Inside the exam room
1. You will be asked where a headache hurts, what other symptoms occur, how long it lasts, and what treatment does. Explain a typical attack. Separate milder headaches from attacks that stop normal activities.
2. You will be asked how often attacks stop normal activities and how long they last. Use a headache log or label estimates. Explain tasks you stop, whether you must lie down, and recovery time.
3. You will be asked how headaches affect work and daily tasks. Explain missed time, changes your employer makes, unfinished tasks, and recovery.
How VA rates migraine
Keep two counts: all headache days, and attacks that leave you substantially unable to do ordinary activities through extreme exhaustion, powerlessness, debilitation or incapacitation. VA calls the second kind prostrating attacks. Record how long each attack lasts and what you cannot do. The 50% rule requires very frequent attacks that completely stop ordinary activity, last a long time, and cause or are capable of causing serious effects on your ability to earn a living (severe economic inadaptability). You do not have to be completely unable to work. There is no set weekly count for 50%; frequency alone does not establish it.
What each rating percentage means
Match the whole description with your exam and records. A single symptom or illustration does not decide your rating.
| Rating | What the rule requires |
|---|---|
| 0% | Attacks less frequent than the rules below for a paid rating. |
| 10% | Attacks that leave you substantially unable to do ordinary activities through extreme exhaustion, powerlessness, debilitation or incapacitation (characteristic prostrating attacks) averaging one in two months over the last several months. |
| 30% | Attacks that leave you substantially unable to do ordinary activities through extreme exhaustion, powerlessness, debilitation or incapacitation (characteristic prostrating attacks) averaging once a month over the last several months. |
| 50% | Very frequent attacks that completely prevent ordinary activity and last a long time, causing or capable of causing serious effects on the ability to earn a living (very frequent, completely prostrating and prolonged attacks productive of severe economic inadaptability). |
Check these details in your records
The examiner uses a condition form called a Disability Benefits Questionnaire (DBQ). Compare these items with your own records and explain what actually happens in daily life.
- Attacks less frequent than the rules below for a paid rating.0%Compare the whole description with your medical records. Choosing it here does not decide your VA rating.
- Attacks that leave you substantially unable to do ordinary activities through extreme exhaustion, powerlessness, debilitation or incapacitation (characteristic prostrating attacks) averaging one in two months over the last several months.10%Compare the whole description with your medical records. Choosing it here does not decide your VA rating.
- Attacks that leave you substantially unable to do ordinary activities through extreme exhaustion, powerlessness, debilitation or incapacitation (characteristic prostrating attacks) averaging once a month over the last several months.30%Compare the whole description with your medical records. Choosing it here does not decide your VA rating.
- Very frequent attacks that completely prevent ordinary activity and last a long time, causing or capable of causing serious effects on the ability to earn a living (very frequent, completely prostrating and prolonged attacks productive of severe economic inadaptability).50%Compare the whole description with your medical records. Choosing it here does not decide your VA rating.
What may happen in the exam room
- History and review of headache treatment and attack records.
- Assessment of attack duration, severity, effects on daily life, and effect on work.
What the measurements tell you
- Attack frequency over the last several months.
- Duration and ability to perform ordinary activities during attacks.
- Records showing how symptoms affect work and your ability to earn a living.
Questions the examiner may cover
- How often do attacks occur and how long do they last?
- What activities must stop, and what can you still do?
- How have attacks affected attendance, task completion, or work arrangements?
Questions to expect
Which attacks force you to stop ordinary activities?
Explain: Separate all headache days from attacks that leave you largely unable to function. Describe what stops, whether you must rest, treatment and recovery time.
Rating connection: DC 8100 distinguishes characteristic prostrating attacks from less severe headaches; the label alone does not establish their effect.
How often, over the last several months, and for how long?
Explain: Use a dated log or clearly labeled estimates. Record each disabling attack and its duration, not just the total number of headaches.
Rating connection: The 10% and 30% rows use average attack frequency. The 50% row requires very frequent, completely prostrating, prolonged attacks that cause, or are capable of causing, severe economic inadaptability.
What happens to work or your ability to earn a living?
Explain: Describe missed time, reduced hours, accommodations, unfinished work and any supporting employer or attendance records.
Rating connection: Economic impact matters to the 50% standard. A weekly attack count alone does not establish it; unemployment is not a prerequisite.
Your answer outline
Over [time period], I recorded [number or approximate frequency] attacks. During an attack, [what happens and what must stop]. I can still [remaining activity, if any]. It lasts about [duration], with [recovery time]. [Treatment effect and specific work or routine impact].
Mark approximate dates and counts as estimates.
