The truth is that getting Social Security disability benefits for any medical or mental condition can be difficult for anyone applying, even those who are applying for Migraine, as well as all other medical or mental benefits can be challenging. Migraines are no different.
The Social Security has created what they call a Social Security Ruling, in SSR 19-4p which means because Social Security mandates for all people who decided your case must follow. In its introduction it states as follows:
Primary headache disorders are among the most common disorders of the nervous system. Examples of these disorders include migraine headaches, tension-type headaches, and cluster headaches. We are issuing this SSR to explain our policy on how we establish that a person has an MDI of a primary headache disorder and how we evaluate primary headache disorder in disability claims. In 2018, the Headache Classification Committee of the International Headache Society published the third edition of the International Classification of Headache Disorders (ICHD-3). The ICHD-3 provides classification of headache disorders and diagnostic criteria for scientific, educational, and clinical use. We referred to the ICHD-3 criteria in developing this SSR.
We consider a person age 18 or older disabled if he or she is unable to engage in any substantial gainful activity due to any medically determinable physical or mental impairment(s) that can be expected to result in death, or that has lasted or can be expected to last for a continuous period of at least 12 months. In our sequential evaluation process, we determine whether a medically determinable physical or mental impairment is severe at step 2. A severe MDI or combination of MDIs significantly limits a person’s physical or mental ability to do basic work activities. We require that the MDI(s) result from anatomical, physiological, or psychological abnormalities that can be shown by medically acceptable clinical and laboratory diagnostic techniques. Our regulations further require that the MDI(s) be established by objective medical evidence from an acceptable medical source (AMS). We will not use a person’s statement of symptoms, a diagnosis, or a medical opinion to establish the existence of an MDI(s). We also will not make a finding of disability based on a person’s statement of symptoms alone.
As you can see the Social Security Administration here is trying to explain to you, that past your diagnosis, you must prove that the condition will last more than 12 months and how the condition prevents you from working, yet what they fail to inform you is that they are looking to do so from what your medical records say or do not say.
Most migraine records refer to it, with aura or without aura; and medication prescribed and say nothing as to how these migraines affect your abilities to work, how your migraine will require you to be absent from work or even be off task because you need to lay down.
And the Social Security Administration states in the instruction of this Social Security Administration ruling 19-4p as follows:
In this SSR, we explain how we establish a primary headache disorder as an MDI and how we evaluate claims involving primary headache disorders. The following information is a question and answer format. Question 1 explain what primary headache disorders are. Question 2 explain how the medical community diagnoses primary headache disorders. Questions 3, 4, 5, and 6 provide the ISHC-3 diagnostic criteria for four common types or primary headache disorders. Question 7 explain how we establish a primary headache disorder as an MDI. Questions 8 and 9 address how we evaluate primary headache disorders in the sequential evaluation process.
List of Questions
- What are primary headache disorders?
- How does the medical community diagnose a primary headache disorder?
- What are the ICHD-3 diagnostic criteria for migraine with aura?
- What are the ICHD-3 diagnostic criteria for migraine without aura?
- What are the ICHD-3 diagnostic criteria for chronic tension-type headache?
- What are the ICHD-3 diagnostic for cluster headache (a type of trigeminal autonomic cephalalgias)?
- How do we establish primary headache disorder as an MDI?
- How do we evaluate and MDI of a primary headache disorder under the Listing of Impairments?
- How do we consider an MDI of a primary headache disorder in assessing a person’s residual functional capacity?
The rest of the Social Security Ruling 19-4p goes to give definitions of the above 9.
They really are more in tune with the American Migraine Foundation and American Neurological Association definitions and standards.
Yet, this really does not help you in understanding the requirements to obtain Social Security Disability benefits.
The reality is that not all migraine conditions are the same, nor all medical records are the same it is for this reason that you will need an experienced Social Security Lawyer to help you in your claim.
I have limited my practice to Social Security Disability claims, and I specialize in those cases where Social Security has denied claims due to the failure to understand all the complications of this claims.
Please feel free to contact me for a free review of your claim by scheduling a phone or in-person conference at 407-894-4779.