VA Migraine Rating UPDATE: The Exact Words That Get You 50% Instead of 30%

Indexed: 2026-05-22

[00:00:00]The difference between 30 and 50% for migraines comes down to one word completely. That one word is worth over $500 a month, more than $6,000 a year.

[00:00:14]And the VA just updated their criteria to make it clear what that word actually means. Because here's the issue. For years, veterans have been getting denied or underrated for migraines because the criteria used vague terms like prostrating and completely prostrating.

[00:00:34]What the hell does prostrating even mean? It sounds like something you'd read in like a Victorian medical textbook. Ah, yes. Private Snuffy appears to be quite prostrated. Fetch the smelling salts. But here's why this matters. I talked to a veteran last week named Marcus. Marcus had migraines since his second deployment. Started with a blast exposure, got worse over the years. Now he gets three, four times a month migraines. When one hits, he is done. Lights off, curtains closed. He can't look at his phone, can't talk to his kids, can't think, just has to lie there and wait for it to pass. Sometimes that's 12 or 14 hours. Marcus got rated for 30%. But Marcus has missed so much work because of his migraines that his boss pulled him aside last month and told him they needed to have a conversation about his attendance.

[00:01:30]That's not frustrating. That's completely prostrating. That's severe economic inadaptability.

[00:01:39]That's a 50% rating. But Marcus didn't know the difference. His CMP exam didn't capture it. and the vague criteria made it easy for the VA to lowball them. Now, the VA just updated their criteria to clarify what these terms actually mean.

[00:01:57]And understanding this could be the difference between 30 and 50% for you.

[00:02:02]And today, I'm going to break down what prostrating actually means and how to describe it. What completely prostrating actually means and the one factor that separates it from 30%. what severe economic inadaptability actually means and why you can still be employed and still get a 50% rating, the evidence that wins migraines, and how to track your migraines so the VA can't ignore them. I am Dr. Marshall Bar, an actual doctor, Army Ranger, and a former CMP examiner. And I have seen migraines underrated more times than I can really even count. And I'm sick and tired of it. So, if you have migraines, you deserve to be rated correctly. So, let's make sure that happens. So, hit subscribe because I will teach you how to win your VA claims. No BS, no vague medical terms, just straight answers.

[00:02:56]So, let me start off by explaining how migraines are rated and the ratings actually work because this is a lot simpler than the VA makes it seem. So, let me give you the migraine rating structure in plain English. Migraines are rated at four levels. 0, 10, 30, and 50%. That's it. There's no 70, no 100% rating. The max is 50% for migraines alone. Now, can migraines contribute to TDIU or be a part of a combined rating that gets you higher? Yes, absolutely.

[00:03:29]But the migraine rating itself caps at 50%. So, real simple breakdown. A 0% rating means you have migraines, but they're not really affecting your life much. Maybe mild headaches that respond to medication, but you can work through them. So, if you're watching this video, you're probably not at 0%. Nobody's stressed about their 0% migraine rating.

[00:03:52]Now, a 10% rating, that means characteristic prostrating attacks averaging one in two months over the last several months. So, translation means you're having significant migraines. the kind that knock you down but only about once every couple months.

[00:04:09]Now 30% this is where most veterans are that are those are characteristic prostrating attacks occurring on average once a month over the last several months. So translation means we're talking monthly migraines. You're getting hit with a serious migraine at least once a month. The kind where you have to stop what you're doing. Now the key word here is prostrating. Now 50% is the largest rating. That means you have very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability. So in translation this means your migraines are now so severe and so frequent that they are seriously affecting your ability to work and function. So notice the differences. At 30% it's prostrating. At 50% it's completely prostrating. At 50% there's also this phrase severe economic inadaptability.

[00:05:13]But what do these terms actually mean to you? That's been the problem for years.

[00:05:18]The criteria were vague. Different examiners interpreted them differently.

[00:05:24]Veterans got inconsistent ratings because of this. That's what is changing. The VA is updating their criteria to clarify these definitions.

