability rating for migraines. First, the Veteran has reported that the episodes of migraine symptoms are prostrating. The Veteran has reported occasional staggering, lightheadedness, "black outs," and even the inability to start a car due to migraine symptoms. The Board finds that such symptoms amount to "prostrating" attacks of migraines because they caused "a lack of strength to the point of exhaustion" of almost falling to the ground and an inability to physically start a car. See Merriam-Webster Dictionary, merriamwebster.com/dictionary-/prostrating, (last visited Dec. 11, 2024); VA Compensation Service's Medical Electronic Performance Support System. This is the first requirement for a 30 percent rating under DC 8100.

Second, the Board finds that such characteristic prostrating attacks occurred on average at least once a month. The Veteran has reported that the episodes of migraine attacks occurred up to four times per week, or two to three times per month, and that the attacks were regular. This evidence shows that the migraine attacks occurred a minimum twice a month to a maximum of 16 times per month. The foregoing evidence that the migraine attacks were both "prostrating" and occurred at a minimum twice per month meets the requirement for a 30 percent rating under DC 8100. See 38 C.F.R. § 4.124a; DC 8100.

A higher rating of 50 percent is not warranted for this initial rating period because while the evidence shows characteristic prostrating attacks that occurred frequently, the evidence does not show that such attacks were productive of severe economic inadaptability. The Veteran has not submitted evidence to support such a rating. See DC 8100.

For the foregoing reasons, and resolving reasonable doubt in the Veteran's favor, the Board finds that the criteria are met for a higher initial disability rating of 30 percent for migraines from February 28, 2000, to April 5, 2021; therefore, the appeal is granted.

J. PARKER

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board I. Comis

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.

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