Living With Migraines

What You Need to Know About Migraine and Disability Benefits

Almost everyone who experiences migraine—more than 90%, in fact—find it practically impossible to work normally (or at all) during an attack. And considering the attack can last anywhere between 4 to 72 hours, that’s pretty significant.

What you might not know is that there’s a chance you could qualify for Social Security disability benefits, should your medical condition be so severe that you can’t perform your job duties well on a consistent basis.

That’s right. Chronic migraine (defined as 15+ migraine days a month) is an absolutely acceptable reason to apply for disability. Why? Because some people’s migraine attacks are so frequent and incapacitating that they’re either completely unable to hold down a full-time job or they need some accommodations in order to do so.

Yet, 87% of the migraine sufferers who took Cove’s survey about the impact migraine has on careers had no idea they could apply. That’s why we want to not only make you aware, but to walk you through what you need to know.

Here’s the thing, though, before we get started: While you can apply for disability, it’s very hard to be approved for it with migraine as the sole basis and it can take a long time to go through the process (we’re talking months). It is an option—and you should definitely consider it—but it’s also imperative that you know you may get denied.

Here’s what you should know if you think this might be right for you.

The Social Security Administration (SSA) doesn’t list migraines as a disability

The SSA has a comprehensive list of disabilities, including the criteria to qualify for each one. It’s formally titled Disability Evaluation Under Social Security but more commonly referred to as the Blue Book (which is much easier to say and write, thankfully).

Migraine does not appear in the Blue Book. But before you stop reading and throw in the towel, know that this doesn’t mean you can’t get benefits. It just means you have to work harder to prove why you need them.

The factors the SSA will consider to determine if you’re eligible for disability benefits

To qualify for benefits with migraine as the reason, ”you need to prove that you’re unable to maintain a full-time job and earn a gainful living due to [chronic migraine].”

Unfortunately, this isn’t a situation in which you can simply describe your symptoms and—voilá!—approval is granted. There are several factors the SSA will look at, such as:

  • migraine severity and frequency
  • how long your attacks last
  • number of sick days
  • typical symptoms

They’ll also examine how your migraines impact your daily functioning (and thus your work). For example, do you experience extreme light sensitivity during your migraines? Should you work outside during the daytime, your job becomes a whole lot harder during an attack.

Basically, what the SSA wants to see is that your migraines get in the way of maintaining a consistent work schedule and adequately fulfilling your job duties. Because if you can’t do those two things, it’s going to be hard to keep your job.

The medical records the SSA will want to see when assessing your eligibility

It’s hard enough to get disability benefits as it is. Not having detailed medical records makes it even less likely it’s going to happen. Not only will the SSA want to see an official diagnosis, but they’ll want to see the medical records and functional reports you complete with your doctor, too.

Medical records could include MRI and other imaging results, prescriptions, tests done to eliminate the possibility of other conditions, and more. The functional report is a comprehensive explanation of how migraines impact your activities of daily living (i.e., getting dressed, bathing, brushing your teeth).

And, again, this process isn’t easy. Even if you have some medical documentation, it may not be enough. When Cove customer America M. applied for benefits, she tells us that she was denied because there wasn’t enough proof, despite the fact that she’d been let go several times due to migraine.

“The judge was very understanding of my situation,” she explains, “but he said he was just going to need more doctor visits. It’s just hard to see a doctor as frequently, and I can’t currently afford to go.”

If you don’t have these records, or if you don’t have many of them, we suggest speaking to your doctor as soon as possible so you can start building a stronger case.

The disability benefits application process

How to apply

When you’re ready, you can complete the application online. You can also visit your local SSA office if you’d rather do it in person. The advantage of doing it online is that you can do it from anywhere, start immediately rather than needing to schedule an appointment (or wait in Disney World-like lines), and save the application and come back later.

Once submitted, the SSA will review it and let you know their decision. Note that it can take three to five months to receive the final decision.

What happens if you get approved for disability benefits

Well, first of all, that’s great! We hope things get easier for you from here on out.

One important thing to know is that there are generally limitations on how much you’ll be able to work and how much income you’re allowed to make to continue receiving your benefits (the Social Security Administration has more on there here).

Qualifying for disability may also allow you to receive a check that helps cover your main living expenses like rent, bills, and groceries. If your migraines impact you so badly that you can’t work a full-time job (or piece together enough part-time jobs) or consistently have to miss shifts, then this lifts a huge financial burden off your shoulders.

As you can see, it’s unfortunately a little complex and not as straight-forward as we all might like.

What happens if you don’t get approved (and thus don’t receive disability benefits)

Again, it’s really hard to be approved for disability benefits for migraines. We don’t like this, but it’s the truth. If you apply and get denied, you can always appeal the decision within 60 days of the original ruling. This isn’t a fun or easy process by any means, but it’s worth knowing that the first decision doesn’t have to be the final say. And when it comes to your health and your ability to provide for yourself financially, it’s likely worth the time and effort.

America filed appeals several times because she kept getting denied. Eventually—a year after she first applied—she got her court date with the judge (which is when he told her she needed more proof).

If you decide not to move forward with an appeal, or if the appeals are denied, don’t lose all hope. Work with your doctors to continue exploring more treatment options, try speaking with your current manager to see if there’s some type of plan you can agree to, or consider building a career in which you can set your own hours.

What you should know about the Americans With Disability Act

One very important thing to know is that an employer cannot discriminate against you for having a disability if you’re qualified to do the job and have a record of your disability (yep, there’s more information and you guessed it, nuance, here).

If you’re covered under the ADA, your employer is now required to make accommodations for you. This could be providing certain equipment that’ll help eliminate migraine triggers (i.e. white noise machines), agreeing to a flexible work schedule or different shift hours, revisiting and adjusting your job duties, and more.

Migraine shouldn’t hold you back from having a fulfilling career. You just might have to work a little bit harder to get there than those who don’t have to live with it. But you’ve got this! While migraine is debilitating, it also teaches you how to advocate for yourself and push forward, no matter what’s standing in your way.

Note: This article has been prepared for general information purposes only. The information presented is not legal advice and is not to be acted on as such. If you need legal advice, you should consult an attorney. But it’s also imperative that you know you may get denied.

Photo by Candice Picard on Unsplash