How to Maximize Your VA Disability Rating for Migraines (Video)

 Posted on August 03, 2023 in Uncategorized

In this episode, Ed breaks down the VA's disability rating for migraines and steps to get to 50%. If you suffer from migraines, this video is for you. It breaks down the four elements you need to pay attention to, and shares examples and tips for proving migraine symptoms to the VA.

Audio only version:

VA Forms mentioned in this episode:

- To apply for VA benefits for a new condition use Form 20-526EZ: https://www.vba.va.gov/pubs/forms/vba-21-526ez-are.pdf

-To provide new evidence if it's been less than a year since you submitted your claim use Form 20-0995 https://www.vba.va.gov/pubs/forms/vba-20-0995-are.pdf

Full transcript:

Ed Farmer [00:00:25]:

Lately, in my law practice, I've been seeing a lot of clients who are surface connected for migraine headaches, but they have less than a 50% rating. I mean, they have 0% rating or maybe 10% rating. I think that's unacceptable. We need to go for the maximum here, guys, this video, I'm going to teach you how to do it. I'm going to tell you the four elements you need to meet to get a 50% rating for migraines. I'm also going to tell you the four pieces of evidence you could submit in order to help prove that 50% rating. Before we get started, just a little disclosure. When I say the word migraines, I'm generically referring to migraine headaches, normal headaches, tension headaches, anything that's rated under the VA's diagnostic code for migraines, this video will be applicable to.

Ed Farmer [00:01:13]:

I put a version of it on the screen here. The VA rates migraines from zero to 50%. For purposes of this video, we're going to focus on the 50% criteria. So the criteria for 50% rating are conjunctive, meaning you need to meet all these elements. If you not meet even one element, you cannot obtain the 50% rating for migraines. All right, element number one, your migraines must be prostrating. Yes, that's right. Prostrating.

Ed Farmer [00:01:44]:

Now, what does that mean, Ed? Well, unfortunately, VA law does not define prostrating, but there is a definition we could use the VA adjudicators. The people at the regional office use a manual called the M 21. This manual basically dummies down VA law for the adjudicators so they could properly issue the decisions or at least try to properly issue the decisions. So the M 21 does define prostrating. It is defined as such causing extreme exhaustion, powerlessness, debilitation, or incapacitation with substantial inability to engage in ordinary activities. You know when you have a migraine and just hurts so bad right here, and you're nauseous and you want to throw up, and the only thing that helps is you go lie in a dark room until the migraine goes away? That's prostrating. For a 50% rating, they have to be completely prostrating. That just means you can't do a damn thing when you're having a migraine.

Ed Farmer [00:02:57]:

I'm going to show you in a minute how to prove these elements. But first, let's go through all the criteria, and then we'll discuss what types of evidence you guys could submit. So the second element is they have to be very frequent. Of course, VA law doesn't define what very frequent means either, but M 21 does. Give us some guidance. M 21 says very frequent is defined as having a prostrating attack, on average, less than one month apart over the last several months. In English, you're having at least two prostrating migraines a month over the last several months. The third element, the migraines, must be prolonged.

Ed Farmer [00:03:35]:

This just means they last a long time. Tell you the truth, I wouldn't worry too much about this element. I've never actually seen the VA deny a 50% rating because they weren't prolonged. I think if your migraines are lasting at least several hours, then you're going to meet that element. The fourth element necessary to meet the 50% rating for migraines, your migraines must be productive of severe economic inadaptability. Of course, there's no definition alongside what severe economic inadaptability means, but in this case, the courts have given us a little bit of guidance. So the Court of Appeals of Veterans Claims has said what severe economic inadaptability is not. It does not mean you're incapable of employment due to your migraines.

Ed Farmer [00:04:29]:

They've said that it does not mean that you're incapable of employment due to your migraines. What it doesn't mean is that you're incapable of employment due to your migraines. What it does mean is that your migraines cause you a severe work impairment or can cause you severe work impairment. So that means if you're not working, the VA still has to consider whether or not your migraine headache symptoms could cause severe work impairment. So they have to put themselves in your shoes and see if those symptoms would cause you work impairment. And if you're not working because of your service connective migraines and you're incapable of working due to your service connective migraines, then you, my friend, should apply for individual unemployability. I'll do another video about individual unemployability soon. If you have any questions about that, feel free to reach out to me.

Ed Farmer [00:05:25]:

So, examples of severe work impairment. You don't go into work because you're having a severe migraine. You leave work early because a migraine begins while you're working. You sleep under your desk in the middle of the workday because you have a migraine. Your work performance has declined because you're in migraines. These are all good examples of severe economic inadaptability. All right, guys, so that's the four elements. One, they have to be completely prostrating.

Ed Farmer [00:05:59]:

Two, very frequent. Three, prolonged, and four, capable of producing severe economic inadaptability. Now, we're going to talk about the four types of evidence you could submit to support this claim. The strongest evidence is always medical evidence, right? So if you have progress notes detailing the symptoms of your migraines, by all means, please submit that. Unfortunately, many of us don't go to the doctor every time we have a migraine, unless it's to the Er, because it's so severe. And that's okay. If you don't have medical records, if you have prescription records, that could be helpful too. It shows what type of medication you're on.

Ed Farmer [00:06:41]:

It could go towards severity and frequency, depending on how often you're refilling your prescriptions. But if you don't have medical evidence, that's okay guys, I'm going to harp on this. Video after video. Lay statements. Statements from you, statements from your buddies. Use them in every claim you have. It's some of the most powerful evidence you have and some of the easiest you could obtain. The VA must consider it.

Ed Farmer [00:07:09]:

So guys, write a statement about the severity of your migraines, how often they occur, how they affect you. Can you function when you have migraines? Did you cough work the other day because you have migraines? Put that on a statement. Get statements from other people. Now they can't write a statement about how severe your migraines are, but they could write a statement about what they observe. And if they observe you every time you say you have a migraine, you go lay in the bedroom in a dark room and don't want to be bothered for 4 hours. That's some good evidence. If they say you're unable to function every time you have a migraine, that's good evidence. Get your coworker or your bosses to write a letter stating that you leave work early because of migraines.

Ed Farmer [00:08:00]:

You've called off X amount of times due to migraines. Your work ethic is declined because you can't focus because you have migraines. Get that type of evidence. If they have employment records backing that up, get that too. And the fourth piece of evidence is you guys need to keep a headache journal. What this is, is just a record of the date you got a migraine, description of the symptoms, if you were able to function, how you treated it, and whether it caused severe economic impairment. Did you leave work early? Just keep it in a notebook or on a Word document. And I'll put an example here in the video.

Ed Farmer [00:08:49]:

If it's been more than a year since you've received a rating for migraine headaches, what you're going to do is you want to get VA form 21 five two six easy, ask for an increase for your migraines and submit all this new evidence you just put together. If it's been less than a year since you received your migraine rating, you're going to use VA form 29 nine five and submit all this new evidence as well. Thanks for listening guys. I really hope this was helpful. You guys have been great. Thanks for supporting the channel. I wasn't expecting as many views as I got. If you guys want to see a future show, please put it in the comments and maybe I'll address it.

Ed Farmer [00:09:29]:

If you need anything, feel free to reach out. My website is vetmaoffice.com and I put a link to my calendar if you want to set up a 30 minutes consultation with me. Look forward to seeing you next time, guys. Hey guys, thanks for listening. I hope this was helpful in navigating the VA disability system. Please continue to follow me and listen for further help. If you guys have a particular issue or story you would like to share, it may help others who have similar problems. Feel free to reach out to me and we could talk about sharing your issue or problem on the next show.