Migraines are rated on one main thing: how often you get “prostrating” attacks — headaches so severe you have to stop what you're doing and lie down. The frequency sets your percentage.
How it's rated (DC 8100)
Migraines fall under 38 CFR §4.124a, Diagnostic Code 8100, with four levels from 0% to a maximum of 50%:
| Rating | Criteria |
|---|---|
| 0% | Less frequent attacks (diagnosed, but not prostrating or very infrequent). |
| 10% | Characteristic prostrating attacks averaging one every 2 months over the last several months. |
| 30% | Characteristic prostrating attacks averaging once a month over the last several months. |
| 50% | Very frequent, completely prostrating and prolonged attacks productive of severe economic inadaptability. (Maximum.) |
Two phrases in those criteria do most of the work. First, only prostrating attacks count — ordinary headaches, however unpleasant, don't move the percentage. Second, the standard is an average over the last several months: a single terrible month doesn't establish a 30% rating, and one quiet month doesn't defeat one. That averaging language is why documentation kept over time beats memory reconstructed at an exam.
The 50% ceiling — and how to go higher
50% is the most DC 8100 allows. The 50% level adds two requirements beyond frequency: the attacks must be completely prostrating and prolonged, and they must produce “severe economic inadaptability” — serious interference with your ability to work. That phrase doesn't require being totally unemployable; missed work days, lost jobs, or an employer's accommodation records are the kind of evidence that speaks to it. If migraines (alone or with other conditions) actually prevent you from working, the path past 50% is TDIU, which pays at the 100% rate — $3,938.58 a month in 2026 — despite the schedular ceiling.
What it pays in 2026
Migraine pay follows the standard schedule. For 2026:
| Migraine rating | Veteran alone | With a spouse |
|---|---|---|
| 10% | $180.42 | — (no dependent additions below 30%) |
| 30% | $552.47 | $617.47 |
| 50% | $1,132.90 | $1,241.90 |
Dependent additions begin at a combined rating of 30% and grow with the level — children and dependent parents add more, per the 2026 pay chart. The jump from 10% to 30% is worth $372.05 a month for a single veteran, and 30% to 50% another $580.43 — which is why proving attack frequency accurately matters so much.
How a 50% migraine rating combines
A 50% rating is a large block in VA math, because each rating removes its percentage of whatever efficiency remains. Two worked examples:
- 50% migraines + 50% other condition: start at 50, then the second 50% takes half of the remaining 50 — 50 + 25 = 75, which rounds to an 80% combined rating ($2,102.15 a month alone in 2026).
- 50% migraines + 30% condition: 50 + (30% of 50) = 65, which rounds to 70% ($1,808.45 a month alone).
Note what rounding does in both cases — 75 and 65 each round up. Small differences in the underlying ratings can cross a whole payment tier, so run your exact combination in the calculator.
Documentation is everything
Because there's no blood test for a migraine, ratings hinge on evidence of frequency and severity. Three kinds of records carry the most weight:
- A headache diary or log recording each attack — date, duration, symptoms, whether you had to stop and lie down, and whether you missed work. Kept consistently, it's often the difference between a 10% and a 30% (or 30% and 50%) rating, because it answers the “average over the last several months” question directly.
- Work absence records — leave requests, sick days, FMLA paperwork, or an employer statement. These speak to both frequency and “severe economic inadaptability.”
- Treatment notes and ER visits — every appointment where you reported headache frequency creates a dated record. Tell your provider the real frequency at every visit so the chart matches your claim.
Statements from family or coworkers who see what an attack does to you help corroborate all three.
The C&P exam for migraines
The exam is typically an interview built around the DC 8100 criteria, so answer in its terms. Say how often attacks come on average over recent months, how long they last, and what a bad one forces you to do — stop working, lie down in a dark room, lose the rest of the day. If attacks have cost you work, say so specifically: days missed, duties reassigned, jobs left. Bring your headache log; an examiner who can cite dated entries writes a stronger report than one working from your recollection under pressure.
Migraines as a secondary condition
Migraines are frequently service-connected as a secondary condition — they are commonly claimed secondary to a traumatic brain injury (TBI), a neck condition, or PTSD and its medications. A secondary migraine rating gets its own percentage under DC 8100 and then combines with the underlying condition's rating — so a veteran with 50% PTSD who service-connects monthly prostrating migraines at 30% moves from 50% combined to 65, which rounds to 70%.
Frequently asked questions
What does “prostrating” mean?
An attack severe enough that you must stop activity and lie down or rest — extreme exhaustion, weakness, or near-total inability to function until it passes. Only prostrating attacks count toward the frequency criteria at 10%, 30%, and 50%.
Is 50% the highest migraine rating?
Yes — 50% is the schedular maximum under DC 8100. If migraines keep you from working, TDIU can pay at the 100% rate despite the ceiling.
How do I prove how often I get prostrating migraines?
A headache diary, work absence records, and treatment notes (including any ER visits). The criteria turn on average frequency over the last several months, so records kept over time are what carry the claim.
Do I need ER visits to get rated?
No single type of evidence is required. Most prostrating attacks happen at home, not a hospital — which is why the log and work records matter. ER and treatment notes corroborate severity when they exist.
Can migraines be secondary to another condition?
Yes — commonly claimed secondary to TBI, neck conditions, and PTSD or its medications. The secondary rating combines with the underlying condition under VA math.
What does a 50% migraine rating pay in 2026?
$1,132.90 per month for a veteran alone, or $1,241.90 with a spouse; 30% pays $552.47 alone. See the 2026 pay chart for other households.