Migraine headaches, or migraines, are neurologically based headaches that often include additional symptoms such as nausea, vomiting, and increased sensitivity to light and sound. Migraines can range in severity from mild to debilitating, and can last anywhere from 4 to 72 hours (and sometimes longer).
Qualifying for Social Security Disability Based on Migraines
Occasional migraines may be nothing more than an inconvenience, but those who experience regular, severe migraine headaches can find it very difficult to function on a daily basis, often able to do nothing more than stay in bed in a dark room for hours – or days – at a time. Medications to treat migraines may not always be effective, and can sometimes have side effects such as dizziness or drowsiness.
If you’re suffering from chronic migraines, you may be considering applying for Social Security disability benefits. Here's what the Social Security Administration (SSA) will look at in determining if your migraines reach the level of a disability.
Limitations on Activities
The SSA doesn’t set forth exact guidelines that must be met in order to qualify for disability due to migraines. However, it is possible to be approved for disability based on a migraine diagnosis. To do so, you must prove to the SSA that your migraines affect your level of functioning to the point where you cannot perform basic work activities on a regular basis.
For the SSA to deem you unable to work, you must experience significant limitations in things like concentrating, understanding instructions, dealing with others, lifting, walking, and standing. The SSA will take into consideration the frequency of your headaches and how often you would need to miss work due to your migraines. Last, the SSA will also consider any other conditions you have that further limit your ability to work (for example, if you have a shoulder injury that prevents you from lifting heavy items).
When you apply for disability, the SSA evaluates your ability to perform any type of full-time employment. This means that even if you can prove that you are unable to do your previous work due to your migraines, if the SSA determines that there is another type of work that you could perform, your disability claim will be denied.
When making the disability determination, the SSA will consider your age, level of education, and your past employment (called your "vocational factors") in addition to the limitations caused by your migraines to see whether there is other work you could learn to do. In general, it is easier to get approved for disability if you are over the age of 50, have little education, and a history of unskilled work.
To learn more, see How Social Security Decides If You Are Disabled.
Medical Evidence Required for Disability Due to Migraines
To be approved for disability, it’s critical that you have obtained regular treatment for your migraine headaches. Although the SSA will consider your reports of your symptoms, they are most interested in objective medical evidence.
Although there is no definitive test to diagnose migraines, the SSA will want to see in your medical records that your doctor has diagnosed you with recurrent migraine headaches. Migraines can often be diagnosed based on the patient’s reporting of their symptoms and the presence of a family history of migraines. In addition, doctors may order additional tests, such as an MRI or CAT scan to rule out other reasons for the headaches.
The SSA will also be looking for things like the following in your medical file:
- doctors’ notes regarding the frequency and severity of your migraines
- results of any tests done to rule out other conditions
- list of medications and other treatments tried, and their outcomes, and
- records from any ER visits or hospitalizations related to your migraines.
The SSA may also ask your doctor(s) to complete a report or questionnaire regarding your medical condition. In some cases, they will also seek input from family members or friends who are around you on a frequent basis.
Treatment for migraines usually includes pain medications, anti-nausea medications, and sometimes, medications taken regularly to reduce or prevent migraines. Sometimes doctors will prescribe other drugs, such as beta-blockers or anti-depressants, which can also help migraine symptoms.
The SSA will want to know what treatments you have tried. An applicant who alleges disabling migraines but hasn't tried several different medications will not be credible to the SSA. In addition, if treatment can improve you migraines, the SSA will want to know that you are complying with the doctor's recommended treatment (unless you have an acceptable reason for failing to comply with treatment).
Applying for Social Security Disability for Migraines
You can apply for Social Security disability by visiting your local Social Security office, calling the SSA at (800) 772-1213, or online at www.ssa.gov (however, you can't apply for SSI online). After your application is processed at your local SSA office, your file will be sent to your state’s Disability Determination Services (DDS), where a claims examiner will analyze your file, further investigate your case, and eventually make the determination on whether to approve your disability claim. Although this claims examiner will request copies of your medical records directly from your provider, it can help speed up the decision process if you submit any records that you may have on-hand to your local SSA office or to the DDS office directly.
The claims examiner may also call you for a phone interview, send you additional reports to complete, or ask you to go for a doctor’s exam (at the SSA's expense.)
You will receive your disability decision in the regular mail, and in general, it takes 3-4 months for an initial Social Security disability decision to be made.