Medication managed migraines

HAWK184

Registered Member
How does the VA and DOD rate migraines that are managed by medication? There is a difference in the frequency and intensity Pre medication treatment and post treatment.

I began getting migraines after a mTBI and was getting an average of 2 attacks a week with an avg intensity of 9/10 over a period of about a year. After starting a daily regimen of topirimate and imitrex at onset of migraine the frequency of migraines decreased to 1 per week/1 every 2 weeks with an intensity of 4/10. Previously, I would need to go home and get into bed and now I can manage working (stay at work but limit doing much).

How do the DOD and VA doctors access the severity for ratings when there is a difference between managed with medication and without?

Since these migraines were caused by a TBI, are they rated separately from the TBI rating?

Have not tried Botox - any experiences with Botox combined with medication or able to stop medication with Botox use.

First time posting- thanks.
 

concernedwife

PEB Forum Veteran
Registered Member
my husband is navy and currently fighting for a finding of FIT because of migraines. he has had them for seven years now and they got worse after his first deployment. he was directed to a medboard in august 2017 and he was found fit. we are contesting that and he was finally granted a formal board which will be may 8th.

i wish i could tell you how and what they rate folks with migraines. from what i have read here and other sites, it definitely varies from case to case.

on the front of botox, my husband gets botox every 3 months and it has helped him out a lot. because of botox, though, he is not deployable. he cannot get that treatment on a ship. the botox only lasts 5-6 weeks though, and he can only get it every 12 weeks - so when the botox starts to wear off, he has a medication called relpax that he takes. sometimes it works - others it doesn't.
 

Warrior644

Staff Member
PEB Forum Lifetime Supporter
PEB Forum Veteran
Registered Member
How does the VA and DOD rate migraines that are managed by medication? There is a difference in the frequency and intensity Pre medication treatment and post treatment.

I began getting migraines after a mTBI and was getting an average of 2 attacks a week with an avg intensity of 9/10 over a period of about a year. After starting a daily regimen of topirimate and imitrex at onset of migraine the frequency of migraines decreased to 1 per week/1 every 2 weeks with an intensity of 4/10. Previously, I would need to go home and get into bed and now I can manage working (stay at work but limit doing much).

How do the DOD and VA doctors access the severity for ratings when there is a difference between managed with medication and without?

Since these migraines were caused by a TBI, are they rated separately from the TBI rating?

Have not tried Botox - any experiences with Botox combined with medication or able to stop medication with Botox use.

First time posting- thanks.
Welcome to the PEB Forum! :)

Bottom line via the criteria as annotated within 38 CFR VASRD. It states under "§4.2 Interpretation of examination reports." that:

"Different examiners, at different times, will not describe the same disability in the same language. Features of the disability which must have persisted unchanged may be overlooked or a change for the better or worse may not be accurately appreciated or described. It is the responsibility of the rating specialist to interpret reports of examination in the light of the whole recorded history, reconciling the various reports into a consistent picture so that the current rating may accurately reflect the elements of disability present. Each disability must be considered from the point of view of the veteran working or seeking work. If a diagnosis is not supported by the findings on the examination report or if the report does not contain sufficient detail, it is incumbent upon the rating board to return the report as inadequate for evaluation purposes.

[41 FR 11292, Mar. 18, 1976]"

Based upon my experiences with the DoVA VBA via appeals for my TBI and migraines medical conditions, both were eventually granted as military service connected then issued a disability rating in accordance with the criteria as annotated in 38 CFR VASRD. That said, my TBI was rated under DoVA code "8045 Residuals of traumatic brain injury (TBI)" and my migraines were rated separately under DoVA code "8100 Migraine:" due to being a residual of the TBI. Take care!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
 

SSGMB

Registered Member
This is how it was explained to me. It they (medical staff) can find a medication that helps or rids the patient of the migraine, it is considered controlled by medication. I have not been able to find anything that helps (including Botox). I was tried on several medications for about 4 years, before I was refereed to the PEB/MED process. Also, the 38 CFR VASRD is a wonderful resource.

