Tension-type headaches are the most common form of headache among adults, and for many veterans, they can become a long-term issue tied to service-related stress, injury, or environmental exposure. These headaches may not involve visual disturbances or nausea like migraines, but their persistent nature can still interfere with your ability to work, concentrate, or maintain a normal daily routine.
Tension headaches are typically the result of muscle tension or tightening in the head, scalp, or neck, and can be triggered by emotional or physical stress, low mood, anxiety, or even trauma to the head and neck area.
A large study conducted through the Veterans Health Administration revealed that headache symptoms appear more frequently in female veterans than in their male counterparts. That said, over three-quarters of men studied were diagnosed with nonspecific headaches, compared to just over two-thirds of women, meaning many veterans may not receive an accurate diagnosis for a particular headache type. The same report showed that men experienced higher instances of traumatic brain injuries (TBI) and post-traumatic stress disorder (PTSD), both of which are factors known to influence headache development. Additionally, 33% of the women and 3.2% of the men who were surveyed reported experiencing sexual trauma while in the military— which can contribute to long-term neurological effects, including chronic headaches.
Service Connection for Tension Headaches
The Department of Veterans Affairs (VA) recognizes two main ways for veterans to prove their tension headaches are connected to military service: directly or secondarily.
A direct link is established when the headaches can be clearly tied to a specific event or condition that occurred while the veteran was actively serving. For example, service-related brain trauma whether from explosions, vehicle accidents, or falls can result in chronic post-traumatic headaches. Even if the veteran doesn’t suffer from migraines, they may still experience tension-type pain after a head injury. These symptoms often show up as persistent head pressure, stiffness, and fatigue rather than the intense throbbing seen in migraines.
In addition to physical injuries, veterans may have been exposed to environmental or emotional stressors during their service that increase the likelihood of developing headaches. These include:
- Mental health conditions linked to combat stress or military sexual trauma (MST)
- Exposure to toxic substances, such as those from burn pits
- Airborne hazards encountered during deployment
It can be difficult, however, to provide documentation that proves these headaches have been ongoing for years. This is especially true for veterans who didn’t seek consistent medical treatment while serving.
On the other hand, tension headaches may be eligible for secondary service connection if they develop as a result of a different service-connected disability. Conditions that can lead to the development of tension headaches later on include:
Tension Headaches Secondary to Mental Health Conditions
There is a well-documented link between mental health disorders and physical symptoms, and one of the most common examples of this relationship is the connection between psychological distress and chronic headaches. For many veterans, especially those with post-traumatic stress disorder (PTSD), depression, or anxiety, the impact of mental illness doesn’t stay confined to emotions or thought patterns—it takes a physical toll as well.
These conditions can lead to prolonged muscle stiffness, particularly in the neck, jaw, scalp, and upper back. The continuous tightening, even when not consciously noticed, creates the perfect conditions for tension-type headaches to develop. Unlike a migraine, which often comes on suddenly with intense throbbing or light sensitivity, tension headaches may build gradually and linger, making them harder to treat.
In addition to physical tension, veterans living with mental health disorders may experience heightened sensory sensitivity, making them more vulnerable to light, sound, or crowded environments. This can exhaust the nervous system, contributing further to headache frequency and severity.
Moreover, many veterans endure chronic hypervigilance, especially those with PTSD. This heightened state of alertness—originally a survival mechanism—can turn into a long-term strain on the nervous system. When the body is constantly on edge, cortisol and adrenaline levels remain elevated, and this biochemical imbalance often manifests as recurring physical symptoms, including persistent headaches.
Sleep Disturbances Are a Factor Too
Veterans with trauma-related mental health issues often report inconsistent or fragmented sleep and an inability to reach deep, restorative sleep stages. Over time, this can compromise the body’s ability to regulate pain perception and manage inflammation, making individuals more prone to developing and sustaining chronic pain conditions like tension headaches.
Scientific studies showed that half of all patients diagnosed with tension headaches or migraines also struggle with clinically significant insomnia. The data also confirmed that those with disrupted or low-quality sleep experienced worse and more frequent headaches.
Tension Headaches from Burn Pit Exposure
New research keeps showing the link between burn pit exposure during deployment and the onset of chronic headache conditions, including tension-type headaches. Veterans who served near these disposal sites—or who were assigned duties involving their operation—are at increased risk of developing neurological symptoms that may persist for years after separation from service.
A large-scale study published in JAMA Network Open reviewed health outcomes in over 247,000 veterans. Those with both direct job-related exposure and physical presence near active burn pits experienced the highest incidence of diagnosed headache disorders, including both migraines and tension headaches. This group also reported the most disabling headache symptoms—suggesting they’re tied to the intensity and duration of exposure.
