Everything to know about claiming disability due to migraine

Whether a person can apply for disability benefits due to migraine will vary depending on where they live, but in the United States, people can apply for disability benefits if they have migraine.

In the United States, there are distinct types of disability benefits. They include short-term and long-term disability, as well as Social Security Disability Income (SSDI).

Short-term disability

A person’s employer may offer this type of disability benefit as part of their health insurance. This covers 90 days of paid medical leave, which someone can use to recover from migraine symptoms and potentially try new treatments.

Long-term disability

After taking 90 days of short-term disability, a person may need to apply for long-term disability.

Again, a person’s employer may offer this. It provides between 50-70% of a person’s salary while they are off work sick. People should check with their individual employers for the criteria and evidence required.

Social Security Disability Income (SSDI)

This is a federally funded program that is usually used in addition to employer-backed disability benefits. People are only eligible for this if they have paid enough Social Security taxes in recent years to qualify.

If a person thinks that they are eligible for SSDI benefits, they should apply for them as soon as possible, because they have a 5-month waiting period.

This means that people will not receive a benefit payment until the sixth full month of disability. This is on top of the time that it takes for the government to decide whether they will receive the benefit.

Collate medical evidence

The most important thing a person can do to strengthen their chances of being accepted for disability benefits is to gather their medical records.

People will need to provide:

• the name of their condition
• the name, address, and phone number of any medical professionals they have seen about migraine
• a list of any medications that the person takes for migraine, and details about who prescribed them
• detailed information from the medical professionals whom the person has seen
• information about any tests conducted including who requested them, and the results of the tests

In general, people should gather as much information as possible from all of the medical sources they have consulted.

Gather work history

In order to qualify for SSDI, people must have worked enough to earn enough “credits” as outlined by the SSA. The SSA bases Social Security work credits on the total amount a person has earned in a year.

In 2021 people can earn one credit for each $1,470 in wages or self-employment income. People can earn up to 4 credits a year.

To qualify, people generally need to have 40 credits, with 20 of them earned in the 10 years before their disability. However, the SSA adjusts for age when calculating this.

Complete an application

A person can apply online, by mail, or submit an application directly to a local SSA office.

To file for benefits, some of the information a person will need to provide includes:

• date and place of birth
• details of any marriages and divorces
• names and dates of birth of any dependents
• an alternate contact
• medical release form SSA-827
• medical and job worksheet form SSA-3381

The SSA has a checklist that people can download that details all the information an adult will need when applying for SSDI.

To qualify for SSDI, a person must have worked long enough and recently enough to meet the U.S. Social Security Administration (SSA)’s guidelines.

The SSA consider a person with migraine disabled if:

• they experience migraine headaches that prevent them from continuing their job
• they are unable to adjust to a different job due to migraine
• their headache disorder has lasted or is expected to last at least a year

If the government denies someone’s SSDI claim, they can file an appeal online within 60 days of receiving the denial.

It is important that a person thoroughly read through the reasons given for denial so they can look for evidence or arguments to counteract them.

Individuals have the choice of appealing the decision themselves or hiring a lawyer.

There are four levels of the appeals process:

1. Reconsideration: A different person will look at the application again, along with any new supporting documents.
2. Hearing: An administrative law judge will hear the case. The appellant may need to produce more documentation, and produce doctors or other witnesses to provide evidence.
3. Appeals council: Here, a person may have their appeal dismissed, decided, or sent back to the previous stage.
4. Federal court: People can also file a lawsuit in a federal district court.

If a person wishes to continue to work, they may want to discuss their options with their employer.

Many employers will make reasonable accommodations if a person is able to clearly detail their request.

Things that may count as reasonable accommodations in the workplace include:

• working from home when required
• flexible working hours, to work around migraine
• different lighting
• reducing noise

It is important that people make sure to prepare concrete examples of how work may trigger migraine or make it worse, as well as steps that they or their employer can take to remedy the situation.

People experiencing chronic migraine headaches severe enough that they are unable to work may be eligible to apply for disability benefits either through their employer or a federal program known as SSDI.

To get SSDI, they need to have earned adequate credits throughout their working career and have plenty of evidence to demonstrate that they are unable to work due to migraine.

It is not necessarily easy to claim disability due to migraine, but it is possible. Also, there are steps a person can take to appeal if an initial SSDI application is unsuccessful.