[00:05:33]So, let me show you exactly what these terms mean now because this is the difference between hundreds of dollars a month. Okay, so let's break down prostrating first. Here's how the VA now defines it. Prostrating means causing extreme exhaustion, powerlessness or debilitation that makes it difficult to engage in ordinary activities. So in plain English, a prostrating migraine is one that knocks you on your ass. You can't function normally. You're you're exhausted. You feel powerless. You are debilitated. The VA specifically notes that prostrating migraines often require the veteran to lie down in a dark, quiet space. That's the picture. That's what prostrating actually looks like.

[00:06:21]Remember Marcus? When his migraines hit, he goes to his bedroom. He uses blackout curtains, no lights, no TV, no phone.

[00:06:29]His wife knows not to bother him unless the house is literally on fire or his kids know to whisper as well. He calls it going to the bunker. 12 hours of combat with his own skull. That's what prostrating is. Extreme exhaustion, powerlessness, has to lie down in a dark, quiet space. Now, here's the critical part. How do you describe this to the VA? Most veterans say something like, "I get bad headaches." Well, that doesn't paint the picture. That could mean anything. That doesn't communicate prostrating. Here's what you need to communicate. When I get a migraine, I can't function. I have to stop whatever I'm doing. I go to a dark room, close the curtains, turn off all the lights. I can't look at screens. I can't talk to people. I have to lie down and wait for it to pass. These episodes last how many hours they do. During that time, I cannot do anything. You need to paint the picture of extreme exhaustion, powerlessness, and debilitation that makes it difficult or really impossible to engage in ordinary activities. And for 30%, this needs to be happening at least once a month on average. If this sounds like you, if you're having monthly migraines that knock you out of commission, you should be rated at least 30% for migraines. But now the question is what about a 50% rating? What's the difference there? Now 50% rating is where the money is, right? The difference between 30 and 50% comes down to the one word completely. Now here's how the VA now defines completely prostrating. So completely prostrating means extreme exhaustion or powerlessness with a total inability to perform ordinary activities. Did you catch that? A at 30% it's difficult to engage in ordinary activities. At 50% it's total inability to perform ordinary activities. At 30% it's hard. At 50% it's impossible. At 50% you're not struggling through. You're not pushing through. You are literally out completely out of commission. So I want to tell you about a veteran I worked with called Dana. Dana's a nurse. Was a medic in the army. did two tours in Iraq. Her migraine started overseas. The combination of stress, sleep deprivation, and she thinks the burn pits, right? When Dana gets a migraine, she describes it like this. It's like someone is driving a railroad frag through my right eye while while simultaneously putting my head in a vice. The nausea is so bad, I can't even keep water down. The light sensitivity is so severe that even the glow from my phone charger feels like someone is shining a flashlight in my face. When it hits, Dana can't do anything. She can't work, can't care for her kids, can't drive, can't cook, can't shower, can't do laundry, can't have a conversation.

[00:09:29]And these episodes last 24 to 36 hours, sometimes longer, and they happen two to three times a month. That's not difficult to engage in ordinary activities. That is total inability to perform ordinary activities. That's a 50% rating. But there's another piece to the 50% criteria, and that is the severe economic inaptability piece. This sounds like legal jargon because, well, it is.

[00:09:58]But here's what it actually means in real terms. Severe economic inadaptability means significant impairment to your ability to work. And here's the critical part that a lot of people get wrong. You do not have to be unemployed to qualify for 50%. So, let me say that again. You can be employed and still have severe economic inadaptability. It just means your migraines are significantly impacting your work. So, here are some examples. You're using all your sick leave because of your migraines, or you've had unpaid absences because you ran out of sick leave, or you've had to leave work early multiple times, or you've had to call out the last minute, or you've been talked to by your boss about your attendance, or you've been written up, or you've been passed over for promotions because of reliability concerns, or you've lost jobs because of migraines, or you've had to take lowerpaying jobs with more flexibility.

