Social Security disability (SSD) benefits are for people who cannot work due to a chronic condition lasting 12 months or longer. The Social Security Administration (SSA) determines what conditions quality for benefits and which do not, based on the SSA’s Blue Book. While this Blue Book doesn’t have a specific listing for migraines, you can still qualify for SSD benefits. That’s because in 2019, the SSA issued a policy ruling on evaluating claims for primary headache disorders, including migraines. If you suffer from migraines, here’s what you need to know about qualifying for Social Security disability payments.
How Do You Know If Your Headaches Are Migraines?
There are a variety of different headaches people may suffer from, but a migraine is definitely one of the worst. This type of headache can cause throbbing or pulsating pain on one side of your head. In addition, migraines are often accompanied by intense light and sound sensitivity, nausea and vomiting. Migraines can last from several hours to a few days, and many sufferers require a cool, dark place to lie down until it passes. Some people may also experience warning symptoms — called prodromes — such as arm or leg tingles, flashes of light or blind spots.
Medications, lifestyle changes and other therapies can reduce the intensity and frequency of chronic migraines. But not every severe, chronic headache is a migraine, so how can you tell if one’s coming on? There are a number of migraine triggers, including:
- Foods like aged cheese and salty processed snacks
- Skipping meals
- Hormonal changes
- Food additives like aspartame or MSG
- Over-stimulated senses (i.e., loud sounds, strong smells, sun glare, bright lights)
- Environmental changes (including weather)
- Medication side effects
- Sleep-wake pattern changes
- Certain drinks, especially wine and too much coffee/caffeine
2019 Policy Outlines How SSA Evaluates Disability Claims for Migraines
The SSA shows in its SSR 19-4p policy ruling that chronic headaches are among the most common nervous system disorders. The policy specifically says that for your migraines to count as a qualifying disability, most approved applicants will:
- Need prescription medication
- Schedule routine doctor visits to treat migraine symptoms
- Have gone to the ER at least once with a migraine
If your migraine symptoms are “equal” to another “severe” eligible condition, you’re more likely to get benefits. The key thing to say on your claim is that when combined, all your medical conditions and symptoms prevent you from working for one year. Some medical research finds that migraines are closest to seizure disorders, including epilepsy. For this to be equal, your migraines must happen a certain number of times and impair your mental ability to function normally for several hours.
Evaluation Criteria for Migraine With Aura Disability Claims
If you suffer migraine with aura headaches at least 2x per week even under your doctor’s treatment, they must include one or more of the following:
- Visual symptoms
- Sensory symptoms
- Speech or language symptoms
- Motor symptoms
- Brainstem symptoms
- Retinal symptoms
In addition, your headaches must have at least 3 of these 6 characteristics to qualify as a disability:
- At least one aura symptom gradually spreads over a period lasting five minutes or longer
- Two or more symptoms occur one right after the other
- Each aura symptom lasts anywhere from 5 minutes to an hour
- At least one symptom is “unilateral” (for example: you cannot talk or understand what others say to you)
- At least one symptom is “positive” (for example: you feel pins and needles)
- Your migraine headache happens at the same time as your aura symptoms, or begins within an hour
Evaluation Criteria for Migraine Without Aura Disability Claims
If you suffer at least five migraine without aura attacks, each incident must meet the criteria listed under 1-3 below:
- Lasts anywhere from 4-72 hours (either without any treatment or unsuccessfully treated by your doctor), AND
- Has at least 2 out these 4 characteristics:
- Unilateral location (meaning, you feel the pain on one side only)
- Pulsating quality
- Pain level is moderate to severe
- Worsens with routine physical activity, or makes those impossible to do (i.e., walk up or down stairs), AND
- You suffer one or more of the following during your actual headache:
- Photophobia (sensitivity to light)
- Phonophobia (sensitivity to loud noises)
Regardless of which type of migraine you suffer from, you also need the right medical evidence to support your claim.
Medical Evidence That May Help You Get Social Security Disability Benefits for Migraines
The SSA will consider your symptoms in combination with other findings when reviewing your SSD application. First, you must have a doctor who’s an acceptable medical source diagnose your condition. Second, you and your doctor should keep a migraine journal detailing a typical headache event, including:
- Pain intensity
- How long it lasts
- Any observable signs (i.e., tremors, flushed skin, sweating, etc.)
- Possible triggers
- Medication and dosage, if applicable
- Relief level
Third, the SSA reviews your medical records for the following information:
- Doctor’s notes showing how often you have migraines and their severity
- Lab test results to rule out other conditions
- List of medications and treatments tried, along with their results
- ER visit and hospitalization records related to your migraines
Fourth, your doctor should complete a residual functional capacity (RFC) form. This form describes how your migraines limit your ability to work and complete daily living tasks. Your disability application alone isn’t enough to get approved for benefits.
You May Qualify for Legal Assistance
Getting Social Security disability benefits for migraines isn’t easy. You’ll double your approval chances the first time you apply if a Social Security attorney files your claim. The SSA approves less than 1 in every 4 first-time applicants for disability benefits (23%). Most people wait up to two years before getting their first disability check!
Luckily, you can sign up for a no-obligation consultation and have a lawyer review your claim for free. Your free consultation can happen over the phone while you’re at home. You’ll get confidential legal advice about your specific situation. If a lawyer can’t get your claim approved, you pay $0 for legal assistance. And if you do win, then you’ll only pay a small, one-time fee.
Ready to see if you may qualify? Click the button below to start your free online benefits evaluation now!