Disability Determination for Chronic Migraine Headaches

It's quite difficult to get Social Security Disability benefits for chronic migraines, considered by some to be a neurological disorder.

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Most headaches are not severe enough, or frequent enough, to prevent a person from working, but some migraines can be so debilitating that sufferers are not able to work. Migraines, a severe form of headache that causes nausea and sensitivity to light and sound, can last hours or even days, and happen daily or weekly to some people. Suffering from chronic migraine headaches can result in frequent absences from work, which can make it hard to hold down a job, and can sometimes result in a person's complete inability to work on a regular basis.

If you are one of the people who suffer from frequent, long-lasting, severe migraines that keep you from working and that don't respond to treatment, you may be able to collect Social Security disability benefits. If your situation is less severe, you may face an uphill battle getting benefits.

What Is a Migraine?

A typical migraine focuses a throbbing pain on one side of the head and lasts anywhere from four hours to three days. About a third of people who suffer from migraines experience "migraine with aura" (which used to be known as "classic migraine"). Coming about 15 minutes before a migraine, the aura is a warning sign, usually manifesting as a disturbance of vision such as flashing lights, colors, or blurred vision in both eyes. Since migraine symptoms worsen with physical or even routine activity, most migraine sufferers are not able to work when they have a migraine.

How Does the SSA Define Chronic Migraines?

Headaches, and even chronic migraine headaches, are not one of the medical conditions considered severe enough by the Social Security Administration (SSA) to have an official impairment listing, which is a medical definition describing the impairment and the severity required for an immediate award of Social Security disability benefits. Instead, the SSA will look at your medical evidence to determine if your migraines rise to the level of not allowing you to work. As a result, to be successful in your disability claim, it's imperative that you provide substantial medical documentation to demonstrate your headaches' disabling side effects.

Proving Your Migraines Are Disabling

There are no laboratory tests to prove a headache is a migraine or so severe that it's disabling, and a physical examination probably won't be able to uncover anything wrong with you. The SSA will need to rely on your statements about the severity of your migraines and your doctors' reports documenting your symptoms. The SSA, however, does not have to believe your claims of how severe your migraines are. That's why medical documentation is so important in migraine cases.

In order for SSA medical consultants to determine whether the severity and frequency of your migraines are sufficient to create a disability, they will want to see the following documentation.

  • Reports by the doctor who primarily treats your condition, such as a neurologist, pain management specialist, or headache specialist
  • Specific documentation of your daily symptoms and migraines, so as to measure the frequency of occurrence, duration, location, and intensity of your migraines as well as their effects on your daily living activities, and
  • Documentation of medications taken and treatments tried, whether successful or unsuccessful, and any side effects you experienced from them.

Your treating doctor should provide a comprehensive report to the SSA that includes how your activities of daily living (ADLs) are affected by your migraines, how often you get migraines and how long they last, their severity, what triggers a migraine for you, and the effectiveness of any treatments tried, including alternative treatments such as biofeedback or acupuncture.

To help document your disability, keep a migraine diary. Include details of when pain worsens and what causes it to worsen, when you have nausea or vomiting, any changes in vision, and whether and how often you experience fatigue, confusion, or light-headedness. Also record how long you have symptoms following a migraine, such as fatigue, loss of appetite, and inability to concentrate.

It's important to show how much your migraines are interfering with your life and your ability to work by showing you have repeatedly asked for help from doctors and tried different treatments, and also that you've taking steps to try to avoid migraines, such as eliminating certain foods that may trigger your migraines or changing irregular sleep patterns.

Headaches Combined With Other Medical Problems

While headaches alone may not be enough to prove disability in many cases, when combined with other disabling impairments, the SSA may consider that their cumulative effect render you disabled. Headaches can be caused by many illnesses, and often contribute to anxiety or depression. Be sure to have your doctor document your headache pain if you are applying for disability based on other impairments as well.

Applying for Benefits for Chronic Migraine Headaches

Call the SSA to set up an appointment to submit an application through your local SSA office. The SSA may ask you to undergo an independent medical evaluation by a different doctor. Once you have submitted all necessary information to the SSA, a medical consultant will consider your claim and make a decision as to your entitlement to SSDI or SSI benefits.

If Your Application Is Denied

Most people who apply for disability based on migraine headaches alone are initially denied benefits. But some of these cases can be won on appeal. You can file a request for reconsideration by yourself, but hiring a lawyer at this point will help your chances of getting benefits. When you're interviewing disability lawyers, ask if they've been successful in winning any migraine cases on appeal.

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