Applying for Social Security Disability Benefits with Migraines
The Migraine Research Foundation reports that around 18 percent of women and six percent of men in the United States suffer migraines. Ninety percent of these individuals are unable to work during an active migraine and often for hours or even days after an attack. If you are among them, you may be entitled to Social Security disability benefits.
The frequency, duration, and severity of your migraines determine whether you qualify medically for benefits, but the Social Security Administration (SSA) also has technical or financial eligibility rules. If you’re able to satisfy all requirements for Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI), then you can count on having a steady source of income, even if your migraines stop you from working.
The Financial Costs of Migraines
While most sufferers experience a migraine attack about once or twice a month, the Migraine Research Foundation reports that about 14 million Americans are affected by debilitating pain, fatigue, and other symptoms on a daily basis. As the eighth leading cause of disability in the world, according to the World Health Organization (WHO), migraines may prevent employment entirely and may erode your social life, your enjoyment of hobbies, and even your ability to care for yourself, you home, your pets, or your children.
Given these implications, the costs of chronic migraines obviously cannot all be quantified in dollars, but the financial impact can’t be overlooked either. Unlike many chronic illnesses that develop later in life, migraines tend to strike during a person’s most productive years. They’re most common in people ages 25 to 55, according to the WHO, which means they take a tremendous toll on earnings ability. In fact, the Job Accommodation Network estimates that 157 million workdays are lost in the U.S. annually due to migraine headaches.
In addition to loss of earnings and the impact chronic headaches have on your personal life, you also face ongoing medical expenses. There is test to discover migraines though. Instead, the diagnosis is one of elimination, which means your doctor must rule out other causes. The Migraine Trust indicates that a full neurological evaluation, extensive blood work, and other exams and lab work may be necessary. Your doctor may order MRIs and other imaging tests. In 2014, Time magazine noted the average cost of an MRI at $2,600.
Diagnostic expenses only skim the surface of ongoing healthcare costs you’ll face though. Once you have a diagnosis, migraine medications become a major, monthly expenditure. The American Journal of Managed Care reports average prescription costs of more than $160 per month for a single migraine medication, and many patients require multiple drugs to manage symptoms and decrease the frequency of attacks.
Medically Qualifying for Benefits for Migraines
The SSA has no standard disability listing for migraines in their Blue Book, but this doesn’t mean you can’t get approved for benefits with chronic migraines. It simply means you’ll need to prove that you’re unable to maintain a full-time job and earn a gainful living due to your limitations.
To determine your eligibility, the SSA will:
- Look at your daily limitations
- Consider the frequency and severity of your headaches
- Examine your employment options
- And review your medical evidence
If after taking all of these factors into account, the SSA finds you’re unable to perform the essential job duties of any job for which you’re otherwise qualified, then you’ll be deemed medically eligible for SSDI and/or SSI benefits.
The frequency and duration of your headaches and the extent of your migraine symptoms (nausea, fatigue, imbalance, light and noise sensitivity, etc.), tell the SSA how often you must miss work. The length of migraine attacks, which can average a few hours or several days at a time, inform the SSA about your ability to keep a consistent work schedule.
When it comes to evaluating daily limitations, the SSA will use your medical records and functional report forms that you and your doctor complete. Ensure you accurately reflect all of your limitations by thoroughly completing these forms and describing in detail the manner in which your headaches and other symptoms affect your ability to perform everyday tasks.
For example, if you work in a manufacturing environment, the SSA needs to see that the noise and active pace of the workplace will exacerbate migraine symptoms and increase their frequency. If during your migraines, you’re able to do little else beside lie in bed in a dark and quiet room, then the SSA will know you cannot reasonably set foot on a manufacturing floor.
To be approved for disability though, you’ll also need to show that your migraines prevent you from working in an office environment or sedentary position as well. This means they need to see evidence that you’re unable to effectively communicate, interact with others, look at a computer screen, or perform other essential job duties because of your headaches and other migraine symptoms.
How to Apply for Disability Benefits with Migraines
When you’re ready to apply, just in mind that the review process will take some time and that the application is only the first step. You’ll receive functional report questionnaires in the mail that you must fill out and get back to the SSA quickly. This is usually just 10 days from the date they were mailed to you.
Since your migraines may make it hard for you to read, write, or concentrate, consider preparing for these questionnaires in advance, and be sure to ask for help if you need it. An SSA representative, a friend or family member, or a Social Security disability advocate or attorney can assist you.
You can ready yourself for the functional report by writing down notes about your daily challenges and struggles. Make a list of the tasks you have to ask others to help with when you have a migraine. These may include everything from washing your hair and preparing food to shopping for groceries and running other errands. Keep track of how often you have attacks and how long they put you out of commission. Your notes can be invaluable “cheat sheets” when it comes time to fill out questionnaires.
Your medical records are a primary source of details for the SSA when determining eligibility as well. Although the SSA has no disability listing for migraines and therefore no clear list of essential medical evidence, they generally need to see the following for a migraine application:
- Diagnosis methods your doctor used to rule out other conditions and determine that your headaches are migraines
- Imaging scans results, like MRIs and CTs, if you’ve had them done
- Medications your doctor has prescribed and their affects
- A list of your symptoms and ideally notes from your primary care doctor and other medical professionals that have witnessed your symptoms first hand during office or emergency room visits
In addition to these key pieces of medical documentation, the SSA will also likely need to see a “longitudinal report” from your primary care physician. This report will document:
- your diagnosis, symptoms,
- frequency and duration of migraines,
- prescription medications,
- and other treatment methods.
The report should cover a minimum of three months, showing that your migraines are frequent, severe, and debilitating when they occur. The report should also show that you’ve received ongoing care from a physician and that you’ve followed prescribed therapies.
If you’re applying for SSDI, you can do the entire application online and at your own pace. You can also apply in person, at the local SSA office, or in some cases, over the phone. SSI applications however require a personal interview, which means you’ll need to visit the branch office or call the SSA at 1-800-772-1213.