Tension Headache VA Rating: Why You're Judged by the Migraine Code
If you have been diagnosed with tension headaches and gone looking for the VA's rating criteria, you will not find any. There is no diagnostic code for tension headaches. There is no code for cervicogenic headaches, and none for post-traumatic headaches either.
The VA rates all of them under DC 8100 — the migraine code — by analogy.
That one procedural fact decides how the claim is argued, and most veterans never learn it. They read the migraine criteria, decide their headaches do not sound like migraines, and either do not file or accept a 0% without asking why.
What "by analogy" actually means
When a condition has no code of its own, 38 CFR §4.20 allows the VA to rate it under a closely related code — matching the affected body part, the symptoms, and the functional impairment.
For headaches of any kind, that related code is DC 8100.
Here is the part that matters: a rating by analogy borrows the criteria without requiring the diagnosis. You do not have to have migraines. You do not have to satisfy a neurologist's definition of one. What has to be in the record is what DC 8100 measures.
So the argument in a tension-headache claim is never "these are really migraines." It is "these attacks are prostrating, and they happen this often."
What DC 8100 measures
| Rating | What the record has to show |
|---|---|
| 50% | Very frequent, completely prostrating and prolonged attacks, productive of severe economic inadaptability |
| 30% | Characteristic prostrating attacks, on average once a month over the last several months |
| 10% | Characteristic prostrating attacks averaging one in two months over the last several months |
| 0% | Less frequent attacks |
Two words carry the whole schedule: prostrating and frequency. Everything else in a headache claim is in service of documenting those two.
"Prostrating" is not a medical term with a lab value behind it. It describes what the attack does to you — extreme exhaustion or incapacitation, an inability to carry on with ordinary activity. In practice, an attack that sends you to a dark room and stops the day is prostrating. A headache you work through, however unpleasant, generally is not.
Our guide to what "prostrating" means and how frequency gets proven covers those two words in depth, including the economic-inadaptability question at 50%. It applies identically here, because it is the same code.
The three headache types the VA sees most
Tension headaches. Band-like pressure, often bilateral, frequently tied to stress, poor sleep or muscle tension. No code of their own.
Cervicogenic headaches. Headaches originating in the neck — cervical spine damage, muscle strain, or nerve irritation referring pain into the head. These matter for a second reason, below.
Post-traumatic headaches. Following a head injury or TBI. Often rated under DC 8100 as a residual, and worth understanding alongside the TBI rating itself rather than instead of it.
All three land on the same scale. The diagnosis on the paperwork changes very little about how the claim is won.
Where the secondary route often is
Headaches are one of the more connected conditions in our data — a documented secondary of 12 different primary conditions. The two routes that come up most often:
From a neck condition. Cervical strain and nerve irritation are a recognised mechanism for cervicogenic headaches. If you already hold a rating for your cervical spine, that is an existing, settled service connection with a documented pathway running from it.
From medication or sleep. Headaches follow disrupted sleep, and disrupted sleep follows a long list of already-rated conditions.
A secondary claim does not require the headaches to have started in service. It requires a documented medical link to something already service-connected — which is a different, and often much shorter, argument. Our explainer on secondary claims covers how §3.310 works, and the full map of documented pathways shows where headaches sit in it.
Why so many headache claims come back at 0%
A 0% under DC 8100 is not a denial. Service connection was granted — the VA agreed the headaches came from your service. It simply did not find prostrating attacks at a compensable frequency in the record.
That is usually a documentation problem rather than a medical one. Three things are missing most often:
Frequency, written down as it happens. "Frequent headaches" is not a frequency. "Four attacks in October, two of them lasting past midday" is. A dated log kept over a few months is the single most useful document in a headache claim, and it is the one nobody has.
What the attack stops you doing. The schedule is measuring incapacitation. A record that says "headache, prescribed sumatriptan" documents a headache. A record that says the veteran had to leave work and lie down documents a prostrating attack.
The work consequence, at the top end. Severe economic inadaptability is what separates 30% from 50%. Missed shifts, used leave, changed duties, a job lost — that belongs in the file, and it is rarely in the medical record because doctors do not chart it.
The wording that matches the schedule
The VA rates what is written down, and it looks for its own language. A personal statement that says "my headaches are really bad and happen a lot" is describing the same reality as one that says:
In the last six months I have averaged three attacks a month. During an attack I cannot tolerate light or sound and have to lie down in a dark room, usually for four to six hours. I have left work early eleven times this year because of them and used all of my sick leave by August.
The second one is measurable against the schedule. The first is not. Neither is exaggerated — the difference is entirely in specificity, and specificity is free.
Our Statement Builder walks through the questions that produce that kind of statement, in the schedule's own terms.
Bottom line
Your headaches are being measured against the migraine code whether or not anyone calls them migraines. That is not a trap — it is the door. You are not required to prove a migraine diagnosis. You are required to show prostrating attacks and how often they happen, in a record that says so plainly.
If you are already service-connected for a neck condition, a mental-health condition, or anything requiring long-term medication, the headache claim may be a secondary rather than a fresh one — and the connection is the argument, not the headache.
Accredited VSOs will work a headache claim with you for free, and they are good at exactly this kind of documentation problem. Find one at VA.gov.
Quick questions
What is the VA rating for tension headaches?
0%, 10%, 30% or 50%, under DC 8100 — the same scale used for migraines, because the VA has no separate diagnostic code for tension headaches and rates them by analogy. The percentage is set by how often you have prostrating attacks and, at 50%, whether they are frequent and prolonged enough to produce severe economic inadaptability.
Do tension headaches have to meet the definition of a migraine?
No, and this is the most useful thing to understand about the claim. A rating by analogy borrows another code's criteria without requiring the other code's diagnosis. What has to be documented is what DC 8100 measures — prostrating attacks and their frequency — not whether a neurologist would call your headaches migraines.
Why did the VA rate my headaches at 0%?
A 0% rating under DC 8100 means the VA accepted service connection but did not find prostrating attacks at a compensable frequency in the record. It is service connection you already own. What is usually missing is documentation of what an attack does to you and how often — which is a record-keeping problem more often than a medical one.
Can I get a separate rating for tension headaches and migraines?
Generally no. Rating both under DC 8100 for the same headache disability is pyramiding, which 38 CFR §4.14 prohibits — the VA rates the overall headache disability once, at the level the worst attacks support. Headaches secondary to a different condition are still one headache rating, not two.
Are tension headaches secondary to a neck condition?
Cervicogenic headaches — headaches originating in the neck — are a documented pathway, and our condition map records a route from cervical spine conditions to headaches. Whether yours qualifies depends on your evidence and a medical opinion connecting the two, and the VA decides that.
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Lima Charlie is an educational tool — not a law firm, VSO, or VA-accredited representative, and nothing here is legal or medical advice. Only the VA decides ratings; no outcome is ever guaranteed. Free help is available from accredited VSOs at VA.gov.