Can I be approved and awarded disability if I have migraines?

Migraines are a legitimate condition to list on an application for Social Security or SSI disability. That said, Social Security does not have an impairment listing that specifically provides the medical criteria needed to be approved for disability. This does not mean that you cannot be approved for disability, although it is not easy with migraines only.

Generally, migraines fall under the classification of neurological impairments. Therefore, if migraine headaches were listed in the SSA Blue Book listings, this condition would most likely be evaluated using the adult listing section 11.00, Neurological System'Adult. Unfortunately, migraines do not have their own SSA listing, in spite of the fact they are a commonly listed condition on disability applications.

Individuals with chronic migraines often have a difficult time proving that their migraines are so debilitating that they prevent earnings which the Social Security Administration considers to substantial and gainful income (this is known as SGA, the income limit for those on disability).

However, because Social Security Disability is based upon functionality rather than specific conditions, if migraines cause significant limitation to your daily activities you have the possibility of being approved.

What you need to prove for disability with migraines

A person filing for disability on the basis of migraines must prove that they are no longer able to perform SGA level work activity. This is done through:

A) the information contained in their medical records (medical records should document the frequency, duration, and severity of the migraines in addition to medications, testing, treatment, response to treatment), and

B) the information revealed in their vocational work history, specifically, what types of work they have done, the functional requirements of each of the jobs listed, and their job skills that might enable them to transition into another kind of work.

Social Security Disability considers the ways and extent to which a person is functionally limited, because it impacts their ability to engage in work activity. Consequently, disability specialists must consider a person's ability to do past work or other kinds of work, if they do not meet or equal an impairment listing. If a person's limitations prevent the performance of past work or other kinds of work when their limitations, age, education, an job skills are considered, they may qualify for disability through a medical vocational allowance.

Your own documentation for a migraine disability claim

You need to have a well-documented medical history that supports your allegation of disability. Social Security Disability examiners look for medical treatment records that show the frequency and severity of your migraines. Additionally, they look for objective medical testing such as: MRI results, CT scans, and any other testing available.

You may be able to help your disability claim by completing a migraine journal. Doctors often suggest keeping a diary that provides A. the dates of your migraines, B. if there was an aura prior to the migraine, and C. whether or not the prescribed medication had any effect, etc.

Information from your doctors for a migraine case

Of course, it is imperative that your doctor's treatment notes are in sync with the contents of your migraine diary.

You will not be able to be approved if you only have occasional migraines that are easily controlled by medications. You have to be able to show that the migraines are happening often in spite of your medical treatment, and that the migraines cause you to be mentally impaired for a lengthy amount of time.

It is also very helpful for your treating physician to provide a statement that provides your diagnosis, response to treatment, and your prognosis along with a detailed statement as to their opinion of the limitations caused by your migraines.

If you do not have a medical professional, but you have been to the ER, or hospitalized due to your migraines, you may be able to show that your migraines are disabling. Evidence must show that you have had multiple hospital visits for your migraines.

Basically, this kind of information allows the disability examiner to consider other impairment listings than be equaled by the limitations caused by your migraines. It has been suggested that a possible equaling of the seizure impairment listing could be used to approve individuals who suffer from migraines.

Qualifying for disability benefits if you have migraines

Whether or not you qualify for disability and, as a result, are approved for disability benefits will depend entirely on the information obtained from your medical records.

This includes whatever statements and treatment notes that may have been obtained from your treating physician (a doctor who has a history of treating your condition and is, therefore, qualified to comment as to your condition and prognosis). It also includes discharge summaries from hospital stays, reports of imaging studies (such as xrays, MRIs, and CT scans) and lab panels (i.e. bloodwork) as well as reports from physical therapy.

In many disability claims, it may also include the results of a report issued by an independent physician who examines you at the request of the Social Security Administration.

Qualifying for SSD or SSI benefits will also depend on the information obtained from your vocational, or work, history if you are an adult, or academic records if you are a minor-age child. In the case of adults, your work history information will allow a disability examiner (examiners make decisions at the initial claim and reconsideration appeal levels, but not at the Social Security hearing level where a judges decides the outcome of the case) to A) classify your past work, B) determine the physical and mental demands of your past work, C) decide if you can go back to a past job, and D) whether or not you have the ability to switch to some type of other work.

The important thing to keep in mind is that the social security administration does not award benefits based on simply having a condition, but, instead, will base an approval or denial on the extent to which a condition causes functional limitations. Functional limitations can be great enough to make work activity not possible (or, for a child, make it impossible to engage in age-appropriate activities).

Why are so many disability cases lost at the disability application and reconsideration appeal levels?

There are several reasons but here are just two:

1) Social Security makes no attempt to obtain a statement from a claimant's treating physician. By contrast, at the hearing level, a claimant's disability attorney or disability representative will generally obtain and present this type of statement to a judge.

Note: it is not enough for a doctor to simply state that their patient is disabled. To satisy Social Security's requirements, the physician must list in what ways and to what extent the individual is functionally limited. For this reason, many representatives and attorneys request that the physician fill out and sign a specialized medical source statement that captures the correct information. Solid Supporting statements from physicians easily make the difference between winning or losing a disability case at the hearing level.

2) Prior to the hearing level, a claimant will not have the opportunity to explain how their condition limits them, nor will their attorney or representative have the opportunity to make a presentation based on the evidence of the case. This is because at the initial levels of the disability system, a disability examiner decides the case without meeting the claimant. The examiner may contact the claimant to gather information on activities of daily living and with regard to medical treatment or past jobs, but usually nothing more. At the hearing level, however, presenting an argument for approval based on medical evidence that has been obtained and submitted is exactly what happens.

Facts about Migraines

1) Migraine is a type of severe headache that lasts anywhere from four hours to 3 days and is oftentimes accompanied by painful throbbing on one side of the head, sensitivity to light and sound, sweating, fatigue, chills, nausea, and vomiting.

2) Although not present in all migraine patients, some people experience warning symptoms before migraine called aura. These symptoms include altered body perceptions such as unusual visual perceptions, strange smells, or other odd sensory perceptions. Aura usually appears an hour or so before the headache stage. It is estimated that nearly 30 percent of migraine sufferers experience aura.

3) It is thought that nearly 11 out of every 100 American experience migraine. While migraine is more prevalent in women than men, women report having less migraines while pregnant.

4) It is thought that the cause of migraine is abnormal brain activity brought on by environmental triggers. There are many known 'triggers' for migraine, or things that seem to cause a migraine attack for certain patients. Some known triggers are: bright lights, stress, smoking, alcohol, loud noises, skipping meals, offensive or strong odors, birth control pills, certain foods, and tension headaches.

5) It is thought that foods containing MSG (monosodium glutamate) can trigger migraine, as well as foods containing nitrates or tyramine. Many doctors recommend patients keep a food diary to determine if certain foods are triggering migraines so they may be omitted from the patients diet.

6) There is no cure for migraine, though different medications can be used to combat individual symptoms. Over-the-counter pain medication such as nonsteroidal anti-inflammatory drugs (NSAIDS) may be used as a first defense, although narcotic pain relievers may be more effective for more severe migraine. Sedatives and anti-nausea medications are also frequently prescribed.

7) Many studies have also found that weather changes such as changes in barometric pressure, high humidity, and other significant changes in temperature and weather were triggers for migraine.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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