MIGRAINE

REBECCA N. POULSON · 2026 · Case ID: A26040687

GRANTED

Summary

The Veteran, who served from September 1966 to September 1969, appeals the rating assigned for his headaches. Service connection for headaches was previously granted at 30 percent effective May 23, 2023. The Veteran sought an increased rating, arguing that his headaches met the criteria for a 50 percent evaluation. The Board reviewed evidence including a VA examination from June 2024, a headache log submitted by the Veteran from January to August 2024, VA treatment records, a September 2024 MRI, a neurological consult in October 2024, a December 2024 VA examiner's review of the record, and testimony from a March 2026 Board hearing. The Veteran's headache log documented 55 prostrating headaches over eight months, many lasting all day, leading to his retirement. The Board found the evidence, particularly the headache log and the Veteran's testimony about missing work and needing to rest in a dark room, supported a 50 percent rating. The Board noted the December 2024 VA examiner's failure to adequately explain why the log's prostrating headaches did not meet the criteria for very frequent, completely prostrating, and prolonged attacks. Resolving doubt in the Veteran's favor, the Board found the criteria for a 50 percent rating were met, constituting a full grant of the appeal.

Rationale

Headaches rated under DC 8100; 50% rating for very frequent, completely prostrating, prolonged attacks productive of severe economic inadaptability; Headache log documented 55 prostrating headaches over 8 months, many lasting all day; Veteran reported missing work and needing to rest in dark room; Benefit of doubt afforded to Veteran

Special Benefit

NO SPECIAL BENEFIT

Diagnostic Code

8100

Docket No.

251121-610085

Full Decision Text

Citation Nr: A26040687
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 251121-610085
DATE: April 30, 2026

ORDER

An initial evaluation of 50 percent, but no higher, for tension headaches to include migraines is granted.

FINDING OF FACT

Resolving all doubt in the Veteran's favor, his headaches are productive of very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability.

CONCLUSION OF LAW

The criteria for an initial evaluation of 50 percent, but no higher for tension headaches to include migraines are met. 38 U.S.C. § 1155 (2018); 38 C.F.R. § 4.124a, Diagnostic Code 8100 (2025).

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from September 1966 to September 1969. This appeal is before the Board of Veterans' Appeals (Board) from a September 2025 higher-level review (HLR) decision of the agency of original jurisdiction (AOJ), a Department of Veterans Affairs (VA) Regional Office (RO).

Service connection for headaches was granted by a June 2025 Board decision, and the implementing June 2025 rating decision assigned a 30 percent evaluation effective May 23, 2023. In July 2025, the Veteran requested HLR of the assigned rating. In September 2025, the AOJ issued the HLR decision on appeal, which considered the evidence of record at the time of the prior June 2025 decision.

In his November 2025 notice of disagreement, the Veteran elected the Hearing docket. In March 2026, the Veteran testified during a Board hearing before the undersigned Veterans Law Judge via videoconference. A transcript is included in the claims file.

Therefore, the Board may only consider the evidence of record at the time of the June 2025 AOJ decision, which was subsequently subject to higher-level review, as well as any evidence submitted by the Veteran or his representative at the March 2026 hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). The Board recognizes that the 90 day period following the hearing has not yet lapsed; however, the Veteran waived this time period at the hearing, requesting that the decision be based on evidence already of record.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, he 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, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a supplemental claim are included with this decision.

Entitlement to an initial evaluation in excess of 30 percent for tension headaches to include migraines

The Veteran claims an increased rating for his headaches.

Disability evaluations are determined by application of the criteria set forth in the VA's Schedule for Rating Disabilities, which is based on average impairment in earning capacity. 38 U.S.C. § 1155; 38 C.F.R. Part 4. An evaluation of the level of disability present must also include consideration of the functional impairment of the claimant's ability to engage in ordinary activities, including employment. 38 C.F.R. § 4.10.

When a question arises as to which of two ratings apply under a particular diagnostic code, the higher evaluation is assigned if the disability more closely approximates the criteria for the higher rating. 38 C.F.R. § 4.7. After careful consideration of the evidence, any reasonable doubt remaining is resolved in favor of the Veteran. 38 C.F.R. § 4.3. The claimant's entire history is to be considered when making disability evaluations. See generally 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1995).

The Veteran's headaches are rated as migraine headaches under 38 C.F.R. § 4.124a, Diagnostic Code 8100. Under this code, headaches a 30 percent rating is warranted for headaches with characteristic prostrating attacks occurring on an average once a month over a period of several months. The maximum rating of 50 percent is warranted for headaches with very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability.

The criteria of Diagnostic Code 8100 are successive. Johnson v. Wilkie
disability evaluations. See generally 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1995).

The criteria of Diagnostic Code 8100 are successive. Johnson v. Wilkie, 30 Vet. App. 245 (2018). Successive criteria exist where the evaluation for each higher disability rating includes the criteria of each lower disability rating, such that if a component is not met at any one level, the claimant can only be rated at the level that does not require the missing component. Tatum v. Shinseki, 23 Vet. App. 152, 156 (2008).

