Chronic Migraine and Employment

By Evan Starkman, WebMD

If you’re living with chronic migraine, you know disabling it can be. But many employers don’t. Some haven’t learned what it is, and others may have bought into the faulty belief that it’s “just a headache.”

The reality is that chronic migraine is a neurological disorder. It causes 15 or more headache days a month. On at least 8 of those days, you’ll have other migraine symptoms. Even after the head pain goes away, an attack might continue to lay you low with symptoms like fatigue, nausea, dizziness, and trouble focusing.

As you’re managing this life-disrupting disorder, you might be tempted to try to “push through it” at work. But hiding or downplaying your symptoms could backfire, especially if chronic migraine causes you to miss workdays or finish assignments late. Your employer might mistake this for a lack of effort or skill. That could take a toll on your morale, finances, and career.

You owe it to yourself to level the playing field. If you’re able to keep working, it’s important to speak up for yourself at work and ask for accommodations that could make you more productive and satisfied, and lower your stress.

What Types of Accommodations Can You Ask For?
Before you talk about your health needs with your human resources department or boss, learn about the types of accommodations you might want to ask for if you work on site.

These can help you avoid things that trigger your migraine attacks or make them worse:

If you’re sensitive to light, your employer may be willing to:

  • Take out bright or fluorescent lights near your work area, or put glare-dimming filters over them
  • Turn off harsh lights above your desk, and let you use your own desk lamp instead
  • Put a filter over your computer monitor if glare from it hurts your head or eyes
  • Put blinds or curtains over bright windows
  • Let you wear sunglasses in the office

If you’re sensitive to sound, you could ask your employer to:

  • Give you noise-reducing headphones
  • Put you at a desk in a quieter part of the office, where there’s less loud conversation or other noise
  • Arrange for a private, quiet space to rest and recover from migraine symptoms. For instance, you could ask to use an empty room in the office.
  • Put thick rugs or curtains around the office to reduce echoes
  • Ask that your co-workers mute sounds from non-urgent texts, calls, or emails
  • Install panels in the walls that absorb sound
If scents are a trigger for you, you can ask your employer to:

  • Ask that your co-workers not wear perfume or cologne
  • Get rid of any air fresheners in the office or in the bathrooms
  • Get air purifiers for the office
  • Provide unscented soap and have the cleaning staff use unscented products
  • Give you a desk far away from smelly areas of the office, like the kitchen or a big trash can

If poor posture is a trigger, and you have a job that involves sitting in front of a screen for hours, consider requesting a computer stand or an ergonomic chair.

If you tend to get migraine attacks during office hours, you could consider asking for a more flexible work schedule. You may need to start work later in the day to ease a headache or migraine attack that you woke up with. Or, if you have migraine attacks that last up to 3 days, you may want to request the option to work fewer hours. You can also ask to be able to work remotely from home.

Do You Have the Legal Right to Work Accommodations?

An anti-discrimination law called the Americans With Disabilities Act (ADA) requires employers with 15 or more employees to provide “reasonable” accommodations for qualified workers with disabilities, unless those accommodations would create “undue hardship” for the company.

The law doesn’t list the medical disorders it covers. That means it doesn’t specify that it protects people with chronic migraine. Instead, it says that you’re eligible for its protection if you meet its definition of having a disability. According to the ADA, that’s someone who:

  • Has a physical or mental challenge that greatly limits them from doing one or more “major life activities,” like working, hearing, seeing, speaking, and walking
  • Has a history or record of such an impairment
  • Is perceived by other people as having the impairment

You could ask your doctor or headache specialist to write you a letter that explains to your employer how chronic migraine impacts your ability to function day to day.

To be covered under the ADA, you also have to be a “qualified” employee, meaning you meet your employer’s requirements for the job (in terms of things like education, experience, skills, or licenses) and you’ve shown that you could perform your key duties with or without accommodations.

Are You Eligible for Unpaid Leave?

You might be able to get up to 12 weeks of unpaid leave over a 12-month period under a law called the Family and Medical Leave Act (FMLA). During that time, you’d keep your health insurance coverage if you get it through your employer. And at the end of your leave, you’d be entitled to return to the same role or one that’s equal to it.

The FMLA protects people who have serious health conditions that keep them from being able to do their jobs. In general, if you work for a company that has at least 50 employees, the law applies to your employer.

You need to meet these requirements to take FMLA leave:

  • You’ve worked for your employer for at least 12 months total. The 12 months don’t have to be back-to-back, but there can’t be a gap in your work of more than 7 years.
  • You worked for them for at least 1,250 hours in the 12 months before you take leave.
  • You work at a location where your employer has at least 50 employees within 75 miles of the worksite.

How Can You Speak Up for Yourself at Work?

A letter from your doctor that describes your chronic migraine diagnosis and your health needs can help you get the ball rolling. You could show it to your human resources department or boss when you sit down with them to have a private conversation about your condition.

When you’re asking for accommodations, it helps to explain how the adjustments could help you keep up or even boost your productivity on the job.

That said, if you’re not comfortable telling your employer that you have chronic migraine, you don’t have to. When you’re requesting a certain accommodation, like moving to a quieter workspace for example, you could simply say you have a medical condition that’s triggered or made worse by loud noise. If your employer asks for more details, you could describe the symptoms that loud sounds cause you.

But you may be more likely to get accommodations — and improve your employer’s understanding of chronic migraine — if you’re direct about it rather than vague.

Also, consider telling a co-worker you’re friendly with that you have chronic migraine. That way, you’ll have someone in the office you can turn to for emotional support or help when you need it. For example, if you needed to go home during a migraine attack, you could ask them to drive you back safely and check on you later.

Pack a Migraine Emergency Kit for Work

Keep important items like these on hand at work in case you have a migraine attack:

  • A bottle of water, since dehydration can be a trigger
  • Healthy snacks
  • Your migraine medication, to take as soon as you feel an attack coming on
  • A cooling pack for your forehead, if you find coldness soothing

What Are the Basics on Disability Benefits?

If chronic migraine makes holding a job very hard or impossible for you, consider applying for Social Security disability insurance (SSDI), which gives you financial assistance. You or a family member must have had a recent job and made SSDI payments to be eligible for this benefit.

When you’re filing a claim, you’ll need to provide medical documents that show you have chronic migraine. Work with your doctor or headache specialist. You’ll need their help to put together the proof that backs up your claim, like a statement from them explaining that you have a serious neurological disorder that affects your ability to work. Other types of relevant documents include treatment plans, medical bills, and any relevant test results.

Be sure to also keep detailed records about your symptoms, trouble doing daily tasks, medications you’ve tried, and doctor appointments.

If your SSDI claim gets denied, don’t give up. Most claims get turned down at first. If that happens, the Social Security Administration will include instructions on how to appeal the decision. That involves sending in your evidence again with new medical records and claim forms.

If your appeal gets denied, you can request that the Social Security Appeals Council review your application. Consider asking a disability lawyer to help you work through the process.

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