Occipital Neuralgia Disability: What Veterans Need to Know

Occipital Neuralgia is a type of headache in which pain is associated with areas that are supplied by the greater and lesser occipital nerves. These nerves run from the head region where the spinal column meets the neck up to the scalp (at the back of the head).

What Causes Occipital Neuralgia Disability?

The pain is caused by injury or irritation to the nerves. This could include:

• Nerves being pinched due to overly tight muscles of the neck
• Trauma to the back of the head
• Nerve compression as it leaves the spine (due to osteoarthritis)
• Tumors or other types of lesions in the neck

Gout, diabetes, vasculitis (blood vessel inflammation), localized inflammation or infection, and lengthy and frequent periods where the head is extended forward and looking down (usually at technology like a computer or mobile device) contribute to this occipital neuralgia.

What Are Symptoms of Occipital Neuralgia Disability?

The most noticeable and documented symptoms of occipital neuralgia disability are:

• Pain starting in the neck and spreading upwards
• Pain in the forehead, scalp, and behind the eyes
• Light sensitivity
• Scalp tender to touch
• Throbbing, piercing, electric-shock-like chronic pain in the back of the head, upper neck, and behind the ears, typically on one side of the head

Sometimes, there is no one specific cause that can be pinpointed.

How Is Occipital Neuralgia Disability Diagnosed?

If you are experiencing pain and symptoms of occipital neuralgia, you are encouraged to seek medical care. A credentialed provider can prescribe you an anesthetic nerve block. If it decreases your pain and you have relief, this is considered a positive response to treatment and enough to substantiate a diagnosis of occipital neuralgia. Sometimes, the provider can give you an injection that numbs the nerve. If you get relief from this procedure, it can also signify that you have occipital neuralgia.

Also, the provider would take a thorough medical history and physical exam. The provider could potentially replicate the pain points through the physical exam, and if you feel the pain (positive result), you could be diagnosed with occipital neuralgia.

If you are aware of having had a previous head injury, it is important to let your provider know as this may be a contributing factor to diagnosis. In some cases, the provider may order blood tests or an MRI scan to confirm the diagnosis.

How to Access Treatment for Occipital Neuralgia Disability

As a veteran, you have benefits and can access treatment through your VA medical center.

Treatment would entail resting, getting a massage, or applying heat or pressure to decrease pain. Your medical provider might prescribe you nerve blocks or do an injection of steroids directly into the site of pain. You may be referred to a psychiatrist or other mental health provider if there are associated feelings of depression, anxiety, and other mood symptoms. They can treat you for any co-morbid disorder or mood-related condition you may be experiencing as a result of the pain from occipital neuralgia disability. The mood-disorder aspect of these neuralgia issues should always be investigated. Typically, the constant pain can lead to depression, and so if the occipital neuralgia can be service-connected, then depression should also be service-connected on a secondary basis.

What Is the VA Rating System for Occipital Neuralgia Disability?

The VA’s disability system uses a rating scale for each condition to determine the severity of symptoms that must be present for you to receive a particular level of compensation.

Occipital neuralgia headaches are categorized under Diagnostic code 8100 for migraines.

The VA rating scale for migraines in 2022 consists of four rating possibilities ranging from 0 to 50: 0%, 10%, 30%, and 50%.

The symptoms increase in severity at the 30% and 50% rating levels. The criteria are as follows:

• 0% rating: Migraines with less frequent attacks
• 10% rating: Migraines with characteristic prostrating attacks averaging one in 2 months over the last several months
• 30% rating: Migraines with characteristic prostrating attacks occurring on an average once a month over the last several months
• 50% rating: Migraines with very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability

The term “prostrating” is defined as a condition of being powerless or being made powerless. Another way this term is described is total mental and physical exhaustion, as in a collapse.

This word can be found in the VA ratings for migraines after 10% and is considered a key symptom. The VA will also consider if your condition was diagnosed in service, within twelve months of discharge, or as a secondary condition to another service-connected impairment.

Service treatment records from your service, VA medical treatment records, and records from other doctor and clinic visits can assist you in establishing service connections for occipital neuralgia disability.

If you are a veteran experiencing occipital neuralgia disability and need help to qualify for VA assistance, contact a veterans benefits attorney.