You enlisted in the military to defend your country but a training accident, vehicle crash, explosion, or other incident caused trauma to your head. Ever since then, you’ve been dealing with a variety of symptoms related to your TBI, including migraines that debilitate you for hours at a time.
Experiencing TBI with migraines isn’t uncommon, and it can make getting through the day a challenge. In this article, we explain how to get a VA rating for TBI with migraines and what to do if you can no longer work because of this combination.
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In this article about the VA rating for TBI with migraines:
TBI in veterans
Traumatic brain injuries (TBI) typically result from a blow or jolt to the head or something penetrating the skull. The trauma doesn’t just break the bones of your skull, but causes short- and long-term effects to brain functioning. Some causes of TBIs include falls, gunshot wounds, vehicle crashes, and assaults.
Service members can experience TBIs during training or while serving in combat. They are a group considered at increased risk for TBIs with long-term mental and physical health effects. They are also at greater risk for death and suicide resulting from TBIs.
One study found post-9/11 veterans were dying at higher than anticipated rates, and those numbers were highest in veterans with any level of TBI.
Veterans with TBIs experience differing levels of disabilities, and some may not be able to maintain employment after their head injury.
VA rating for TBI
The VA rates the residuals of traumatic brain injury with diagnostic code 8045 in the Schedule of Ratings.
“A TBI isn’t really an individual distinct disability in and of itself,” said VA lawyer Zack Evans. “Rather, it’s a cluster of disabilities or symptoms that flow from a single event, the event being the brain injury.”
The VA considers the veteran’s cognitive, emotional/behavioral, and physical dysfunction. Here is how the VA rates the conditions in each of these categories:
- Cognitive residuals are defined as decreased memory, concentration, attention, and executive functions of the brain. The VA’s process of determining the level of cognitive impairment is complex. It involves evaluating 10 facets of TBI-related cognitive impairment.
- Emotional/behavioral residuals. When a veteran has a diagnosed mental disorder related to their TBI, the VA rates it using the General Rating Formula for Mental Disorders criteria.
- Physical residuals, including neurological issues, resulting from TBI are evaluated under the specific area of physical dysfunction. Headaches and migraines fall under this category.
Migraines in veterans
Migraines, or recurring moderate to severe headaches, are a health concern diagnosed more commonly in veterans than civilians.
These odds go up even more significantly for veterans who were deployed during military service, with one study finding 36% of participants who deployed to Iraq for at least a year experienced migraine symptoms.
Additionally, the VA has recognized many veterans who have migraines experience more severe symptoms than non-veterans.
More than one million veterans currently receive VA disability compensation for migraines, making it the tenth most commonly service-connected condition.
VA rating for migraines
The VA rates migraines using diagnostic code 8100 with the following rating criteria:
The word “prostrating” is key in the rating of migraines. The term is not specifically defined in the code, but it has been interpreted as the level of incapacitation a person experiences during a migraine. It may mean needing to lay down and rest through a migraine.
How are TBI and migraines related?
Migraines and headaches are a common complication for individuals with a TBI. They may be more likely to continue long term in cases of moderate or severe TBI.
One study found a year after head trauma, about 18% to 22% of the participants still reported headaches and that headaches were the most common “physical complaint” after a TBI.
Another found patients with TBIs were about 1.5 times more likely to experience migraines than patients without a TBI diagnosis. These chances slightly increased in patients whose TBI resulted in hospitalization or major trauma.
Because they are so often comorbidities, if you are a veteran with migraines who experienced a TBI, you may want to look into whether the two are related, even if you haven’t considered this before.
“I operate on a TBI rule of three, which is that if you are pursuing a traumatic brain injury claim, you should almost always develop claims for mental health and headaches,” Evans said.
VA rating for TBI with migraines
Most residuals related to TBI are rated under the TBI formula rather than under separate diagnostic codes. Migraines are one distinct exception.
Diagnostic code 8045 calls for the VA to “separately evaluate any residual with a distinct diagnosis that may be evaluated under another diagnostic code, such as migraine headache, even if that diagnosis is based on subjective symptoms, rather than under the ‘Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified’ table.”
In other words, veterans with migraines caused by their TBI should receive two separate VA ratings. One for their migraines, and one for the TBI, using the criteria listed above.
TDIU for TBI with migraines
In some cases, a veteran may be awarded total disability based on individual unemployability (TDIU) for TBI with migraines. TDIU is also known as individual unemployability or simply IU. Veterans are eligible for these benefits if they can’t hold down “substantially gainful” employment due to their service-connected conditions.
Veterans with TBI and migraines may experience symptoms that make both physical and sedentary work difficult or even impossible. Their mood and sleep may be frequently disturbed and they may struggle to work well with customers or coworkers as a result.
TBI can cause impairments to memory, judgment, orientation, and motor activity. In some cases, veterans may be unable to make it through the day without accommodations for their prostrating migraines, further limiting their ability to work.
Veterans who receive TDIU benefits are compensated at the same level as those with a 100% disability rating, even though their combined rating is below 100%.
Veterans will typically be eligible for TDIU if they have:
- At least one service-connected disability rated at 60% or more disabling OR
- Two or more service-connected disabilities with at least one rated at 40% or more disabling and a combined rating of 70% or more
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Frequently asked questions
Veterans who have migraines stemming from a service-connected TBI should receive two ratings from the VA: one for their TBI and one for their migraines. Most symptoms of migraines are rated under diagnostic 8045 as part of the VA rating for TBI in order to avoid pyramiding. However, the VA is explicitly directed to rate migraines separately under diagnostic code 8100.
PTSD, TBI, and migraines are often experienced together. We explain the link between TBI and migraines above, and you can read more about the relationship between TBI and PTSD here.
Neil Woods
Neil Woods is a VA disability attorney and the owner and president of Woods & Woods. He received his law degree from Western Michigan University.
