Matthew: Hello, and welcome. This is Matthew Hill.
Carol: I’m Carol Ponton.
Matthew: We’re here with you on another Veterans Video Blog. Today we’d like to talk to you about the max rating for migraines.
Migraines are headaches that are so severe, typically, they cause a person to lie down. There is nothing they can do to stop the migraine.
The VA rates migraines in somewhat of a strange way I think in that when they look at it, the only real thing they consider is the frequency with which the headaches make you lie down. They call it prostrating. If you have one prostrating headache every couple of months, it’s a 10%. If you have one on average a month, that’s a 30%.
Now, the next rating is a 50%. What’s interesting about that is it doesn’t just look to a higher frequency of prostrating migraines; it looks to whether they interfere with your ability to work.
Carol: I think that 50% is the highest rating they give for migraines, but then you also need to figure out whether it keeps you from working. You want to get that 50%. First, I’d like to talk about the fact they talk about how frequently you have the migraines. One of the mistakes I see is my veterans may say, “I have them twice a month.”
They fail to mention that it lasts three days each time. “I’ve had to lie down in this bed for three days in a dark room, no noise, nauseous to my stomach. I can’t stand to talk to anybody. My thinking is impaired for three days.” That’s six days a month. Remember, when you’re describing these migraines, you need to be very descriptive of what happens.
Then to get to the 50% level, anybody who is out of work that much – six days a week – they’re not going to work, but most of the Veterans fail to comment on how this affects them economically.
“I lost my last job because I was missing four or five days a month.” Or get a letter from the employer, “I tried to keep this guy who is a great guy, but missing that much because of migraines, I couldn’t keep him.”
You need to address the economic problem. That gives you the 50%, and then that makes you eligible for the unemployability if you’re not working – eligible to be evaluated for that.
Matthew: It’s a harder path to unemployability through migraines because they max you out at 50% but, as Carol said, you want to get that 50% first.
We have veterans who have prostrating migraines two a week, five every other week. Sometimes they are working but, as Carol said, the important thing is not only showing proof of how often that I have these, but if you’re already at that level, you need to show here’s how often I’m missing work or here’s how I’ve had to take a job with a lower pay because I’m allowed to go home more or I don’t have as much responsibility so that they’ll keep me on.
What Carol is alluding to is that once you’re at the 50%, the only bridge from there to get higher to 100% is unemployability. Now, with individual migraines, I see that several ways. The only real way is to show that you can’t work. Unfortunately, with the 50% or lower rating, you have to apply for unemployability through what I call the long and hard way in that your case has to go through the central office.
Carol: It’s up in D.C.
Matthew: Your case will be automatically denied by the regional office because it’s too much work for them to process it there. It typically goes up to the Board of Veterans Appeals. If they get it right, they send it back to the regional office to then send it over to the central office, and all that takes lots and lots of time.
One thing that I’ve talked to a lot of veterans about who have this severe of migraines is I ask them about depression. These migraines can be so isolating, so painful, and they can see the life they had and what they’re reduced to as far as what they are able to do now versus what they did do and it is depressing.
Carol: It’s depressing, and sometimes you wonder is it worth living. It is that bad. If you haven’t had a migraine, you don’t know how bad it is. To have days where you can’t think, you can’t relate, you’re just so nauseated, you just can’t barely stand up, and know you’re going to have them over and over and over and there’s nothing they can do about it, is more than depressing.
Matthew: If depression is there – we would ask you to speak to a loved one about it if you don’t feel like there’s any depression involved in your migraines if they’re this severe – then that is something you should apply for, for a secondary service connection because the ratings for depression are much greater. You can get 10%, 30%, 50%, 70%, and 100% for those. That would, hopefully, allow you to get the rating you deserve.
Or if you’re not working and they don’t give you a 100% rating, then at least you can get an unemployability claim that should be approved in the regional office without that long trip all the way up and down to central office.
Carol: Remember, for unemployability you need one rating of 60% or combined of 70% or more. If you have the migraine headache combined with the depression, then that may get you up to those figures. Therefore, that’s something that the regional office can handle. It’s a much quicker and much easier way to the 100% unemployability.
Matthew: The last thing I’d say on this is that if you are working and you’ve got multiple prostrating headaches a week, my thought would be that you still are unemployable because you’re in a sheltered work environment.
A sheltered work environment is essentially a job where you are working for a family member, you are working for a friend, or you’re working for someone who essentially would not have that job. They created a job specifically for you, and they let you do all kinds of things that others are not allowed to do. Again, if you’re in that situation, I’d look to push the 100% as well.
Thank you for joining us again on this space. We look to catch you next time. That is all for the Veterans Disability blog. Thank you.
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