Separating Migraine Headaches from Fibromyalgia

As with my previous post regarding fibromyalgia and mood disorders, your military rheumatology providers are likely to attribute chronic migraines- even if longstanding in nature- to your fibromyalgia diagnosis.  To overcome this tendency, you will need to have your treating neurologist prepare an addendum that specifically addresses how your prostrating migraines differ from the tension headaches usually associated with fibromyalgia with respect to severity, frequency, etc.  This provider will then need to show that it has been necessary to prescribe a prophylaxis regimen including classic medications such as Topamax, Propranolol, Minipress or Neurontin as well as whether a trial of Botox injections was attempted.   Then your neurologist must explicitly identify what abortive medications- such a as Maxalt, Zomig, Imitrex, Treximet, etc., – you are taking. Finally, you will need nonmedical evidence letters from peers and supervisors describing the frequency and severity of your migraines and how they may arise even if you aren’t experiencing a flare of your fibromyalgia.  Otherwise, your headaches are unlikely to be assigned a separate disability rating.