[00:10:53]Any of these examples show severe economic inadaptability. You don't have to be unemployed. You just have to show that your migraines are seriously impacting your work. So remember Marcus in the beginning, the one whose boss pulled aside about his attendance. That right there is an example of severe economic inadaptability. He's not unemployed, but his migraines are now affecting his job. He's using all his sick leave. He's getting warnings from his boss. Marcus should be at 50% because of that, not the 30% he received. So, if this sounds like you, if your migraines are affecting your work, even if you're still employed, you may qualify for 50%. But the question is, how do you prove all of this? Well, let me show you the evidence that wins migraine claims. So, let's talk about the evidence. All right? because you can have the worst migraines in the world, but if you can't prove it, the VA, well, they can't rate it. But here's the good news. The VA acknowledges that veterans don't seek medical treatment for every individual migraine episode. Because let's be real, when you're in the middle of a migraine, the last thing you want to do is get in a car, drive to the ER, sit under fluorescent lights for hours, and wait three hours to see a doctor.

[00:12:14]Uh, excuse me. Can you turn off these lights? Also, everyone, please stop existing so loudly, right? That's going to happen. So, the VA knows your medical records won't show every migraine.

[00:12:26]That's where other evidence comes into play. So, evidence type one is what we call lay evidence. This is personal statements from you, your spouse, your family members, your co-workers, even your boss. The VA considers lay evidence as credible and important for documenting symptoms and functional limitations. Now, your personal statements you should include, and they should describe how often you get migraines, what they feel like, and you need to be vivid in your descriptions, how long they last, what you have to do when one hits, like lie down in a dark room, whatever it may be. what you can't do during a migraine like work, care for your family or kids, drive, whatever it may be. How they affect your work, are you missing days, leaving early, getting warnings from your boss, how they affect your relationships and your daily life.

[00:13:17]Now, there is an extreme power of using spousal statements, too. Statements from your spouse or family are very powerful.

[00:13:25]They see what you go through. They see you disappear into the bedroom. They see you unable to parent. They see the impact on the family life. Say, you know, here's an example of a spouse statement. When my husband gets a migraine, he goes to our bedroom and closes the door. I have to keep the kids quiet. He can't help with anything like dinner, homework, bedtime, and this happens two to three times a month and lasts about 12 to 18 hours each time.

[00:13:51]He's missed several family events because of his migraines. Now, what about co-worker and boss statements?

[00:13:58]Well, statements from bosses or co-workers can also document the worked impact. Like, here's an example. I've noticed that Joe Snuffy has had to call out a sick frequently due to migraines.

[00:14:09]On at least three occasions in the past 6 months, she has had to leave work early because of a migraine. This has affected her project deadlines. Okay.

[00:14:19]Now, the second type of evidence is what we call migraine or headache tracking.

[00:14:24]This is the secret weapon recommendation. Use a migraine tracking app. There's an app that you can download from the Google Play Store or the Apple Store and it's called Migraine Buddy. Listen, it's free and it lets you log every migraine, when it started, how long it lasted, the severity on a scale of 1 to 10, what symptoms you had, what you had to do, what activities you missed. And over time, this starts to build a record, a documented timestamped record of your migraines. You can actually export this data and then submit it as evidence with your claim.

[00:15:00]Now it's not just say you saying I get migraines a few times a month. Now it's documented data showing exactly when, how often, how severe, and how long. And the VA can't argue with the timestamps.

[00:15:15]Oh, you want to question my migraine frequency? Well, here's 47 logged entries with time, dates, severity ratings. Take your time, sir. Now the third type of evidence is medical records. Very obvious, right? Medical records are still what I call missionritical. You need a formal diagnosis. You need documentation of treatment. But and this is very important. You don't need a medical record of every single migraine. The VA knows that's just not realistic. But what you need is a diagnosis of migraines, record of treatment like medication, doctor visits, neurology referrals, imaging if you have any, documentation of the conditions existence, and treatment. Medical records establish that you have migraines. Lay evidence and tracking establish how severe and frequent they are. But together, this creates a complete picture that the VA just can't ignore. All right. Now, let me quickly hit the mistakes I see veterans make with migraine claims because I don't want you to make them either. So, mistake number one is downplaying your symptoms. Veterans are trained to suck it up. No surprise, right? It's just a headache. I can push through it. But if you downplay to the CMP examiner, they'll rate you to what you describe, not what you actually experience. So, here's the fix. Just describe your worst migraines. Describe what happens when they're at their peak. be honest about how debilitating they actually are. Now, the second mistake I see is not describing the functional impact. So, here's the problem. If you say, "I get migraines." That's not enough. The VA needs to understand how they affect your function. So, paint the picture like, "I can't work. I can't drive. I can't parent. I have to lie in a dark room for 12 hours." Now, the third mistake I see is not documenting your work impact.

