Migraine Nexus Letters
A board-certified physician reviews your records and writes an individualized medical opinion letter connecting your migraines to service. $549 flat rate.
Every nexus letter is written and signed by a doctoral-level provider — a board-certified physician or a Doctor of Physical Therapy (DPT). When a DPT authors a letter, a board-certified physician (MD/DO) independently reviews, validates, and co-signs it, so every DPT-authored opinion carries two doctoral-level signatures.
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$149 deposit, separate from the $400 letter fee.
Most letters delivered within 14 days.
There are several recognized pathways to service-connect migraines. The right approach depends on your service history and medical records.
Direct Service Connection
If your service treatment records document headaches during active duty, or you sustained a head injury, blast exposure, or concussion in service, your migraines may be directly connected to service. A formal migraine diagnosis after separation does not prevent a direct claim if symptoms began in service.
Secondary to PTSD
PTSD and migraines share neurobiological pathways, including central sensitization and serotonin dysregulation. Chronic hyperarousal and sleep disruption from PTSD independently increase migraine frequency and severity. This is one of the most well-established secondary connections. (Peskind ER et al. Psychiatr Ann. 2013)
Secondary to TBI
Post-traumatic headaches are one of the most common sequelae of traumatic brain injury. Veterans with a service-connected TBI frequently develop chronic migraines that persist long after the initial injury. The causal chain runs: in-service TBI → post-traumatic headache disorder → chronic migraines.
Secondary to Cervical Spine / Medications
Cervicogenic headaches arise from service-connected neck injuries and cervical spine conditions. Additionally, some medications prescribed for service-connected conditions cause headaches as a side effect. Both represent recognized secondary pathways to a migraine claim.
The stronger your supporting evidence, the stronger the medical opinion we can write. Here is what we look for in your records.
- ✓A formal migraine diagnosis from a healthcare provider. This can be from your primary care physician, neurologist, or VA provider.
- ✓Documented frequency and severity of your migraine attacks. A headache diary or treatment notes showing how often attacks occur and how long they last.
- ✓Evidence of prostrating attacks. This means attacks that force you to stop what you are doing and lie down. Documenting prostrating attacks is critical for ratings above 10%.
- ✓Impact on work and daily activities. Missed work days, reduced productivity, emergency room visits, or inability to perform routine tasks during an attack.
- ✓A documented connection to a service event or service-connected condition. This could be a head injury, blast exposure, TBI diagnosis, PTSD rating, or cervical spine condition.
- ✓Medical literature supporting the causal pathway between your service-connected condition and migraines. We provide this in the letter.
You do not need all six of these elements. Even two or three strong pieces of evidence can support a favorable medical opinion. Upload what you have and we will assess your case.
The VA rates migraines under Diagnostic Code 8100. Here are the four rating levels.
| Rating | Criteria |
|---|---|
| 50% | Very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability. |
| 30% | Characteristic prostrating attacks occurring on average once a month over the last several months. |
| 10% | Characteristic prostrating attacks averaging one in 2 months over the last several months. |
| 0% | Less frequent attacks. |
Real results from real veterans.
$149 deposit; $400 per letter. If your case is not supportable, the $400 letter fee does not apply and your deposit is refunded in full.
Our secure HIPAA-compliant intake form opens in a new tab. It takes about 10 minutes. No documents needed right away — you can upload records during the process.
Open Secure Intake Form →Fully refundable $149 deposit at intake. $400 for the letter only if we can support your case.