New SSA Rule for Headache Disorders and Disability Benefits

Many people wonder if they can get disability benefits for headache disorders. There is good news for those who suffer from headaches and migraines. The Social Security Administration passed a new rule for headache disorders under the Social Security Listing of Impairments.

Anyone experiencing chronic migraines, tension headaches, or cluster headaches knows they are a nuisance and impact the quality of life. Balin Law attorney Matthew Shupe explains this new SSA rule as it relates to headache disorders:

Video Transcript: New SSA Rule For Headache Disorders and Disability Benefits

Social Security has a new rule that applies to people who suffer from primary headache disorders. The new rule specifically applies to folks with migraines, tension headaches, and cluster headaches, and this new rule specifies that Social Security must consider the effects of your headache symptoms as long as you are able to provide evidence that your headaches are a medically determinable impairment, which is a term of art that the new rule specifies. So this rule explains that Social Security’s not just going to take our word that you suffer from these headaches. We need to show more specific evidence than that. Fortunately, they’ve outlined several different ways that we could prove your case.

Ways to qualify for disability benefits with headache disorders

One way is that you have a diagnosis of a primary headache disorder from a medical professional, that Social Security considers to be an acceptable medical source, which in Social Security looking at the letters at the back of your doctor’s name. Acceptable medical sources are doctors of medicine (MDs), doctors of osteopathic medicine (DOs), physician’s assistants or PAs, and nurse practitioners or NPS.

Another way we could prove your headaches are a medically determinable impairment is that we could get a detailed description in one of your treatment notes from a physician who has actually witnessed you suffering during an appointment or the after-effects of a headache. Social Security will also allow us to submit a headache journal. A headache journal is a daily description of how often you suffer from headaches, how long they last, what sort of associated symptoms you have. Light sensitivity, sound sensitivity, nausea, etc.

Ways to strengthen your disability case

Here at Balin Law, we recommend our claimants arguing for disability based on a primary headache disorder, to keep a headache journal. Social Security will also look to any imaging such as MRIs of your brain or blood work. Social Security will look at what has been done to rule out other conditions that could be causing your headache disorder. And also look to your response to treatments such as Botox or pain medications or anti-seizure medications.

Why is this new rule important?

The new rule is important because before it went into effect, Social Security was very inconsistent in how they considered whether a person’s headaches symptoms would affect their ability to work and in turn the advances for finding them disabled. This led to confusion and frustration for folks applying for disability. It also led to confusion for their doctors and speaking from personal experience, from their lawyers.

So the fact that we have these specific guidelines is great news for folks suffering from primary headache disorders. No doubt about it. That said, when they put these guidelines in place, it introduces new evidentiary hurdles that need to be met. The presence of those hurdles is exactly why it’s in your best interest to contact an experienced Social Security lawyer. Additionally, find a lawyer who is up to date with social Security’s rules and regulations. 

Balin Law has been helping this disabled since 1980. If you have headaches or migraines that impact your ability to work, we invite you to contact Balin Law. We offer free consultations and there is no fee unless we win.