Migraine is not just a headache. It is a complex neurological disease with multiple symptoms that are often incapacitating.
Increasingly, severe and frequent migraines are being considered grounds for winning a disability case; however, it is still an uphill struggle since migraine disease is not one of the conditions actually listed by the Social Security Administration (SSA). The closest condition in terms of limitations and functional capacity is epilepsy which the SSA has listed. Bearing that in mind, to help the disability case you need to include any other disabling conditions so that the SSA may consider their cumulative effect. It is common for people with migraine to have comorbid conditions, so be sure to include medical evidence for that if it is relevant to you.
Disability and Migraine
Filing and winning a disability claim can be a lengthy, exhausting and discouraging process. However, there are many things you can do that are key to your case and which may help smooth the process.
- Build a migraine history
- Ensure your doctor supports your claim
- Educate the evaluator and/or judge on migraine; presume they know nothing about genetics, symptoms, severity, duration or progression. Outline every symptom you experience at every stage (prodrome, attack, postdrome) and show how they affect your daily functioning and ability to work
- Be specific about your disability rather than your illness. Be thorough in describing your level of impairment
- Detail your work history and include examples of why you can no longer do this work
In order to determine eligibility for disability, the social security administration will do several things. They will look at your daily limitations, consider the frequency and severity of your migraine attacks, and consider any other medical conditions which limit your ability to work. They will examine your employment options - not only previous work experience but anything else you might possibly be able to do and review your medical evidence.
The argument used most often and successfully in migraine disability cases is the “functional limitation argument.” A functional limitation is defined as “A substantial impairment in a person’s ability to function in the condition, manner, or duration of a required major life activity.” It’s important that your medical records include specific details about how migraine interferes with your ability to perform on the job. When you build your case around this argument, you claim that the frequency, severity, and duration of your migraine attacks reduce your ability to perform simple or even entry-level tasks—thus, leaving you unable to do any type of work. You will need to show why you cannot do ANY regular full-time work at all, not just the employment you have previously had or were trained/educated for.
After You Have Been Approved for Disability
After you have won your disability case there are still things you need to be aware of, including collecting back benefits, paying your attorney (if you had one), collecting benefits for any of your children under 18, including back benefits for them, and being aware of part-time work limitations going forward.
Once social security has determined that you are eligible for permanent disability, you will receive a letter from them letting you know what your monthly benefits are, the start date for your disability, and when you can expect to be re-evaluated.
Your start date can go back almost to the date when you filed a claim for disability. This means that if you didn't win your case for several years, you may be entitled to a significant amount of back benefits. You will receive instructions about how to provide information for direct deposit, and also when you will be eligible for Medicare.
If you hired an attorney, their payments will be taken out of your back benefits BEFORE it is sent to you. The amount they are paid is not negotiable; it is set by the Federal government. That amount is limited to 25% of your back benefits due up to a maximum of $7,200. You should not have paid them anything directly except for the fees necessary to obtain your medical records. (We always recommend you obtain your own medical records and give them to your attorney)
If you have children under age 18, they will also be eligible for social security benefits up to a maximum of 50% of your benefits between them. So if you are awarded $1,000 per month and have two children under 18, each of them will receive $250 per month. You will be their "payee representative" and will need to set up a separate bank account for these funds which are designed to be used for essentials such as housing, food, clothing and education. Make sure you keep detailed and accurate records of everything you spend these funds on. Every year you will need to provide that information to Social Security.
Your children will also be entitled to 50% of your back benefits between them. If your children are over 18 on the date you win your case but they were under 18 at any point in time since your "award date," their back benefits will be prorated for the time that they were under 18. You will need to go to your local Social Security office with your children's IDs and file a form that claims them as dependents. This enables you to request back benefits for them as well as ongoing monthly benefits.
Social Security has a multi-tiered system for those people on permanent disability who want to work part-time. It is a complex system and we recommend that you download and read the Social Security's "Working While Disabled" handbook from this website for all the details. Each year the monetary limits change, so please check for the current information to make sure this website is accurate.
Whether you are a part-time employee or self-employed, you will need to call your Social Security Case Manager to report your earnings. You may also be able to do this on your Social Security portal. Make sure that you keep accurate and detailed records of your earnings month by month, since Social Security will periodically send you a request for this information and it will need to match up to your annual tax returns. Sometimes these requests will go back 2-3 years, hence the need to keep accurate records.
In 2023, if you earn less than $1,050 gross wages in a month, or less than $1,050 net self-employed income (after business expenses), you can still keep receiving your full benefits amount.
Social Security has something called a Trial Work period. This allows you to test your ability to work for at least 9 months while you continue to receive your benefits. In 2023, a trial work month is any month your total earnings are over $1,050. If you’re self-employed, you have a trial work month when you earn more than $1,050 (after business expenses) or work more than 80 hours in your own business. The trial work period continues until you have used 9 cumulative trial work months within a 60-month period.
It is also worth noting that if you recover sufficiently from migraine and any other conditions so that you want to try and return to work, there is a Ticket to Work program. Please see the above handbook for more information on this.