Anyone who experiences migraine headaches knows how debilitating these headaches can be. Some individuals experience migraines so frequently they are not able to hold a job.
Three Step Process.
In order to prove that migraine headaches are disabling, the individual should use the following 3 Step process.
1. Establish the impairment of migraine headaches. Social Security has a general rule that an individual cannot establish an impairment solely on self reported subjective symptoms. There must be documented clinical signs or laboratory findings that establish the impairment. See SSR 16-3p. Consequently, it is difficult to establish migraine headaches as a severe impairment because the diagnosis is almost always based on subjective symptoms reported by the patient.
In order to establish a diagnosis of migraine headaches, two requirements must be met. First, there must be a detailed description from a physician of a typical migraine headache that includes a description of all associated phenomena. Second, the physician must rule out other possible disorders that could be causing the symptoms.
Three additional clinical indicators support a diagnosis of migraine headaches.
1. A headache that lasts from 4 to 72 hours.
2. Two of the following:
(a) unilateral, pulsating (throbbing) quality.
(b) moderate (inhibits but does not wholly prevent usual activity) or severe (prevents all activity) pain intensity.
(c) worsened by routine physical activity (or causing avoidance of activity).
3. At least one of the following during the headache:
2. Establish the impairment has lasted for more than 12 months. One of requirements for an award of disability benefits is the impairment must last (or be expected to last) for more than 12 months. SSA rarely finds that migraine headaches prevent a person from working for a continuous period of 12 months. To satisfy the 12 month rule, the individual must produce medical records documenting treatment for migraine headaches for more than 12 months.
3. Establish the impairment is so severe that it precludes regular work activity. It is always difficult to prove to a skeptical disability judge that self reported subjective symptoms are so severe that they preclude all substantial gainful activity. The following types of evidence help support a finding of disability.
1. A detailed description of the migraine headaches by a physician.
2. Medical treatment for migraine headaches for more than 12 months.
3. Test results that eliminate other possible causes for the migraine headaches.
4. The type, dosage, effectiveness, and side effects of any medication the individual takes or has taken to alleviate migraine headaches.
5. Treatment, other than medication, the individual receives or has received for relief of migraine headaches (e.g. acupuncture, chiropractic adjustments).
6. Any measures other than treatment the individual uses or has used in an effort to get relief from migraine headaches (e.g., avoiding sunlight, avoiding noise, lying in a dark, quiet room)
7. The location, duration, frequency, and intensity of the headaches.
8. Factors that precipitate and aggravate headaches.
9. The negative impact headaches have on the individual’s daily activities.
10. The unpredictability of the migraine headaches.
11. A letter from a treating physician stating that migraine headaches preclude substantial gainful activity.
12. Medical problems in addition to migraine headaches that make it difficult to work.
This Article was updated February 26, 2018.