The phrase "characteristic prostrating attacks" is used in the criteria corresponding to 10 percent and 30 percent ratings under Diagnostic Code 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. The descriptive phrase "very frequent" connotes a frequency at least greater than once a month, as is required by the rating criteria corresponding to a lesser 30 percent rating. Johnson, 30 Vet. App. at 253. The phrase "completely prostrating" generally means that the migraines attack must render the veteran entirely powerless. Id. The completely prostrating attacks must also be "prolonged," which is defined as "to lengthen in time: extend duration: draw out: continue, protract." Id. (internal citation omitted). Lastly, the 50 percent rating criteria requires that the very frequent completely prostrating and prolonged attacks be "productive of severe economic inadaptability." Productive can be read as having either the meaning of "producing" or "capable of producing," and, regarding severe economic inadaptability, nothing in Diagnostic Code 8100 requires that the claimant be completely unable to work in order to qualify for a 50 percent rating. Pierce v. Principi, 18 Vet. App. 440, 445-46 (2004).

The rating criteria for migraines contemplate all migraine symptoms. As such, Diagnostic Code 8100 contemplates more than just headache symptoms and requires that VA consider all the symptoms a claimant experiences as a result of migraine attacks, rating those symptoms based on the frequency, duration, severity, and economic impact. Holmes v. Wilkie, 33 Vet. App. 67, 73 (2020). Accordingly, the rating criteria for headaches contemplate the various manifestations of such disability by focusing on the resulting overall functional impairment, rather than particular symptoms. Id.

Lastly, the Board notes that ameliorative effects of medication may not be considered when evaluating a disability if those effects are not explicitly contemplated by the rating criteria. Jones v. Shinseki, 26 Vet. App. 56, 61 (2012). Here, Diagnostic Code 8100 does not contemplate the ameliorative effects of medication for migraines.

In May 2024, the Veteran submitted his claim of service connection for headaches.

The Veteran underwent a VA examination in June 2024. He reported worsening headaches two to three times per month. Tylenol helped with relief. The examiner found no characteristic prostrating attacks. He was diagnosed with tension headaches.

In August 2024, the Veteran submitted a headache log for 2024. From January 2024 to August 2024, headaches were recorded on 73 days, 55 of which were recorded as prostrating. Duration varied, with the shortest being 90 minutes, but more than half lasted all day.

VA treatment records reflect that in August 2024 the Veteran reported symptoms of migraine headaches. He stated that he had been keeping a log but never came in for evaluation. A September 2024 MRI was normal. At an October 2024 neurological consult he was diagnosed with migraines and prescribed medication.

In December 2024 a VA examiner completed a disability benefits questionnaire based on review of the
In August 2024, the Veteran submitted a headache log for 2024. From January 2024 to August 2024, headaches were recorded on 73 days, 55 of which were recorded as prostrating. Duration varied, with the shortest being 90 minutes, but more than half lasted all day.

In December 2024 a VA examiner completed a disability benefits questionnaire based on review of the record. The examiner found characteristic prostrating attacks with frequency greater than once per month but did not find completely prostrating and prolonged attacks. Functional impact consisted of difficulty performing occupational tasks due to the need to lay down in a dark, quiet room.

At a June 2025 Board hearing related to his prior appeal for service connection, the Veteran reported that at times he had to take off from work and go in a dark room with a cold, wet towel on his head. He stated that this occurred five to six times per month.

In his July 2025 request for HLR, the Veteran's representative argued that the evidence, specifically the headache log, established that a 50 percent rating was warranted. In his November 2025 notice of disagreement, the representative stated that migraines should be rated at 50 percent per his headache log.

At his March 2026 hearing, the Veteran stated that when he was still working, he would sometimes have to go to the bathroom and wipe his forehead with cold water. At other times he would go home due to the severity. He reported missing a lot of work until he ultimately retired. His representative argued that the submitted headache log established completely prostrating and prolonged attacks, given that some of the headaches marked as prostrating lasted for up to three days.

The Board finds that an initial 50 percent evaluation is warranted for the Veteran's headaches. Such a rating is available for headaches productive of very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability. The evidence is at least in equipoise as to such a finding. His headache log documents a series of headaches over an eight-month period lasting more than 24 hours and requiring him to lay down in a quiet room. There is no evidence to contradict these reports. The Veteran reported that these episodes led to his retirement. The December 2024 VA examiner failed to explain why the contents of the headache log constituted characteristic prostrating attacks but not very frequent completely prostrating and prolonged attacks. The benefit of the doubt is thus afforded to the Veteran. For these reasons, the Board finds that an initial 50 percent evaluation is warranted for the Veteran's headaches. As this is the maximum schedular rating available and is the rating argued for by the Veteran's representative in his July 2025 request for HLR and his November 2025 notice of disagreement, the Board finds that this constitutes of full grant of his appeal.

Rebecca N. Poulson

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board J. Gallagher, Counsel

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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