Long-term disability insurance is a specific type of insurance policy designed to cover individuals who cannot work due to a disability. It provides income (typically 50 to 60% of a person’s salary) during a period of time when an employee is sick or injured. This type of benefit is designed to be used for an extended period of time, as set forth in the insurance policy.
For migraine sufferers, long-term disability benefits may be an option if they are unable to work because of chronic migraines. While migraines can be covered under this type of policy, an individual who seeks benefits must be able to prove that he or she is limited in their ability to work because of their migraines in order to qualify. This can often be challenging, which is why it is helpful to have a disability benefits attorney to assist you in filing a claim.
If you experience migraines, you may be eligible for long-term disability benefits. This article explores what migraines are, and how you can put together a strong case for benefits if you suffer from this condition.
How Migraines Can Make It Difficult — or Impossible to Work
A migraine is a clinical term used to describe a headache that can cause pain so severe that it interferes with daily activities. Although each migraine sufferer experiences different sensations, migraines are often accompanied by a throbbing pain or pulsing sensation, nausea, vomiting, and extreme sensitivity to light and sound. Oftentimes, many different types of painful headaches are labeled as “migraines,” even if they don’t meet the clinical definition, as long as they meet the severity. A migraine may last for hours or days.
There are many symptoms of migraines, not all of which are experienced by every person who gets migraines. For example, some people have mood changes and neck stiffness one to two days beforehand. Other people may get what is known as an aura shortly before or during a migraine; this usually involves visual disturbances, but may include pins and needles sensations, difficulty speaking or other phenomenon.
A migraine itself may involve:
- Pain on one or both sides of the head
- Pain that throbs or pulses
- Sensitivity to light or sound
- Sensitivity to smell or touch
- Nausea and vomiting
Migraines may last from 4 to 72 hours. Afterwards, individuals may feel drained, confused, or exhausted for a day or longer. Sudden head movement may bring the migraine pain back for a brief period of time.
The treatment for migraines involves either preventing them from occurring or relieving the symptoms. This is typically done through the use of medications, although some injections — such as Botox — may be used to help prevent migraines. Lifestyle changes may also help to reduce the frequency and severity of migraines.
Unfortunately, not all migraines respond to medication and other forms of treatment. In these cases, individuals may become disabled due to migraines. According to the Migraine Research Foundation (MRF), migraines are the third most prevalent illness in the world — and the sixth most disabling illness.
The MRF also reports that more than 4 million people suffer from chronic daily migraines, experiencing at least 15 migraine days per month. Over 90% of people who suffer from migraines are unable to work or to otherwise function normally while they have a migraine.
Given this reality, it is easy to see why many people who get migraines may find it difficult to work when they have a migraine. For those who suffer from chronic daily migraines, working may not be possible, given the unpredictability of migraines and the number of days each month that they have this type of headache.
Qualifying for Long-Term Disability Benefits for Migraines
Long-term disability (LTD) benefits provide a portion of your salary if you qualify for leave based on a covered disability. While each policy varies, this type of coverage typically kicks in 6 months after you take leave for a disability (such as migraines). The insurance company will examine your claim carefully to determine if you qualify as disabled based on your migraine diagnosis.
Although millions of people suffer from occasional migraines, severe, persistent or chronic migraines are less common. To be eligible for LTD benefits, you will need to provide evidence that your migraines are more than a periodic severe headache. You will have to document your diagnosis, the treatments that you have attempted, and how your migraines have limited your activities.
The insurance company will first look to see if you have been formally diagnosed with chronic or recurring migraine headaches. This will generally involve a review of your medical records, including any additional testing, a list of medications and treatments tried, notes concerning the frequency and severity of your migraines, and records from any emergency room visits or hospitalizations due to migraines.
This can be challenging as there is no specific test or diagnostic study to “prove” migraines. It is a clinically diagnosed condition, based in part, on your report over time.
Next, you will need to prove that your migraines impact your ability to function to an extent that you cannot perform work activities on a regular basis. For example, you may provide evidence of the number of days that you have missed work due to your migraines. Your medical records or other documentation may also indicate that your migraines make it difficult for you to concentrate, to be in artificial or natural light, to understand or remember instructions, or to work for a full shift.
Based on this information — along with records of any other disabilities that may interact with your migraines to limit your ability to perform work functions — the insurance company will either approve or deny your LTD benefits. Being approved for LTD benefits for migraines can be difficult, since many of the symptoms are self-reported by patients and cannot be objectively tested. Working with a Philadelphia long-term disability benefits lawyer can increase the likelihood of having your application approved.
What Can You Do If You Are Denied Benefits for Migraines?
If your application for LTD benefits was denied, you have the right to appeal this denial. There is generally a very limited time in which to file this appeal, but it is important that you use this time to perfect your appeal and do not just write a letter to the insurance company explaining that you disagree. An attorney can help you gather the necessary evidence to address the insurance company’s reasons for denying the claim and submit an appeal in a timely fashion.
If the appeal is denied, the final step may be to file a lawsuit. While this may seem like a big step to take, if you are suffering from chronic migraines, it is often necessary to ensure that you get the benefits that you deserve.
How a Long-Term Disability Benefits Lawyer Can Help
Whether you have one migraine a month or several migraines a year, there is no doubt that they can be incredibly debilitating. When migraines occur so frequently and are so severe that they affect your ability to work, you may be eligible for LTD benefits. Because qualifying for these benefits can be difficult, working with a Philadelphia long-term disability benefits lawyer can increase your chances of your application being approved.
Bross & Frankel serves clients throughout Pennsylvania and New Jersey who are unable to work due to a range of disabilities, including migraines. We are compassionate advocates who understand what our clients are experiencing — and who are willing to fight to help them get the benefits that they deserve. To schedule a free claim review, contact our office today at 856-795-8880, or reach out online.