September 22, 2019

Winning Arguments in Migraine Disability Cases

There are three main arguments that judges consider when evaluating Social Security disability cases.  Two of these arguments rarely apply in migraine disability cases, but the third – called the functional capacity argument can be used with great success.

The two arguments that rarely work are called the “meet a listing” argument and the “meet a grid rule” argument.  The “listings” refers to a Social Security publication called the “Blue Book.”  In the Blue Book, Social Security identifies a variety of medical conditions that are considered serious enough to prevent a patient diagnosed with one of these conditions from working.   Examples of listing level conditions include certain cancers, serious heart disease, diabetes with complications and schizophrenia.

The “meet a listing” argument does not apply in migraine cases because there is not yet a listing for migraines.  The closest listing that can sometimes apply may be found in the Neurological conditions section of the Blue Book.   Claimants who have suffered significant head injuries and are left with severe headaches and other limitations may meet a neurological listing.  But for a claimant who suffers with migraines alone, there is no listing that directly applies.  Social Security has given some thought to adding a listing category for migraines but this proposed change has not yet happened.

The “meet a grid rule” argument does not apply in migraine cases because the grid rules only apply in cases where you have a physical limitation.  The Grid Rules refer to a set of regulations that applies to claimants over age 50 who have a limited education and limited work skills.  The grid rules reflect Social Security’s recognition that claimants over age 50 with limited skills and a limited education will have difficulty finding simple, entry level work.  Even if such a person could perform simple work, that person is considered “disabled” because he/she would most likely not be able to find a job.  Pain is not considered a physical or “exertional” impairment so the grid rules are not applicable.

The Functional Capacity Argument – Your Best Bet in  Migraine Disability Cases

migraine disability winning strategyA “functional capacity argument” is the most common argument used by successful disability claimants who cannot work because of migraine headaches and associated complications.   When building a case around this idea, you will assert that your capacity to perform even a simple, entry-level, low stress job has been so diminished by the frequency and duration of your headaches, and by the side effects of medications used, that you would not be a reliable worker.

In other words, your capacity to function (“functional capacity”) has been so eroded by your migraine headaches that you can no longer meet the demands of any type of work.

Some functional limitations specific to Migraine cases

In migraine headache cases, the functional capacity limitations that usually apply include job attendance and daily reliability problems.  Migraine patients frequently experience headaches randomly, with no specific cause identified.  When a migraine hits, you may need to lie down in a dark room and avoid all stimuli including noise or light.  If you happen to be at work, you will have to leave or be driven home.  Unscheduled absences from work are also common.  As you know, severe migraine headaches cause pain at such a level that no activities of any type would be possible.

The main questions you will want to discuss relate to:

  • the frequency of your migraines
  • the severity of your migraines
  • how long do your migraines last when they occur?

Your judge will want to know

  • Are you sincere, truthful and credible?
  • Have you tried without success all available therapies and medications proposed by your doctor?
  • Does your medical record support your allegations of the severity and frequency of you headaches?

If your doctor will document activity limitations – preferably in a functional capacity checklist – you have a good chance at winning.  For example, you will want your treating doctor to state that you will need unscheduled breaks from work, that you will miss several days of work each month because you can’t come in, and that you need low stress activities.  Your doctor should also describe the unpredictability of your migraine headaches, side effects of medications and how successful are your medications in reducing your symptoms.

If you find that the frequency and duration of your migraine headaches leave you unable to find or keep a job, you may have a viable Social Security disability claim.   We invite you to complete the case evaluation form on this page to speak to a lawyer experienced in representing migraine disability claimants.