You might be eligible for Social Security disability benefits for chronic headaches or migraines if you can show through objective medical evidence that the headaches cause you to be unable to work to support yourself for at least 12 consecutive months. Qualifying for disability benefits for headaches is challenging.
You might not want to try to get Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits on your own in this situation. A Texas disability attorney can advocate for you and help you answer the question of whether you qualify for Social Security disability benefits if you have chronic migraines or headaches.
The Social Security Administration’s Blue Book Does Not Contain a Category for Migraines
The Social Security Administration (SSA) uses the Adult Listings of Impairments, also called the Blue Book, to evaluate the severity of an applicant’s physical or mental impairment for purposes of disability benefits eligibility. The Blue Book provides objective severity standards for hundreds of medical conditions.
Headaches are a neurological condition, so they would fall under the 11.00 Neurological section of the Blue Book. Section 11.00 contains epilepsy, traumatic brain injury, cerebral palsy, benign brain tumors, coma, and other neurological conditions, but this section does not include a listing for headaches.
In this situation, an applicant would have to show through objective medical evidence from an acceptable medical source (AMS) that the headaches create a severe medically determinable impairment (MDI). The MDI must significantly limit the individual’s physical or mental ability to perform basic work activities.
Primary Headaches Versus Secondary Headaches
A primary headache is a recurring pain in the head, neck, or scalp that is not caused by another medical condition. Secondary headaches are symptoms a person can experience as a result of another medical condition. For example, high blood pressure, tumors, or traumatic brain injuries can cause secondary headaches.
The SSA will only evaluate primary headaches as the MDI for purposes of disability benefits. If an applicant has secondary headaches, the SSA will evaluate the medical condition that causes the headaches using the Blue Book criteria for that condition.
How the SSA Evaluates Migraines and Chronic Headaches for Disability Determination
The SSA will explore whether the headaches, by themselves or in combination with another debilitating medical condition, cause the person to have an impairment that is equivalent to another listing in the Blue Book. The SSA says that epilepsy is the closest impairment to headaches in the Blue Book.
The applicant must provide objective medical evidence, like laboratory test results, symptoms, and treatment notes, from a medical professional whom the SSA accepts. A diagnosis or statement of the applicant’s symptoms is not, by itself, enough proof to satisfy the SSA. The treating doctor must have ruled out other potential causes of headaches.
An AMS must have observed the applicant during a typical headache event and document the signs the patient experiences before, during, and after a headache event. In some situations, the SSA will accept a third party’s direct observation of a typical headache event.
Also, the applicant must have tried appropriate medical treatment, like medication, without success. The headaches must persist despite medical treatment.
These factors are but a few of the things a person needs to know when applying for Social Security disability benefits for chronic headaches or migraines. A Texas disability attorney can guide you through the application process and appeal an adverse ruling when appropriate. Get in touch with our office today.