Tension headaches can be debilitating. For many veterans, they are a daily reality tied to the stress, trauma, or injuries experienced during service. Unfortunately, understanding how the Department of Veterans Affairs evaluates this condition isn’t straightforward. The VA doesn’t have a specific diagnostic code for tension headaches. Instead, it rates them by analogy using the migraine rating system under Diagnostic Code 8100.
Here is what you need to know about how the VA rates tension headaches, how to prove service connection, what evidence you need, and how to increase your chances of receiving the highest possible tension headache VA rating.
What Is a Tension Headache?
A tension headache feels like a steady, squeezing pressure on both sides of the head—similar to wearing a tight band. Unlike migraines, tension headaches usually don’t involve nausea, vomiting, or extreme sensitivity to light and sound. However, they can still be painful and disabling, especially when frequent.
Common symptoms include:
- Dull, aching head pain
- Pressure or tightness around the forehead, scalp, or neck
- Muscle tension in the neck or shoulders
- Difficulty concentrating
- Mild sensitivity to noise or light
- Irritability, fatigue, and reduced productivity
These headaches can be episodic (fewer than 15 days per month) or chronic (15 or more days per month). Chronic cases are more likely to interfere with work, daily activities, and social functioning.
Causes of Tension Headaches in Veterans
Tension headaches are often linked to service-related issues. Common causes include:
- Physical trauma, including traumatic brain injuries (TBIs)
- Mental stress from combat exposure or training
- PTSD and anxiety disorders
- Poor sleep quality or sleep deprivation
- Exposure to burn pits or environmental toxins
- Neck and back injuries from carrying heavy gear
- Poor posture from military service or vehicle conditions
- Secondary effects from tinnitus, hearing loss, or other chronic pain conditions
Veterans experiencing these triggers may be eligible for a tension headache VA rating if they can prove the connection to their service.
How the VA Rates Tension Headaches
Since there is no dedicated diagnostic code for tension headaches, the VA rates them under the migraine code: Diagnostic Code 8100. The VA evaluates the condition based on the severity and frequency of prostrating attacks. A prostrating attack is a headache so severe it forces you to stop all activity and rest.
VA Disability Rating Breakdown
| Rating | Criteria |
| 0% | Headaches occur infrequently (less than once every two months) and don’t significantly disrupt function. |
| 10% | Prostrating attacks occur on average once every two months. Some functional limitations exist. |
| 30% | Prostrating attacks occur about once per month and interfere with daily activities. |
| 50% | Very frequent, completely prostrating and prolonged attacks that cause severe economic inadaptability. |
Most veterans with tension headaches who file claims are rated at 10% or 30%, but those with chronic and severe symptoms that interfere with employment may qualify for the maximum 50% rating.
Important Terminology
To understand how the VA evaluates claims, you need to understand what certain terms mean.
- Prostrating: A headache that forces you to stop all physical and mental activity and rest in a quiet, dark room.
- Completely prostrating: You are unable to function at all during the attack.
- Prolonged: The attack lasts long enough to severely disrupt your schedule. There’s no strict time requirement, but the longer the attack, the more likely it will support a higher rating.
- Severe economic inadaptability: The headaches prevent you from working consistently. This may involve frequent sick leave, missing shifts, or being unable to hold a job.
How to Prove Service Connection
To receive a tension headache VA rating, you must first establish a service connection. There are two common routes: direct service connection and secondary service connection.
Direct Service Connection
This applies when you can show your headaches began during service or were directly caused by a specific event or injury. You’ll need:
- A current medical diagnosis of tension headaches
- Evidence of an in-service event, injury, or illness
- A medical nexus opinion stating it is “at least as likely as not” that the headaches are related to your military service
Example: A veteran who suffered a head injury during training and now experiences daily tension headaches would file under a direct connection.
