New SSA Ruling for Primary Headache Disorder
In August 2019, the SSA released a new ruling for primary headache disorder. The ruling explained how the agency establishes a medically-determinable impairment (MDI) of a primary headache disorder and how it evaluates this disorder for disability claims. Because the SSA recognizes that severe headaches can be debilitating, it issued the ruling to explain the new policy.
The new ruling defines primary headache disorders as “complex neurological disorders involving recurring pain in the head, scalp, or neck” and classifies headaches as either primary or secondary:
- Primary headaches occur independently and are not caused by other medical conditions or illnesses.
- Secondary headaches are symptoms of other medical conditions such as hypertension, stroke, or fever.
Examples of primary headaches include migraines; tension headaches brought on by stress, anxiety, or other factors and caused by muscle spasms in the neck and shoulders; and trigeminal autonomic cephalalgias (one-sided pain). To receive disability benefits for primary headache disorder, there can be no underlying medical condition causing the migraines.
How the SSA Determines a Primary Headache Disorder as an MDI
The SSA doesn’t recognize a headache in its Blue Book—a compiled list of conditions and impairments that qualify for disability. Rather, it considers a person disabled if they’re unable to engage in any substantial gainful activity due to an MDI that will result in death or is expected to last for a year or more. If the SSA determines the primary headache disorder severely limits a person’s physical and mental ability to do routine, typical activities, it may grant disability benefits. The determination is made in the following ways:
1) You must receive a diagnosis of a primary headache disorder. This must come from an acceptable medical source (AMS) such as a licensed physician or physician’s assistant. The diagnosis must provide evidence that shows the AMS conducted a physical exam, reviewed the patient’s medical history, and made the diagnosis after excluding other medical and psychiatric causes.
2) Your doctor must observe a typical headache event. The AMS must provide a detailed description of the event and all associated symptoms, including observable signs such as:
- Issues with concentration or memory
- Neck stiffness
- Pupil constriction
- Need to be in a dark or quiet room during the exam
If the AMS has not directly observed the event, the SSA may consider a third-party observation if it’s documented by the AMS.
3) Your lab results cite remarkable or unremarkable findings. The SSA will make a reasonable attempt to obtain test results; however, it won’t purchase tests related to the patient’s headaches.
4) Your response to treatment. The SSA will consider if a patient’s symptoms have improved, worsened, or remained stable despite treatment.
Cuddigan Law for Migraine Disability Benefits
If you suffer from migraine headaches that interfere with your life and make it difficult to hold down a job, you may want to apply for SS disability benefits. However, proving that your migraines are debilitating and working through the SS application process can be a complex and frustrating task. Hiring a disability attorney can be the best way to help ensure a successful outcome for your claim.
The trusted attorneys at Cuddigan Law are skilled and experienced in SS disability Law and have handled disability claims for over 25 years. We will go over the new SSA ruling with you, work closely with your treating physician to get the appropriate documentation necessary for your claim, and discuss whether your symptoms meet the criteria for disability benefits. Additionally, if your claim is denied, we’ll help you file an appeal and provide other necessary information to support your case.
Contact Cuddigan Law by filling out the form on our website or by calling our Omaha or Lincoln office to speak with an intake specialist for free.