We know that migraine impacts every facet of our life – migraine tends to strike during a person’s most productive years! Frequent attacks are most common in people between 25 to 55, which means they take a tremendous toll on earnings ability. It is estimated that 157 million workdays are lost in the U.S. annually due to migraine.(1)
Whether you have episodic migraine or chronic migraine, adding the demands of a career often makes finding a balance challenging. During an attack, the difficult decision to leave work early or stick it out happens all too often. The challenge is that when you fight migraine for too long, you end up “hurting” for much longer than necessary and increasing the risk of chronification. However, if you take time off too frequently or quickly, people see you as unreliable and it could even cost you your job.
Family and Medical Leave Act (FMLA)
When migraine results in having to take time away from work frequently, you may want to consider requesting FMLA. FMLA covers illnesses, injury impairment or physical or mental conditions that involve inpatient care as well as continuous treatment by a health care provider.(2) Fortunately, managing migraine attacks counts as continuous treatment, and since job protection is an important factor of FMLA, people with migraine have rights that often enable them to keep their jobs. When it comes to using FMLA leave, there are two options – an intermittent or reduced-schedule basis.(2) What this means is that you may be able to take either longer blocks of time off, or use the FMLA time to shorten your workday or week. Understanding these rights can leave you feeling empowered.
One of the challenges that many people with migraine face is that they simply may not be able to take leave, or they need to continue to work through their migraine attacks. They simply have no other choice – or they may think that they have no other choice! Fortunately, things have changed in many situations, especially since migraine is considered a disability under the American Disabilities Act. As a result, there are a variety of accommodations you can legally request from your employer. Some accommodations are free or cost very little for your employer to put into place for you, so don’t be afraid to ask! Remember, migraine is a disability, and the goal is for you to remain at work and be productive, which is something your employer should also want.
The accommodations you request should be personalized to you and your migraine triggers, and they can vary widely from person to person. Bear in mind that a request for accommodations should always be put in writing, and generally it helps to have a letter from your headache doctor confirming that these changes are needed. Here are some of the more common suggestions for accommodations that may help you to continue working while living with migraine:
Many people with migraine are very sensitive to fluorescent lights and find that they trigger attacks. If you work with this kind of lighting, a requested accommodation could be adding filters to those lights to create more natural lighting.
If you are experiencing eye sensitivity from constantly looking at a computer screen, a requested accommodation could be adding an anti-glare filter or filter specific for migraine. In addition, some computer or phone screens have a flicker that can trigger migraine, so requesting a liquid crystal display (LCD) monitor that has a better refresh rate could be an option.
If you are very photophobic and bright light in general triggers or worsens migraine attacks, an accommodation could include moving you to a private area where you can use a low light desk lamp or other lighting more appropriate.
In addition to lighting, perhaps noise has an effect on your migraine? Sound sensitivity or phonophobia is a common issue. Depending on your type of work you may be able to request noise-cancelling headphones while you work. Sound absorption panels can be set up in a work area as well, or even sound machines to help mask loud noise. In addition, asking coworkers to speak more quietly is something to be considered!
Especially since COVID came into our world, flex-time and work from home options have become more accepted. This may reduce the frequency or severity of your migraine attacks, or even enable you to take the necessary abortive medication to treat an attack when it starts – something you may not be able to do if you have to drive home afterwards or if you need to lie down for a short while. For many people with migraine, flex time or working from home proves to be the best solution for both you and your employer!
One of the most common triggers for migraine is smells – both natural and chemical. If that is the case for you, then you can request an accommodation for a scent-free workplace. While some coworkers may be very happy to help out with this without an official accommodation, some may not, so having it in writing is important. You can also request for your employer to provide an air-purification system and keep all areas like bathrooms and conference rooms fragrance free.
In some cases when an attack starts or worsens during the work day, it is necessary to have an “escape option.” This is a place that is dark and quiet so you can rest temporarily and allow your abortive treatment to work.
To Tell Or Not To Tell
While it is good to know that migraine is protected under the ADA, it is not always easy to know whether or not to tell your employer about your medical issues. Depending on your career, your employer may be quick to come to your aid or unfortunately they may choose to give you a hard time, so the decision is up to you and it’s important to understand both your rights and the necessary steps you may have to take ahead of time! The Job Accommodation Network can help you navigate those steps, as well as an organization called Migraine at Work. Bear in mind that while most people who live with migraine are not considered disabled to the point that they cannot work, the majority are not able to function normally during attacks. This leads to lost productivity and something commonly known as “presenteeism,” so exploring accommodations is actually a win-win for both you and your employer!
Remember, if you have migraine then you are living with a complex neurological disease that can affect every aspect of your life. Pushing through constantly and not “making a fuss” may seem easiest at time, but the long-term consequences can end up much more challenging. If you have migraine then you live with a disease that affords you rights and it is OK to speak up – your voice counts!
Let Us Know!
Have you ever had a challenging time working with migraine? What accommodations would be helpful for you to stay working, and have you requested any of them? We want to know what it is like for you to have a career while living with migraine, so let us know in the comments!
Please check out MigraineMeanderings.com for more resources and information on applying for permanent disability for migraine. Also, if you are interested in exploring accommodations for your workplace we encourage you to get familiar with the FMLA (Family and Medical Leave Act), the EEOC (Equal Employment Opportunity Commission), Job Accommodation Network, and Migraine at Work. Know your disease, know your rights, and be empowered as a patient!