[00:17:08]Remember, for that 50% rating, you need to show severe economic inadaptability.

[00:17:14]If you don't document the work impact, you can't prove it. So, track your missed days. Get a statement from your boss if it's possible. Document any warnings or write-ups you may have. Now, the fourth mistake I see, not tracking your migraine frequency. The problem is a few times a month statement is too vague. The VA likes specifics. So, use that migraine buddy or a similar app or heck, use an Excel spreadsheet and track every migraine and then export the data for your claim. The fifth mistake I see, thinking you need ER visits for every migraine. Some veterans still think they need to go to the ER every time to just prove their migraines, but that's just not realistic and it's not required. The VA acknowledges veterans don't seek treatment for every episode. lay evidence and tracking fill those gaps.

[00:18:07]If you now, if you have migraines and you're not sure you're rated correctly or if you're trying to get service connected for migraines in the first place, that's what I do and we do every day at Extera Health. We write Nexus letters that it is that is specifically the medical evidence connecting your migraines to service or to an already service connected condition. and it's often what's missing for veterans trying to get service connected. We also offer a service called a claims roadmap where we review your entire situation from a medical perspective and make sure you're claiming everything you should including migraines if they're service connected and you're not rated yet. And we also offer a service called a CNP exam prep where we teach you exactly how to describe your migraines so the examiner understands the difference between prostrating and completely prostrating.

[00:19:00]If you're interested, we will look at your situation, give you honest guidance, because being stuck at 30% when you should be at 50%, that is money you've earned. So let's make sure you get rated correctly. If you're interested in any of these services, the links in the description below. So quick summary remember migraines are rated from 0 10 30 all the way to 50% which is the max rating 30% is for prostrating that means extreme exhaustion powerlessness difficult to engage in ordinary activities often requires lying down in a dark quiet space and they happen at least once a month. Now for 50% remember those are completely prostrating that is extreme exhaustion with total inability to perform ordinary activities plus you now have severe economic inadaptability which means significant work impact. You do not have to be unemployed to get 50% rating.

[00:19:57]Remember that if migraines are affecting your work missed days, warnings, performance issues that counts. And remember, evidence that wins, lay statements from you, your spouse, or your boss, migraine tracking with Migraine Buddy app, and your medical records. And remember the mistakes.

[00:20:13]Don't downplay. Don't skip functional impact descriptions. Don't forget your work impact. Track your migraines. And you don't need to go to the ER for every episode you have. Remember, this is the bottom line. The VA clarified the criteria. Now you know what the terms mean, and you can go get rated correctly. So, look, I know migraines are miserable. They are invisible.

[00:20:35]People who don't get them don't quite understand them. They say it's just a headache. No, it's not just a headache.

[00:20:42]It's hours of your life gone. It's missed work. It's missing your kids' game. It's lying in the dark wondering when it's going to end. And then to be underrated on top of it, to be told 30% when you're actually at 50%, that is just adding insult to injury. But now you know the difference. Prostrating versus completely prostrating, difficult versus total inability. And you know what severe economic inadaptability doesn't mean and does mean. So document your migraines. Describe them accurately. And if you're stuck at 30% when you should be at 50%, fight for what you've earned. You've already sacrificed enough. Don't leave money on the table, too. Now, I want to shift to something else because there are two VA bills that are currently moving through Congress right now. One could put up to $10,000 more in severely injured veterans pockets. The other, it's just the annual COLA bill. It's important, but not the major boost headlines are claiming. So, watch my next video for the truth on both bills. No clickbait, just facts. So, remember, I am Dr. Marshall Bar, an Army Ranger, a special operations combat medic, an actual doctor, and a former CMP examiner.

[00:21:59]Prostrating versus completely prostrating. That one word is worth $500 a month. So, make sure you're rated correctly. And if you're currently in a migraine and somehow made it through this whole video, man, you are a warrior. Go lie down. I'll be here when you get back. I'll see you in the next video. And until next time, stay mission