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How to Prepare for Your VA Exam: Migraines & Headaches

A C&P examination is one of the most important components in ensuring that you receive an accurate VA decision.

However, as veterans, we’re not medical experts, and we don’t speak in medical terminology very often.

We’ve created this video and article to assist you in preparing for your headache or migraine exam to ensure that you know how the VA assesses headaches and migraines and translate doctor speak into plain English so you receive an accurate examination.

Understand Headaches & Migraines Are Treated the Same

The first thing to understand is that, medically, headaches and migraines are different, but for VA purposes, they’re one and the same. So whether it’s tension headaches, cervicogenic headaches, intractable migraines, or an unspecified headache condition, it all gets evaluated the same way. 

Do Not Discuss the Impact of Medication

When you are explaining the symptoms of your headache or migraine condition, do not discuss the impact of any medication you may be on.

While certain disabilities in the VA rating system consider medication and how it may improve a disability, headaches and migraines do not take medication into consideration. To get an accurate rating, you should not discuss how your symptoms are on medication and instead focus on how they are without. 

How the VA Rates Headaches

The VA rates headaches based on three criteria, and those criteria are severity, frequency, and economic impact.


Severity refers to prostrating attacks of headache pain. 

The VA only cares about headaches that are so severe they require you to prostrate. That means a headache so severe it renders you unable to do ordinary activities due to exhaustion or powerlessness. 

Basically, your head hurts so severely that you cannot do anything other than lie down in a dark room and wait for your migraine or headache to pass.

However, if you’re entirely unable to do what you normally do, then your headache can be considered completely prostrating. 

In particular, the fatigue and exhaustion you feel after a migraine are important and need to be considered. It’s important to mention the limitations you experience before, during, and after a migraine to your examiner.

You should bring your spouse if you have one because they can give more context to your examiner than you’d be able to. 

And remember, don’t talk in legalese. Talk in plain English. 

Suppose you tell your examiner that you’re rendered essentially unable to do ordinary activities because of a prostrating attack. In that case, it shows you’ve read the rating schedule, but that doesn’t tell the examiner how the headaches or migraines affect your life.

Instead, explain that you’ve had to miss your kid’s baseball games because of your migraines.

Explain that you can’t cook, watch TV, look at a computer screen, talk on the phone, or engage in any ordinary activities you usually do. That provides a lot more context to your examiners so they can accurately assess your disability.


The next criterion is frequency. How often do you experience a prostrating attack of migraine pain?

It’s important to explain this in a way your examiner can understand. 

Saying, “I have prostrating attacks of migraine pain two times a week,” doesn’t really give the examiner a lot of information.

Instead say something like, “Twice a week, I get a migraine so severe that I can’t function, I can’t cook my kids meals, and I can’t drive them to their baseball games. I can’t do anything that exposes me to light, sounds, or smells because it hurts my head so much.” 

That gives your examiner quite a bit of information, and that is a lot more persuasive and convincing than just saying, “I get two prostrating attacks of migraine pain per week.”

Economic Impact

Now lastly, we have economic impact. Or as the VA phrases it, severe economic inadaptability.

This is an evaluation as to whether the frequency of your severe prostrating headaches are capable of producing a substantial degree of work impairment. 

Have your headaches impacted your ability to work? What jobs are you able to do? Have they interfered with a promotion or favorable assignments? Have they added limitations to your work capability or capacity? 

Economic inadaptability is not a medical determination. Your examiner isn’t going to determine this. It is a legal one that the rating activity makes. 

However, explaining to your examiner how these headaches impact your ability to work is still important. 

When you’re explaining this, phrase it in terms of weeks, such as saying, “I’ve had to miss two weeks of work this year.” This shows economic inadaptability.

Other ways you can demonstrate evidence of economic inadaptability are:

  • Time off records
  • Call out logs
  • Sick time leave receipts
  • FMLA paperwork
  • Lay statements (from an employer, friend, family, or spouse)

Another piece of evidence that you can use to show economic inadaptability is headache or migraine logs. When creating a headache or migraine log, don’t just log the prostrating headaches; log all of your headaches.

Add as much as possible so the VA and the examiner get a complete picture of your condition. 


That’s how the VA evaluates your headaches. And that’s really all you need to know to prepare for your examination. 

Number one, how severe are headaches? Number two, for those headaches that are prostrating, how frequently do you get them? And number three, how do they impact your economic adaptability or your ability to function in a work environment?

If you have any questions about your upcoming migraine examination or about any other VA disability matter, don’t hesitate to reach out to the VA team here at Stone Rose Law.