Secondary Service Connection
You may also qualify if your tension headaches are caused or aggravated by another service-connected condition. Common secondary links include:
- PTSD, depression, or anxiety disorders
- Sleep apnea or chronic sleep problems
- TBI or residual effects of head trauma
- Tinnitus or chronic ear ringing
- Cervical spine conditions or back pain
- Chronic pain from other service-connected injuries
The medical evidence must show that the condition you’re already service-connected for is either the cause or a contributing factor to your headaches.
Evidence That Supports Your Claim
Winning a tension headache VA disability rating depends on the quality and completeness of your evidence. Here’s what to include.
Medical Documentation
- Diagnosis of tension headaches from a licensed healthcare provider
- Treatment records showing consistency, frequency, and intensity of symptoms
- Notes from neurologists or pain specialists
- Results from diagnostic tests (e.g., MRI or CT scans ruling out other causes)
Functional Evidence
- Headache logs or journals showing the number, duration, and impact of each attack
- Sick leave or attendance records from employers
- Notes on accommodations made at work
- Statements from coworkers, supervisors, friends, or family who’ve observed the impact
- Evidence of lifestyle disruption—cancelled plans, missed appointments, or inability to concentrate
VA-Specific Forms
- DBQ for Headaches (VA Form 21-0960F-1), preferably filled out by your doctor
- Compensation and Pension (C&P) exam results—attend and be honest, clear, and specific
How to Maximize Your Rating
The difference between a 30% and 50% rating can come down to how clearly you document your symptoms and how well you demonstrate economic inadaptability.
Tips:
- Describe your worst attacks, not just average ones
- Track each episode’s length, severity, and what it prevents you from doing
- Note how often you miss work or cancel obligations
- Show patterns of how the condition affects your income or job stability
- Don’t minimize your condition—this is the time to be detailed and factual
If you’re currently working but with difficulty, explain what accommodations are necessary. If you’ve lost jobs or had to change careers, include that too.
When a 50% Rating Isn’t Enough: TDIU
If your headaches are so severe that you cannot maintain employment, you may qualify for Total Disability based on Individual Unemployability (TDIU), even if your combined rating is under 100%.
There are two types:
- Schedular TDIU: You have one condition rated at 60%, or multiple conditions totaling 70% with one rated at 40% or more.
- Extraschedular TDIU: You don’t meet the above but can show your headaches make steady employment impossible.
You’ll need strong evidence that shows how your tension headaches disrupt your ability to perform consistent, gainful work.
Common Reasons Claims Get Denied
- Not enough medical documentation
- Failure to describe attacks as prostrating or prolonged
- Lack of a nexus opinion linking the condition to service
- Downplaying symptoms during C&P exams
- Weak or missing employment impact evidence
Tips for C&P Exams
- Be specific about the frequency, duration, and effects of your worst episodes
- Bring your headache log with you
- Mention any emergency room visits or urgent care due to headaches
- Explain how often you must lie down, stop activities, or isolate in dark rooms
- Avoid saying you “just deal with it”—describe the actual impact
Current Monthly Compensation (No Dependents)
- 10%: $171.23
- 30%: $524.31
- 50%: $1,075.16
These amounts are tax-free and increase with dependents.
Receiving the Compensation You Deserve
Tension headaches can seriously impact your quality of life. Veterans suffering from them should take the time to understand the VA’s rating system, collect the right evidence, and file a well-documented claim.
Even though there’s no specific diagnostic code for tension headaches, the VA recognizes their impact through the migraine-based rating criteria. The key to success is showing how often your headaches occur, how severe they are, and how much they interfere with your ability to function or work.
If your condition is connected to your military service, either directly or through another condition, you may be eligible for compensation. With the right documentation and guidance, you can secure a fair tension headache VA rating that reflects your experience.
Need help? Consider working with a VA-accredited representative or Veterans Service Organization (VSO). They can assist with evidence gathering, form completion, and appeals.
You served—now get the support you’ve earned.
At Allveteran.com, we seek to help veterans connect with resources that may make all the difference. To find out your disability rating, take our free medical evidence screening today!
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