Migraine headaches afflict one in five women in the U.S. Those who suffer from migraines need no description of the symptoms because they know them all too well. But people who live with and love migraine sufferers can learn what a person with migraines really experiences. Anyone who thinks migraines are just mild headaches that are being exaggerated is dead wrong.
Symptoms of migraine headaches are not limited only to an intense, throbbing headache. Migraines frequently cause nausea and vomiting, painful sensitivity to light and impaired vision, mood changes, and other debilitating feelings that can last up to 72 hours.
The prevalence of migraines in women more than in men supports the belief that hormonal changes play an important role in migraines, as does heredity. Children of parents with migraines have a 50% chance of developing migraines.
Can Migraine Headaches Be the Basis for a Long-Term Disability Claim?
The answer is yes, many migraine sufferers can qualify for long-term disability. But since migraines affect different individuals to varying degrees, long-term disability is typically only available to those who can show that they are unable to work consistently.
The determination of whether your case will qualify for benefits under a long-term disability (LTD) policy is whether you meet the policy’s definition of “disabled.” Your long-term disability policy is a contract, and like all contracts, the words can be specifically defined within the contract’s terms. The court will honor how a contract defines terms if the definitions are not unreasonably unfair to the consumer or if it violates the law.
To find how qualifying disability is defined, you must read your LTD policy completely. If you are not confident that you understand every term, you should consider contacting an experienced long-term disability lawyer who can review the documents and fully advise you on your rights and obligations.
Generally, most LTD policies will qualify a person as disabled if they can show that their illness, injury, or impairment prevents them from performing their job on a regular enough basis to maintain employment. With migraines, it’s not unusual for a sufferer to be able to work a few days and then be completely unable to drive to work or even sit in a bright room because of the onset of a migraine.
Physical and Cognitive Abilities
Disabilities are not just physical and visible. Mental impairments, including an inability to concentrate sufficiently to do your work, will be considered a disability. The key to winning a disability claim under a long-term disability policy is obtaining medical evidence supporting the existence and severity of the condition.
Medical evidence “proving” the existence of migraines is not available. But medical records can reveal important evidence that will be accepted as proof if it is thorough, persists over time, and indicates a chronic condition preventing you from performing your normal duties:
- Records containing a detailed medical history of headaches and other symptoms
- features of the headaches,
- frequency of headaches,
- intensity of headaches,
- accompanying symptoms
- How the headaches affect your daily life and activities
- Family history of headaches (genetic origin)
- Complete neurological examination
- MRI and CT scan ruling out other causes
- Thorough, detailed migraine diary noting date, time, duration, and experience of every migraine
Does Your LTD Policy Use “Own Occupation” or “Any Occupation” Standard of Disability?
Different long-term disability policies apply different measures of someone’s inability to work.
- Own Occupation — An own occupation policy will measure your disability by whether you are able to perform you own job. Instead of relying solely on your description of your duties, the insurer will typically use the average duties of a person in your occupation across the nation. If you are charged with special duties in addition to the usual tasks associated with your job, you must note those. Under this kind of policy, if your impairment prevents you from performing your own job, you would be entitled to receive your long-term disability benefits.
- Any Occupation — In an “any occupation” policy, the contract will require the company to pay your benefits only if your medical evidence demonstrates you are unable to perform any job. For example, someone who is unable to perform heavy physical labor in their normal job can still earn a sufficient living doing an office job. With migraine sufferers, this situation is less likely to arise, but an “any occupation” policy is more difficult to qualify under than an “own occupation” policy.
More to Learn About Migraine Long-Term Disability Rights
There is much more to know about filing a successful claim for disability benefits under your long-term disability policy. There are issues regarding waiting periods, income measures defining “gainful employment,” and how to appeal from an initial denial of your LTD claim.
Social Security Disability v. Your Long-Term Disability Policy
You may also be eligible to receive Social Security Disability Insurance (SSD or SSD) benefits even if you are receiving long-term disability benefits from a private policy.