My notes: ________________________
Service connection records
1. How is this connected to your service?
For a direct claim, identify your current disability, what happened in service, and evidence linking them. Being on active duty or orders alone does not prove that link.
- Write the 5 Ws and how: who was there; what happened; when; where; why you were there; how the problem began. Add duty status, treatment, witnesses, and records. Mark uncertain dates as estimates.
- Guard or Reserve: find your orders, dates, duty type, and any line-of-duty records. Active duty, training, and drills have different rules.
- Secondary condition: it may start after service. Identify the service-connected condition and evidence that it caused or worsened this problem. A medical opinion may help explain the link.
- Started before service? Record what changed during service. Presumptive condition? Check the required diagnosis and service history; qualifying claims do not require separate proof of a link.
- Already service connected and seeking an increase? Focus on what has worsened and the records showing it.
If you do not know the cause, say so. Do not guess a medical connection.
Explain what changes in daily life
Describe both what you can do and what becomes difficult. Include how often it happens and how long it lasts.
- Describe what actually happens during an attack rather than using a percentage as a description.
- Explain recovery time, interrupted activities, and treatment response.
- Distinguish ordinary headaches from attacks that substantially prevent activity.
Common mistakes to avoid
- Assuming weekly headaches automatically meet 50%.
- Assuming one missed day of work or lying down alone establishes a level.
- Inflating an attack log to fit a cutoff.
Records to get ready before the exam
- Dated headache log covering several months.
- Neurology and treatment records.
- Attendance, accommodation, or other work records when relevant.
Preparation notes
- Keep how often it happens, how long it lasts, how severe it is, and work impact separate in your notes.
- Continue your prescribed treatment; do not provoke an attack for the exam.
Official rating rule and code numbers
Use this source to check the full rule and its medical terms: 38 CFR 4.124a, DC 8100. Source review recorded 2026-09-04.
Could one health problem have caused another?
A condition VA has already linked to your service may cause another health problem or make it worse. VA calls this secondary service connection. Having both conditions does not prove the link. Your records need to show a current diagnosis and explain how the first condition or its treatment affected the second.
- Start with your records. Find the current diagnosis, the condition VA already linked to service, and evidence from someone qualified to explain the connection.
- Ask about cause and worsening. Did the first condition or its treatment cause the new disability, or make an existing disability worse? These are different questions. The rules call them causation under 38 CFR § 3.310(a) and aggravation under § 3.310(b). If both are raised by your records, the medical opinion should address both; answering only the cause question may not be enough (El-Amin).
- If treatment may be involved, collect the dates. List the medicine or surgery prescribed for the condition VA linked to service, the side effect, and the new diagnosis. Bring pharmacy records and dates when treatment started or stopped. A provider must explain the connection in your case; taking a medicine alone does not prove it.
- If weight gain may be involved, ask how it fits. Weight gain or obesity can be a step between the first condition and another diagnosed disability under VAOPGCPREC 1-2017. Obesity itself does not receive a VA disability rating.
- You do not need absolute certainty. VA uses the “at least as likely as not” standard and the reasonable-doubt rule under 38 CFR § 3.102. Ask a VA-accredited representative how the evidence applies to your claim.
- The same symptom cannot be counted twice. This is the rule against pyramiding in 38 CFR § 4.14. Mental-health diagnoses generally share one § 4.130 rating when they affect the same work and social abilities. Trouble sleeping may be a symptom rather than a separate disability.
- Check whether VA already assumes a link to service. Some conditions qualify based on where or when you served. These are called presumptive conditions. Examples can include chronic rhinitis, chronic sinusitis, hypertension after qualifying herbicide exposure, and type 2 diabetes. Sleep apnea (OSA) is not a PACT Act presumptive. Check eligibility before seeking a medical opinion about the link.
- An exam form and a medical opinion do different jobs. A Disability Benefits Questionnaire (DBQ) records the diagnosis and how severe it is. It may not explain why it is linked to service, often called a nexus. A VA-accredited veterans service organization (VSO) can help you file at no charge.
If another prescribed treatment may have caused a problem, ask your health care provider to record what happened and explain the connection in your case.
Sources: 38 CFR § 3.310 · 38 CFR § 4.14 · VA-accredited representatives
Other health problems to ask about
Use these notes to ask your provider about problems you already have. Your records must explain the connection. VA decides whether the condition is linked to service.
A provider must diagnose the problem and explain the connection in your case. The same effects cannot be counted in two ratings.
Describe how attacks affect sleep. That does not automatically mean a separate sleep disability.
Light sensitivity (photophobia) or visual changes before a migraine (aura) may be part of the migraine. A separate eye disability needs its own diagnosis and supporting records.
Choose the related health problems you want to discuss. Your preparation packet will include the notes you select and the full condition guides available for them.