Cervicogenic Headaches: Description, Symptoms, and Treatment

Cervicogenic headaches are a condition most commonly caused by musculoskeletal issues in the cervical spine. Cervicogenic headaches are a form of “referred pain”, which is pain caused by damage to a part of the body that is felt in another location. These types of headaches may occur as a result of whiplash, weight lifting, sports injuries, or other physical activities that place heavy strain on the cervical spine and/or head. Be sure to speak to your physician about your headaches as well as your injury history to ensure that you receive the correct diagnosis for your headache condition, as different types of headaches require different treatments. 

Cervicogenic headaches present differently in everyone who has them, but usually they are characterized by headaches accompanied by neck pain and/or stiffness. Here are the ten most common symptoms associated with cervicogenic headaches:

– Reduced neck flexibility

– Pain on one side of the head or face

– Neck stiffness and pain

– Headache triggered by certain neck positions/movements

– Light and noise sensitivity

– Nausea

– Pain in the eye area

– Arm, shoulder, or neck pain

– Blurred vision

– Involuntary flexion/tension of the neck

Getting Service Connected for Cervicogenic Headaches: What Evidence is Needed

The VA’s disability evaluation system uses a rating schedule for each condition to determine the severity of symptoms that must be present for a veteran to receive a particular level of compensation. Because no specific rating schedule exists for cervicogenic headaches, they are evaluated based on the rating schedule for migraines (see next section). You are eligible for service connection for cervicogenic headaches if (1) your condition was diagnosed while you were still in service or within twelve months of your discharge from active duty or (2) your headaches are secondary to another service-connected impairment.

For many veterans experiencing cervicogenic headaches, this condition is diagnosed as secondary to other orthopedic conditions such as a cervical strain or other neck injury. Service medical treatment records, VA Medical Center (VAMC) treatment records, and other private treatment records can help you establish service connection for your cervicogenic headaches. Especially for veterans whose cervicogenic headaches are secondary to other disabilities, being forced to lie down for long periods of time makes everyday functioning very difficult, particularly the demands of a full-time job. If your headaches are so bad that you cannot work at all, you are entitled to full unemployability benefits, with monthly rates paid at the 100 percent rate.  

How the VA Rates Cervicogenic Headaches

The evaluates cervicogenic headaches under the rating schedule for migraine headaches under Diagnostic Code 8100, with a maximum schedular rating of 50 percent. 

50 Percent:

With very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability

30 Percent:

With characteristic prostrating attacks occurring on an average once a month over last several months

10 Percent:

With characteristic prostrating attacks averaging one in 2 months over last several months

0 Percent (Noncompensible):

With less frequent attacks

Helpful definitions

Veterans reading the above rating schedule often wonder what exactly the VA means by the terms “prostrating,” “severe economic inadaptability,” and “very frequent” versus “less frequent.”  Though the VA’s regulation containing Diagnostic Code 8100, 38 CFR 4.214(a), is silent on defining these terms, the VA’s Manual M21-1MR defines these terms as follows: 

  • Prostrating – means “causing extreme exhaustion, powerlessness, debilitation or incapacitation with substantial inability to engage in ordinary activities.”
  • Completely Prostrating – means “extreme exhaustion or powerlessness with essentially total inability to engage in ordinary activities.”
  • Severe economic inadaptability – “denotes a degree of substantial work impairment.  It does not mean the individual is incapable of any substantially gainful employment.  Evidence of work impairment includes, but is not necessarily limited to, the use of sick leave or unpaid absence.” (Italics Added)
  • Less Frequent – means “duration of characteristic prostrating attacks, on average, are more than two months apart over the last several months.”
  • More Frequent – means “duration of characteristic prostrating attacks, on average, are less than one month apart over the last several months.” 

Strengthening Your Claim For Cervicogenic Headaches

The best evidence you can have to ensure the success of your claim is medical evidence. Ideally, you will have evidence (1) diagnosing you with cervicogenic headaches that began in service, were caused by an in-service incident, illness, or exposure, or were caused by another service-connected condition and (2) specifying that the headaches are very frequent, prostrating and prolonged. Such evidence usually comes from a neurologist or primary care physician who is treating you for your cervicogenic headaches. Even if you do not have access to treatment with a doctor who specializes in treating cervicogenic headaches, you still need to report your symptoms to your primary care doctor. If you have ever had to receive emergency treatment for your headaches or an accompanying condition that causes the headaches (e.g. whiplash), make sure to obtain the medical records and discharge summaries for those incidents. This medical evidence is very important because the VA will almost certainly refer you to a Compensation & Pension (C&P) examination with one of its examining doctors, who are often incentivized to spend as little time reviewing your records, completing your in-person examination, and filling out the C&P examination report. Having favorable medical evidence already in your VA claims file improves your chances of having the examining doctor adopt the findings of your treating physician. And in the event that the examining physician releases an unfavorable opinion, the existence of favorable medical records from your treating doctor in your file can help decrease the likelihood that your claim will be denied by the VA.

In addition to having favorable medical evidence, it will also benefit you to keep a detailed log of your cervicogenic headaches. In this log, which can be done in an excel file, word document, or by hand in a journal, the most important information you need to document is the occurrence of each headache as well as its severity, length, and associated symptoms. In our experience, keeping a detailed headache log is always beneficial for your claim because upon VA review it lends an extra layer of credibility to any other evidence in your file, from medical records to sworn statements by friends and family.

Lastly, veterans need to be honest and forthright about their symptoms when speaking with the VA’s C&P examining physician. Even if you feel rushed by the doctor or have difficulty opening up about the severity of your cervicogenic headaches, it is important that you quickly and accurately describe the frequency and severity of your headache attacks in a way that the doctor can understand even if he or she is not giving you his or her full attention. Though you should never exaggerate your symptoms, you should downplay or minimize your symptoms because you feel uncomfortable talking about them openly. 

Contact The Veterans Law Office About Your Cervicogenic Headaches Claim

If you are a veteran seeking compensation for your cervicogenic headaches that you believe are a result of your service in the military, please contact us at the phone number above or via our free case evaluation form. Our lawyers have ample experience representing veterans who suffer from cervicogenic headaches and getting them the compensation they deserve, whether that is through assisting with an initial claim for service connection or an appeal for a higher schedular rating for an existing condition.