6 Common VA Secondary Conditions to Migraines 

Chronic (long-term) migraines often cause or worsen other severe conditions, such as sleep, mood, and digestive disorders.

If you are a veteran, receiving, or applying for migraine disability compensation, you may be interested in knowing that if your service-connected migraine condition leads to a VA-ratable secondary condition, you could be entitled to a higher VA rating.

 
Learn more about common VA secondary conditions to migraines and how you can get the VA disability rating you rightfully deserve if you have any of these conditions.

Key Takeaways

• Migraine headaches commonly trigger or worsen secondary conditions such as anxiety, depression, sleep disorders, vertigo, tinnitus, and other disorders. 

• You can maximize your VA disability benefits if you are rated for a secondary condition caused or worsened by your migraine headaches.  

• It’s essential to understand how to get rated for secondary conditions, including how the VA rates these conditions based on the severity of your symptoms and other factors. 

• A Nexus Letter is often the key to linking a primary service-connected condition (e.g., migraine headaches) to a VA secondary condition.

Migraine Headaches in Veterans

Studies from 2017 show that veterans have a higher incidence of migraines than the general population, particularly those who served in deployments such as Afghanistan and Iraq. 

Several factors contribute to the high rate of migraines in veterans. This may be due to unique, intense stressors during military service, stressful situations during combat, noise exposure and other intense experiences during training or active duty. In addition, the high incidence of traumatic brain injuries (TBIs) during military service increases the risk of migraines in veterans, because migraines often occur after TBI,  

A long-term 2022 study showed that females who served in the VHA experienced a much higher incidence (i.e., 30.1%) of migraines than males (i.e., 8.2%). 

Migraine Symptoms

If you’ve ever had a migraine, you probably know it’s not just a bad headache. Although migraine symptoms can differ from one person to another, recurrent symptoms often include, extreme fatigue, mood changes (e.g., depression, anxiety, or euphoria), nausea and vomiting, and various forms of sensitivity, including, olfactory (i.e., sense of smell), light, and noise.  

During a migraine episode, your symptoms may occur all at once or at various intervals between attacks, sometimes lasting hours or even days.  

Untreated migraines usually last between 4 to 72 hours; you may suffer from migraines rarely or several times a month.  Other common symptoms may include: 

• Blurred vision 

• Constipation 

• Neck stiffness 

• Increased urination 

• Yawning frequently  

• Aura (i.e., sensory disturbances such as flashing lights or blind spots, or pins and needles feeling, occurring before or during a migraine headache)  

Considering the severity and impact of these headaches and other symptoms, coupled with common secondary conditions to migraines—such as GERD and Vertigo— it makes sense that the VA often awards higher ratings for those suffering from service-connected secondary disorders to migraines.   

VA Secondary Conditions to Migraines

Several common secondary conditions are associated with migraine headaches, including: sleep disorders, depression, anxiety disorder, GERD, vertigo, and tinnitus. Let’s take a closer look at each of them, including how the VA rates these conditions secondary to migraines.

Sleep disorders

It is not surprising that having migraine headaches during the night can worsen sleep disorders such as insomnia or sleep apnea. Migraines often result in poor sleep quality, causing difficulty falling asleep or staying asleep (i.e., insomnia).

Migraines aren’t known to cause sleep apnea, but they can worsen the symptoms because they disrupt normal breathing patterns when they occur during sleep. A VA rating for sleep apnea secondary to migraines is rated at 0%, 30%, 50%, or 100%, under 38 CFR § 4.97 and based on the severity of the condition and the treatments required. 

Depression

Depression is rated under the General Rating Formula for Mental Health Conditions under 38 CFR § 4.130.

A VA rating for depression secondary to migraines is 0%, 10%, 30%, 50%, 70%, or 100%, depending on severity of symptoms and the impact on social and occupational functioning.

The American Migraine Foundation reports that people with migraines are five times more likely to have depression than those who don’t experience the condition. When you repeatedly suffer from migraines, you may feel angry, powerless, sad, or depressed. If you feel persistently sad, have severe fatigue, a change in your desire to socialize, or an increase or decrease in appetite, it’s important to consult a licensed mental health professional.

Anxiety disorder

The VA rating for anxiety secondary to migraines is 0%, 10%, 30%, 50%, 70%, or 100%. Like depression, the VA’s rates anxiety as a mental health condition, under 38 CFR § 4.130, from 0 to 100 percent, depending on the severity of your anxiety symptoms and the impact it has on social and occupational functioning. 

Anxiety is a mental health condition marked by persistent, intense, and excessive worries and fears. The American Migraine Foundation reports that anxiety affects 30 to 50% of people with chronic (i.e., long-term) migraines. Having migraines can lead to anxiety because of constant worry that an attack will suddenly occur or due to living in fear of pain and discomfort.

