How to Prepare for Your Migraines C&P Exam

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What to Bring to Your Exam

A migraine diary/log — track every migraine for at least 2-3 months before your exam. Record date, duration, severity (1-10), symptoms, and what you had to stop doing.

Emergency room records — any ER visits for severe headaches show the condition's seriousness.

Prescription records — triptans, preventive medications, Botox injections, nerve block records. Show what you've tried.

Work absence documentation — sick days, FMLA records, employer statements about missed work or reduced productivity.

Imaging results — MRI/CT scans that may show structural causes or rule out other conditions.

Buddy statements — from family members who have witnessed your prostrating episodes (lying in a dark room, vomiting, unable to function).

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Understanding "Prostrating" — The Key Rating Word

The VA rates migraines based on frequency of "prostrating" attacks. This word is everything. Prostrating means the headache is so severe you must stop what you're doing and rest.

What counts as prostrating: Lying down in a dark room, inability to work or perform daily tasks, severe nausea/vomiting, light and sound sensitivity that forces isolation.

50% rating criteria: "Very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability." You need to show this happens regularly.

30% rating: "Characteristic prostrating attacks occurring on an average once a month over the last several months." Track your frequency carefully.

Key phrase to use: "My migraines are prostrating — when they hit, I have to stop everything and lie in a dark room for [X hours/days]."

Don't confuse "prostrating" with "annoying." A headache that you push through at work is not prostrating. One that forces you to leave work or call out IS.

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Critical Mistakes to Avoid

Don't say "I get headaches a few times a month." Be specific: "I have prostrating migraines that last 8-24 hours approximately 3-4 times per month."

Don't underreport frequency. If you have 4 migraines per month, say 4. Many veterans round down out of habit.

Don't forget the economic impact. The 50% rating requires "severe economic inadaptability" — meaning your migraines affect your ability to work. Document every missed day.

Don't skip associated symptoms. Aura, nausea, vomiting, photophobia, phonophobia, vertigo — mention ALL symptoms. They paint the full picture.

Don't attend the exam during a good day without context. Tell the examiner: "Today is a good day, but on my worst days, this is what happens..."

Don't forget medication side effects. Drowsiness, brain fog, weight gain from preventive medications — these affect your daily life and should be reported.

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Secondary Conditions to Mention

TBI connection — if your migraines started or worsened after a traumatic brain injury in service, this is a strong secondary link.

PTSD/Mental health — stress and anxiety are well-documented migraine triggers. If you have service-connected PTSD, migraines may be secondary.

Neck condition — cervicogenic headaches originate from neck problems. If you have a service-connected cervical spine condition, migraines may qualify.

Medication side effects — medications for other service-connected conditions can trigger migraines. Document which medications and when migraines started.

Sleep apnea — poor sleep from sleep apnea increases migraine frequency. Both conditions commonly appear together in veterans.

Depression/Anxiety secondary to migraines — chronic pain from frequent migraines commonly leads to mental health conditions. This can be claimed as secondary.

What to Bring to Your Exam

Understanding "Prostrating" — The Key Rating Word

Critical Mistakes to Avoid

Secondary Conditions to Mention

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