April 23, 2019

How to Describe Your Migraine Headaches to a Social Security Judge

How do you describe to a Social Security judge what it is like to experience migraine headaches?   Describing headaches is a difficult task at best, but you can assume it will be more difficult when you add in the stress of testifying in a Social Security courtroom before a judge.

One of the keys to successful testimony is to remember how Social Security looks at “disability” in a migraine case – your inability to perform a simple, entry-level job because of symptoms associated with your migraines, medication side effects and symptoms from any other medical condition you may have.

Another way to think about what you want your testimony to accomplish – how do I show the judge that I would not be a reliable worker?  that I would miss too many days of work and that I would have too many unplanned absences during the days I was there.

Here are some tips about how to prepare your testimony:

  • discuss duration and frequency of your headaches – even though your migraines may not follow a set pattern, for purposes of your disability hearing, decide how you will answer the judge’s questions about the frequency and duration of your headaches.  Do not say “I get bad headaches all the time and they can last all day.”  Instead, say something like this:  “I get severe migraine headaches at least once every 10 days.  When I feel a migraine coming on, I immediately take XYZ medicine and sometimes that will reduce the severity of the headache and it will only last five or six hours.  If I don’t catch it in time, my headache will last at least eight to ten hours.  During cold weather, the frequency of my headaches increases and I have them every 7 days.  If I am under stress, they could happen every 3 or 4 days.  Under the best of circumstances, my migraines will last five or six hours, at worst they can last eight to 24 hours.”
  • discuss severity of your headaches – do not say “when I get a migraine, it feels like a toothache.”  Instead, say something like this:  “when I get a migraine, the pain in my head is at a 9 or 10 on a ten point scale.  The pain is so bad that I cannot tolerate light or noise and I immediately go to bed, pull the shades down and avoid any light nor noise.”
  • discuss your efforts to control your headaches and your frustration at not being able to do so.  Say something like this: “I have done everything my doctor has told me to do.  I took XYZ medication but I found that it did not control my pain and I got nauseous.  My doctor then put me on ABC medication and I take it when I feel a migraine coming on – it can shorten the duration of my headaches but it does not reduce the intensity.  My doctor suggested biofeedback and I tried it.  My doctor suggested XYZ therapy and I tried it.  These headaches have completely altered my life.  I avoid leaving my house because of my fear about what I would do if a migraine hit.  I have not been able to travel to see my (grand)children and I avoid all social situations – even movies and grocery shopping.

Remember, Social Security judges want specifics – not generalities.  The more you can focus on time, distance, and other units of measurement the better.  This allows judges to put those limitations into a question about your capacity that will be posed to a vocational witness.  The more realistic and severe limitations you can set out the better your chances.

 

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