GERD

A VA rating for GERD secondary to migraines can be 10%, 30%, 50%, or 80%. The VA rates GERD secondary to migraines using a new diagnostic code, 7206; under § 4.112(a), focusing on the presence of esophageal strictures and irritation. 

Chronic migraine headaches are often linked with a digestive disorder called gastroesophageal reflux disease (GERD). GERD involves the back up of stomach contents into the esophagus (i.e., reflux).

What’s the connection between these headaches and GERD? Several factors play a role, including long-term use of pain relievers–such as non-steroidal anti-inflammatory drugs (NSAIDs), like Motrin, ibuprofen, and Advil—commonly used to treat migraines. These drugs irritate the esophagus lining, leading to or worsening GERD.

The severity of pain and emotional stress involved in migraines can increase stomach acid production, aggravating GERD.

Vertigo

The VA rating for vertigo secondary to migraines can be 10% or 30%, under 38 CFR § 4.87  

Vertigo is characterized by dizziness, lightheadedness, or feeling unbalanced. Vertigo symptoms may be mild or severe; mild vertigo can cause dizziness, nausea, and vomiting, while severe vertigo can cause nystagmus (i.e., rhythmic eye movements).

Migraines that cause vertigo are called “vestibular migraines,” this type of headache impacts the way the brain influences balance in the inner ear.

Tinnitus

The only VA rating for recurrent tinnitus under 38 CFR § 4.87 is 10%. 

Tinnitus can result from migraine-induced vasospasms (i.e., narrowing of the artery, which restricts blood flow), causing damage to the blood vessels in the inner ear and resulting in tinnitus symptoms. Some studies show that migraine induced tinnitus symptoms occur outside of migraine episodes.

See related: Nexus Letters for Migraines Secondary to Tinnitus

Nexus Letters for Secondary Conditions

While a nexus letter is not required by the VA; they are highly recommended to help prove secondary service connection.  

A nexus letter for a secondary condition with high probative value can strengthen the validity of your VA claim.

Calculating a Combined VA Rating with Secondary Conditions

When calculating your total VA disability rating, it’s important to note that the VA doesn’t use simple math, in other words, a 50% migraine VA rating, plus a secondary VA rating of 30% does not mean you will be awarded a combined VA disability rating of 80%.

Our VA Disability Calculator can quickly and easily help you calculate your combined VA disability rating. 

Other Possible Migraine Secondary Conditions

• Cervical Strain (neck pain)  

• TMJ Disorders (pain in the jaw, head, and neck area due to muscle tension)  

• Cognitive Impairment (difficulty with memory, concentration, managing complex tasks, and other symptoms)  

• Photophobia and Phonophobia (hypersensitivity to light and sound)  

Establishing Service Connection for Migraines

To receive a VA rating for a secondary condition to migraines, you must service-connect your primary condition by showing documentation and other evidence, such as:  

• A current service-connected primary diagnosis of migraines 

• A current medically diagnosed secondary condition that is ratable by VA—performed by a qualified healthcare provider 

• Supporting documentation, such as your medical and/or personnel records. 

• Evidence that your secondary condition was aggravated or caused by your migraines (i.e., a medical nexus). 

• A nexus letter which is often required as evidence of your medical nexus 

VA Ratings for Migraines

Migraine VA ratings are 0%, 10%, 30%, or 50%, depending on the severity, frequency, and whether the migraines are productive of severe economic inadaptability. The VA rates migraine headaches using diagnostic code 8100, under 38 CFR § 4.124a Schedule of Ratings. These ratings correspond to the amount of compensation you will receive.    

How a Nexus Letter Can Help You Prove Service Connection

If you can prove that your service-connected migraines worsened a qualifying pre-existing medical condition or caused a medical condition, such as depression or anxiety, you may qualify for a higher total VA disability rating. 

One way to prove your migraines caused or worsened another condition is to obtain a nexus letter for your secondary condition from a qualified healthcare provider. Unless the VA raters identify an obvious connection between your migraines and your secondary condition, a nexus letter may be required to prove service-connection.

Conclusion

Understanding and claiming your conditions secondary to migraines can significantly increase your VA disability rating and benefits.   

Additionally, it is almost always recommended to get a credible nexus letter when trying to service connect a secondary condition.  

Medical Evidence Wins VA Claims

Whether you need a nexus letter for secondary conditions or something else, we make it easy for veterans to connect with a licensed provider through our HIPAA-compliant telemedicine platform—anytime, anywhere!   

From Nexus Letters and DBQs to Psych Evals and Telemedicine Evaluations, Telemedica is standing by to serve you. Get the evidence you need to win your VA claim today.