Burn pits were frequently used in combat zones to incinerate everything from plastics and medical waste to human waste and industrial chemicals. The unfiltered combustion of these materials released a toxic cocktail of airborne particles, many of which are known to affect the central nervous system. Once inhaled, these fine particulates can enter the bloodstream and cross the blood-brain barrier, potentially triggering inflammation or oxidative stress in the brain—both mechanisms associated with headache development.
For some veterans, the effects are not immediate. Headaches may begin months or even years after exposure, which can complicate efforts to document and connect the condition to service. However, recent medical literature helps bridge that gap by offering scientific backing for what many veterans have long reported: that burn pit exposure can cause long-term, systemic effects, including persistent and treatment-resistant headaches.
Veterans who served at bases where burn pits were in use—especially if they worked in waste management, sanitation, or base maintenance roles—should ensure this exposure is fully documented in their claim. While tension headaches can arise from multiple causes, burn pit exposure is increasingly recognized as a contributing or aggravating factor, especially when no other obvious origin is present.
What Is the VA Rating for Tension Headaches?
The VA assigns ratings from 0% to 50% for tension headaches based on how frequently the condition causes disabling episodes and how much it interferes with everyday functioning. These ratings are applied according to the VA criteria from 38 CFR § 4.124a – Diagnostic Code 8100.
- 50% – “With very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability.” The maximum rating of 50% is for a condition so disruptive that it significantly limits the veteran’s ability to work. It acknowledges not only frequent and severe headaches, but also their long-term impact on the veteran’s life and earning potential.
- 30% – “With characteristic prostrating attacks occurring on an average once a month over last several months.” At the 30% level, the VA recognizes that the condition interrupts daily life on a recurring basis. Veterans may be forced to stop working or withdraw from activities at least once a month due to the severity of the symptoms.
- 10% – “With characteristic prostrating attacks averaging one in 2 months over the last several months.” This rating reflects occasional episodes that require rest but are infrequent and relatively manageable. This is often the starting point for veterans who experience tension headaches but haven’t yet documented a pattern of regular disruption.
- 0% – “With less frequent attacks.” When the headache is diagnosed but it happens rarely enough that it’s not considered disabling under VA standards. It may help get VA healthcare or to service connect secondary conditions, but it doesn’t qualify for compensation.
An Explanation of the VA Rating Criteria for Headaches
Because tension headaches don’t have their own diagnostic code, the VA evaluates them by analogy under Diagnostic Code 8100, which is typically used for migraine headaches. While tension headaches are different from migraines, the VA bases its evaluation on how much the condition disrupts a veteran’s daily functioning—not just the medical label. This means the frequency, severity, and impact of the headaches are what guide the rating decision.
Understanding the VA’s rating criteria for headaches requires more than just reading the percentages—it’s about interpreting what each level actually means for your daily life and your claim. The rating schedule uses terms like “prostrating” and “severe economic inadaptability”, which can be confusing if you don’t know how the VA applies them. In plain terms:
- A prostrating attack means the headache is strong enough to force you to stop all activity and rest, often lying down in a quiet, dark place. It isn’t just a mild inconvenience—it takes you out of commission.
- Severe economic inadaptability refers to how much these attacks interfere with your ability to hold down a job or perform reliably at work. It doesn’t require you to be unemployed, but it does mean the condition must seriously limit your ability to earn a living.
How to Get Maximum VA Disability for Tension Headaches
Achieving the highest possible VA rating for tension headaches (50%) requires more than just a diagnosis and a list of symptoms. Veterans must clearly show that their condition causes persistent, incapacitating episodes that seriously disrupt their ability to function on a day-to-day basis.
This doesn’t just mean experiencing frequent pain. To meet the VA’s highest standard, the headaches must be so bad that they lead to repeated periods of inactivity, prevent the completion of basic tasks, or make it impossible to maintain a consistent work schedule. These aren’t occasional bad days—they’re recurring health episodes that disrupt your ability to function in your daily routine.
To build a strong claim for the 50% rating, it’s critical to provide detailed and consistent medical documentation. Treatment notes that describe the nature of each episode, how long it lasts, what interventions are used, and what activities were interrupted are invaluable. If you’re prescribed bed rest, blackout curtains, or specific medications to manage attacks, make sure those records are included in your file.
But clinical records alone often don’t tell the whole story. Supporting statements from people who witness your daily struggles—such as family members, coworkers, or supervisors—can fill in the gaps. Journals or logs you keep yourself can also be helpful—especially when they track the frequency, duration, and consequences of each episode.
Can You Get More Than 50% Rating for Tension Headaches?
In some cases, veterans may also be dealing with additional health issues that haven’t been service-connected yet, including conditions that may have developed as a direct result of their tension headaches. For example, sleep problems, depression, or even anxiety can begin or worsen due to chronic pain and daily disruption. If you’re regularly losing sleep or feeling emotionally drained from dealing with the condition, that’s not incidental—it’s part of how the headache is affecting your whole system.