8100 Migraine:

1. With very frequent completely prostrating and prolonged attacks
productive of severe economic inadaptability........................................................ 50
2. With characteristic prostrating attacks occurring on an average once
a month over last several months....................................................................... 30
3. With characteristic prostrating attacks averaging one in 2 months over
last several months........................................................................................... 10
4. With less frequent attacks................................................................................... 00
 

PS722

Registered Member
How does the VA and DOD rate migraines that are managed by medication? There is a difference in the frequency and intensity Pre medication treatment and post treatment.

I began getting migraines after a mTBI and was getting an average of 2 attacks a week with an avg intensity of 9/10 over a period of about a year. After starting a daily regimen of topirimate and imitrex at onset of migraine the frequency of migraines decreased to 1 per week/1 every 2 weeks with an intensity of 4/10. Previously, I would need to go home and get into bed and now I can manage working (stay at work but limit doing much).

How do the DOD and VA doctors access the severity for ratings when there is a difference between managed with medication and without?

Since these migraines were caused by a TBI, are they rated separately from the TBI rating?

Have not tried Botox - any experiences with Botox combined with medication or able to stop medication with Botox use.

First time posting- thanks.
I am rated at 50% for migraines. VA will NOT rate your disability by the medications you take, but, by the severity of your migraines. As long as your NEXUS letter says "very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability", it should get you at least a 30% rating. What the VA takes into consideration is how bad your migraines are affecting your daily life. Medications helps you manage the pain, but, the disability is there. The bottom line is the severity and how long they last, thus, how your daily life is affected. If you get a 0% is fine, you are service connected, then you submit evidence of how bad it is plus a DBQ Form from your Dr. for an increase. 30% is what most people get. To hit 50% you must show them that the pain is so bad that you stay in bed for days with the lights off and no noise. My best advice is to submit copies of your time sheet, showing loss of days at work, lay statements from family members or friends, stating that you have almost no social life due to the pain. And again, medication will not be taken into consideration. It's either the pain is manageable or incapacitating. Good luck.
 

HashTZeus

Registered Member
My mom died because of a brain tumor. At first, she is experiencing severe headache from time to time. We went to a doctor to ask whats happening to her but they said its only a migraine, so he gave a medicine to cure the pain. She was bedridden at that time. 1 month later when were busy on something i heard my mom shout because of her head and that point we ran to the nearest hospital but sadly her journey is over. Yes, she died when that thing happens to her. We don't know if who's fault is that because the doctor in that hospital told us she has a brain tumor and all this time we only know that its a simple migraine. It's been 11 years now but i still remember what happened to her. I am experiencing migraine now and i am afraid maybe one of these days it can happen to me also. But i read this article https://www.greenmed.io/blog/top-4-benefits-of-vaping/ that maybe marijuana can cure a migraine, i don't know if this thing works so i want an opinion here. If somebody uses it already? Can you help me with this?
 

concernedwife

PEB Forum Veteran
Registered Member
what you said is something that i worry about with my husband. as much as he is in pain, day in and day out, but they have done scans and nothing has shown except for a gland of sorts - i forget the name.
 

HAWK184

Registered Member
Although I am still on active duty and can't experiment with CBDs or THC yet, I am curious whether CBDs (Cannabidiol Oils) can help with migraines and if anyone who has retired has experience with use of CBDs for Migraines and/or pain. Also looking for more clarity and experiences with how the VA has looked at and rated migraines. I understand the rating by the VASRD but what are peoples experiences since migraine frequency and intensity can vary so much from month to month depending on factors such as diet and sleep. There are some months where I would definitely fit into the 8100 description on 50% with very frequent prostrating attacks and some months where it would be 0% when everything is managed well. Any experiences with CBDs (or the new (Aimvoig medication) and experiences with the VA rating when severity varies by month?
 
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