What are the elements of a winning migraine disability case? Sure, every disability case is a little different, but I believe there are some features which may separate good cases from not-so-good cases. Let’s look at the following migraine case example and then assess what elements of this case are wining elements:
Migraine Case Example
Megan was a forty-year-old marketing executive who had worked with a prestigious company since high school. Having worked during the day and attended night classes at a local university, Megan had earned a Masters degree in Business Administration. Within the last twelve months, Megan had begun experiencing chronic headaches that were often accompanied by blurred vision and vomiting. Having seen her general physician, he diagnosed Megan with migraine headaches. She was prescribed the drugs Midrin and Compazin. Feeling confident with the decision of her general physician of ten years, Megan did not pursue additional testing or seek a second opinion.
Following a migraine attack, Megan would often be physically unable to continue working and would require bed rest. Although the majority of Megan’s migraines normally lasted a few hours, she commonly experienced one or two migraines per month that would last for several days. Despite being prescribed medications by her general physician, Megan continued to experience migraine headaches at a minimum of four-to-six times per month. Having missed an average of 10 days per month over the last twelve months, Megan resigned from her executive position and applied for Social Security Disability benefits.
Assessment
Megan’s case looks like a potentially strong one. What elements make her case strong, you may ask?
A Diagnosis – Having a diagnosis is key to winning a disability claim. In this case, Megan has been diagnosed with Migraine Headaches and has been prescribed associated meds.
Compliance with treatment – Judges always like to see that claimants have been compliant with treatment. They are more willing to award benefits if they see that the claimant has made a good faith effort to get better. It appears from the information given that Megan has been compliant with the treatment for her migraine headaches. Despite taking the appropriate medications, however, Megan’s severe Migraine Headaches continue to ail her.
Severity and frequency of headaches prevent work activity – In order to be approved for disability benefits, you must be able to prove that your condition prevents you from being able to work. In a migraine case, therefore, you must show that your Migraines are frequent and severe enough so as to make employment impossible. In Megan’s migraine case, her debilitating migraine symptoms occur so frequently that she misses 10 days of work on average. Missing this much work in itself precludes employment.
Condition Lasting in Excess of 12 Months – You may have noticed that the last sentence of the case example states that Megan’s symptoms have occurred over a period of 12 months. This point is also key, since in order to be awarded disability benefits, your symptoms must have lasted or be expected to last for at least 12 months (or result in death).
(end of part 1 – part 2 will be published later this week)
Filed under Case Studies, Strategies for Winning by on Oct 12th, 2009. Comment. 
In the last post, I introduced a brief migraine case study (involving 40-year-old Megan) and identified what I believed to be the winning elements of her case. However, since the time of that post, a new issue has been brought to my attention, and that is the issue of whether to see a specialist if you are suffering from migraines and want to pursue a disability claim.
Do I need to see a specialist or is my general/family physician enough?
As we saw with Megan in the beginning of this article, she only consulted with her general physician. Although the opinions and/or diagnosis of a family physician is credible and is in no way minimized or to be considered as such, the Social Security Administration often will not approve a disability claim on the finding of a general physician, family physician, chiropractor, or a DO (Doctor of Osteopathic Medicine) alone.
In considering whether to award an individual who suffers from migraine headaches disability benefits, significant weight is given by the SSA to those test results, opinions, and diagnoses of treating headache specialists, neurologists, and/or pain management specialists. So in essence, in order to strengthen your disability claim, it is always advisable to seek the opinion of a physician specializing in your chief complaint.
Filed under Strategies for Winning by on Oct 16th, 2009. 1 Comment.
Good medical evidence to back up your claim for disability benefits is a must!
This point cannot be stressed enough. If you suffer from migraine headaches and are claiming disability based on your migraines, you better believe that the adjudicator or Judge assessing your claim will look thoroughly through your comprehensive medical record for evidence to back up your claim. People are often denied benefits due to a lack of records or a failure of the records to match up with their alleged impairments.
Florida Social Security Disability attorney Elizabeth Stakenborg recently posted an article which highlights the importance of medical records in a migraine case.
The article tells the story of a migraine claimant who is actually approved early – without even having to appear at a hearing – thanks to having a solid medical record to confirm her allegations of pain arising from migraines.
When the Administrative Law Judge reviewed the record and saw that the claimant’s statements regarding her limitations were supported by the evidence (including medical records prior to the date she last worked) the claim was awarded.
If you are pursuing a migraine disability claim, please be sure to not only seek treatment for your condition but also to keep record of all of your medical treatment. When the time comes to submit records to go along with your claim, you want to be sure to have medical records which confirm your allegations.
Filed under Strategies for Winning by on Oct 16th, 2009. Comment.