It’s always worth filing claims for these related conditions, especially if they’re supported by medical evidence or a provider’s opinion. Even if they aren’t rated at a high percentage individually, multiple service-connected conditions can be combined to increase your overall rating and monthly compensation. And when you’re dealing with something like chronic headaches that bleed into other areas of your health, you deserve to have the full picture reflected in your benefits.
TDIU – A Path to 100% Disability Benefits
Some veterans experience tension headaches with such intensity and frequency that maintaining a steady job becomes impossible. These individuals may qualify for Total Disability based on Individual Unemployability (TDIU)—a VA benefit that provides compensation at the 100% level, even if their combined disability rating is less than 100%.
To qualify for TDIU, a veteran must show that their service-connected conditions—in this case, debilitating tension headaches—prevent them from engaging in regular, gainful work. For those who suffer from multiple severe headache episodes per week, this often means missed workdays, reduced productivity, or the inability to perform essential tasks consistently.
Vocational experts frequently provide key testimony in these cases. They can explain how the unpredictable nature of frequent headache attacks would make it unlikely for any employer to keep an employee with such limitations. These professionals assess the practical impact of the condition, helping to establish that it is not reasonable to expect the veteran to maintain full-time employment.
If TDIU is granted, the veteran receives monthly benefits equal to a 100% rating, along with access to additional VA programs that are only available at the total disability level. If the designation is permanent and total it will offer long-term security for veterans whose conditions are unlikely to improve.
How to Successfully Claim VA Disability for Tension Headaches
To file a successful VA claim, veterans must submit the core elements required for service connection—a current diagnosis, evidence of an in-service event or exposure, and a medical link between the two.
Establish Service Connection
Your initial claim must include the following foundational elements to meet the VA’s criteria for service connection:
- A current, formal diagnosis of tension-type headaches from a licensed medical provider. The VA requires that your condition be medically recognized, not just self-reported. This diagnosis should appear in your medical records and be made by a qualified professional—ideally supported by clinical findings such as symptom duration, frequency, and impact.
- Clear documentation of an in-service event, injury, or environmental exposure linked to the onset of your symptoms. This can be a recorded head or neck injury, exposure to burn pits or toxins, documented combat stress, or a specific incident such as a vehicle accident. If the event isn’t directly recorded in your service records, credible lay statements or unit history may help establish it.
- A professional medical opinion (also called a nexus letter) that connects your current diagnosis to your military service. This is the bridge between the first two components. A strong nexus letter doesn’t just state that your headaches “may be related” to service—it explains how and why your specific history, symptoms, and exposure make it at least as likely as not that your condition began during or was caused by service. The more specific the explanation, the stronger your claim.
Provide Evidence
VA rating specialists will assess not only whether you have a diagnosed condition but also how severely it affects your ability to function in everyday life. Because tension headaches don’t always present with dramatic symptoms like seizures or visible injuries, supporting evidence must clearly show their real-world impact. The following types of documentation can help paint that picture:
- Detailed medical evaluations and treatment history. Notes from specialists such as neurologists can add weight to your claim by demonstrating that your condition requires ongoing clinical attention.
- Personal symptom logs or headache diaries. Include the date, duration, intensity, triggers, and what activities you were unable to complete during or after each episode. A well-kept log can demonstrate patterns—like how often you’re forced to rest, cancel appointments, or miss obligations—over an extended period.
- Buddy statements from spouses, friends, coworkers, or supervisors who witness the impact of your condition. For example, they may notice withdrawal from social interaction, frequent absences, difficulty concentrating, or emotional changes that follow severe episodes.
- Employment documentation, such as time-off records, written warnings, or disability accommodations. Records of sick leave, patterns of missed shifts, or requests for modified duties or flexible scheduling can serve as objective evidence that tension headaches cause significant interruptions to your livelihood.
Prepare to Fight Back
It’s common for tension headache claims to be denied or underrated, especially when the condition is mistaken for a less serious issue or not fully documented. Veterans should be prepared to challenge these decisions, ideally with support from an experienced VA disability lawyer.
Attorneys and veterans advocates can help veterans gather the right types of documentation, connect with medical experts, and build a compelling case that meets the VA’s standards. If you’re looking to appeal a denial or an existing rating, we can evaluate your case and point you in the right direction. Get your free evaluation today.
Content Reviewed by
Attorney Stacey Clark
Attorney Stacey Clark is a native Floridian and has represented veterans before the VA, BVA, CAVC, and other federal courts with over 10 years of hands-on experience. She is the only attorney practicing veterans law who has been recognized as a Florida Rising Star by Florida Super Lawyer Magazine; an award that only 2.5% of Florida attorneys have received.
