For a migraine claim, one question shapes the rating more than almost anything else: how often do your attacks happen, and how bad are they? VA's own manual for claims processors answers a related question that matters just as much to veterans: what counts as proof?
Why frequency matters for migraines
VA rates migraines under Diagnostic Code 8100 in the rating schedule (38 CFR 4.124a). The rating levels are based mainly on how often "characteristic prostrating attacks" happen over the last several months. The highest level also looks at attacks that are very frequent, completely prostrating and prolonged, and "productive of severe economic inadaptability." So two things carry a lot of weight: how often, and how much the attacks affect your ability to work.
What the M21-1 says counts as proof
The M21-1 is the manual VA claims processors use. In the migraine section (Part V, Subpart iii, Chapter 12, Section A, topic 3.g), it says the frequency of migraine attacks is a factual determination, and that raters should look at all the evidence in the record on that question. It lists these as examples of evidence that can carry weight:
- medical progress notes
- competent and credible lay evidence about how often you have symptoms, as long as those symptoms have been identified as migraine symptoms
- contemporaneous notes, such as a headache journal
- prescription refills
- witness statements
No doctor's note for every attack? That isn't the end of it.
The same topic adds a note: the absence of treatment records isn't necessarily evidence about how often headaches happen, because a veteran may not seek treatment for every episode. That's one reason a log you keep at the time can matter.
Sick leave and "severe economic inadaptability"
Topic 3.e of the same section explains the phrase from the 50% level. It says severe economic inadaptability means a substantial degree of work impairment. It does not mean you must be unable to hold any substantially gainful job. And it says evidence of work impairment includes, but isn't limited to, the use of sick leave or unpaid absence. The manual points to the court case Pierce v. Principi, 18 Vet. App. 440 (2004), for more on this.
The same topic notes that when migraines meet that standard and the evidence also shows a veteran can't hold substantially gainful employment because of them, referral for extraschedular consideration of a total rating based on individual unemployability (TDIU) is appropriate.
Ways to keep your own records
None of this means any single document decides a claim. But it does show the kinds of records raters are told to consider. Practical ways veterans keep them:
1. Log attacks when they happen
Write down the date, how bad it was, how long it lasted and what you had to do, such as stopping and lying down in a dark room. Short, factual notes written at the time are easier to rely on than memory months later.
2. Keep work records
If you've used sick leave, unpaid time off or left work early because of attacks, your employer's leave or time-off records may show it. Some veterans ask HR for a printout, or save screenshots from their employer's timesheet system.
3. Don't forget pharmacy history
Prescription refill records can show treatment over time. Your pharmacy (or My HealtheVet, for VA prescriptions) can usually provide a history.
4. Ask people who have seen it
A spouse, coworker or friend can describe what they've personally seen and how often. VA's form for this is VA Form 21-10210 (Lay/Witness Statement).
Log flare-ups and print them with your leave records
The Symptom & Flare-up Tracker in Claim Compass Pro keeps a dated log (severity, how long it lasted, missed work, and whether you had to stop and lie down). Print it as a PDF and attach screenshots like an employer leave record, each on its own page. Try it free for 14 days.
Explore Claim CompassOrganize a buddy statement, free
The free Statement Organizer walks a witness through what they personally saw, including how often they've seen episodes, and arranges their own words under clear headings. Nothing is saved or sent.
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Educational information only. This article is general information, not legal, medical, or financial advice, and The Veteran Roadmap is not affiliated with the Department of Veterans Affairs. The M21-1 is VA's internal guidance for claims processors, not law, and it changes over time. For advice on your situation, talk with an accredited VSO, claims agent, or attorney.
Official sources: M21-1, Part V, Subpart iii, Chapter 12, Section A (KnowVA) · 38 CFR 4.124a, Diagnostic Code 8100
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