Lay Evidence of Prostration from Migraine Headaches

Lay Evidence Of Prostration From Migraine Headaches

A claimant’s own testimony regarding his or her symptoms and limitations when having those symptoms can establish prostration as long as the testimony is credible and symptoms are otherwise competently attributed to migraine headaches through medical evidence.

Two things are taken into account when rating migraines:

Frequency (how often they occur) and severity (how bad they are). To receive a proper rating, it is essential that the physician records these clearly along with how they affect the individual’s ability to work and function. In order to get that information across to the doctor or the VA Rater (RVSR) and the VBA (Veteran’s Benefits Administration), you create a headache log.

A headache log showing date, time, length of attack and if you were PROSTRATE due to the attack are key evidence. There are free PHONE APPS that can help keep a log. The length of the log must be sufficient to show the severity of the condition so typically3-4 months.

Headache Log Example

FILE: HEADACHE LOG 2019.XLSX

People have had good success with a phone app called 'MIGRAINE BUDDY'. LINK: https://migrainebuddy.com/

The term “prostrating” means that the individual must stop all activity, take medication, and either seek medical attention or seclude himself for the rest of the day. The individual is unable to perform any occupational or daily activities either because of the migraine itself or because the migraine medication makes him too drowsy, etc.

Example: A claimant provides testimony in writing that he/she

  1. experiences severe headaches and vomiting when exposed to light;
  2. does not engage in any activities when this occurs; and
  3. must rest or sleep during these episodes.

If there is medical evidence that the claimant’s description of symptoms is in fact symptoms of migraine headaches, a determination that the headaches cause prostration can be made by the VBA.

The ratings for migraines only go up to 50%. The Rating Authorities, however, can give a higher rating if the case is so severe that 50% doesn’t truly reflect the disability. It is completely up to the Rating Authorities, however, exactly what makes a condition severe enough to warrant a higher rating.

If the condition does not make occupational activity impossible, then it cannot be rated more than 0%.

From the CFR 38 Schedule of Ratings:

Disability Code (DC) 8100 Migraine:

 

CFR Wording

Real World Language

Percentage

With very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability. 

ANY COMPLETELY PROSTRATING HEADACHES no matter how often

50%

With characteristic prostrating attacks occurring on an average once a month over last several months

Once a month and prostrating

30%

With characteristic prostrating attacks averaging one in 2 months over last several months

Once every 2 months and prostrating

10%

With less frequent attacks

Once every 3 months or less and prostrating

0%

If the condition does not make occupational activity impossible, then it cannot be rated more than 0%

 

Referneces: 

Espiritu v. Derwinski, Jun 16, 1992, 2 Vet.App. 492 (1992)

M21-1, Part III, Subpart iv, Chapter 5, Section A - Principles of Reviewing Evidence and Decision Making

M21-1, Part III, Subpart iv, Chapter 4, Section N, 7, d - Neurological Conditions and Convulsive Disorders - Lay Evidence of Prostration from Migraine Headaches

Updated 3/21/2019

August 9, 2019 - 9:47am
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