HEADACHE DISORDERS & WINNING SSD BENEFITS
Primary headache disorders can be some of the most disabling medical conditions the Social Security Administration (SSA) reviews. Migraines, cluster headaches, and other primary headache disorders can cause severe pain, nausea, and vision problems. Obviously, these symptoms create an inability to function in daily life. Additionally, the same headache disorders can make it impossible to sustain a job.
Many people with these conditions struggle to maintain regular attendance or productivity at work. Despite this reality, the SSA has historically treated headache claims with skepticism.
However, Social Security Ruling (SSR) 19-4p changed the landscape for SSDI and SSI claims that involve primary headache disorders. The ruling acknowledges that headaches can be legitimate, medical conditions that do not respond well to treatment. It provides a clear framework for how the SSA must evaluate these cases. When used correctly, SSR 19-4p can increase the chances of winning your disability benefits.
HOW LEGAL REPRESENTATION HELPS YOU WIN BENEFITS
An experienced disability lawyer understands how to apply SSR 19-4p effectively. Legal representation helps ensure medical evidence addresses frequency and functional limitations. Attorneys know how to challenge improper denials and misinterpretation of headache evidence.
A strong legal argument can show why headaches prevent your ability to work. Lawyers focus on attendance, productivity, and employer tolerance. SSR 19-4p gives skilled advocates powerful tools to secure disability benefits. With the right approach, many primary headache disorder claims succeed.
The way to prove you have a primary headache disorder is to obtain a statement from a medical professional that the SSA considers to be an acceptable medical source. Acceptable medical sources for the SSA are doctors of medicine (MDs), doctors of osteopathic medicine (DOs), physician’s assistants or PAs, and nurse practitioners. The statement should document whether the doctor has seen you having a headache in the office. Also, it should discuss how often you have a headache and how long they last despite treatment. The statement should also include what type of headaches you have and talk about the treatments you have tried.
HOW PRIMARY HEADACHE DISORDERS ARE TREATED
Treatment for primary headache disorders is often complex and ongoing. Many people use both preventive and acute medications. Preventive medications aim to reduce headache frequency and severity. Acute medications are used to stop headaches once they begin. Finding the right combination can take years.
Medication side effects are common and sometimes severe. Drowsiness, nausea, cognitive slowing, and mood changes often interfere with daily activities. Some medications stop working over time. Others provide only partial relief. Ongoing treatment does not always restore the ability to work.
Doctors can use non medication treatments. For example, they may suggest lifestyle changes, stress management, and avoiding triggers. These are some common strategies. Some people try physical therapy or various types of injections. Despite treatment, many people remain unable to work consistently. SSR 19-4p recognizes that treatment failure can support your disability claim.
WHY SYMPTOMS AND TREATMENT MATTER FOR YOUR SSD CASE
Social Security closely examines symptoms and treatment history in headache disability claims. SSR 19-4p requires judges to evaluate medical records over time. Consistent reports of severe symptoms support your case. Repeated attempts at treatment and trying different types of treatment show the SSA that your condition is serious. For example, how often do you require emergency medical treatment for your symptoms? How often do you visit with your doctor and try new treatment for your symptoms? Do you try every treatment that your doctor offers? These are some of the questions the SSA will be asking.
Judges must also consider how symptoms interfere with your ability to work. This includes determining whether your headaches interfere with concentration, your work pace, attendance, and stress tolerance. The judge must also consider side effects from medications. For many people, the medication side effects are almost as bad as the headaches themselves. SSR 19-4p makes clear that functional limitations matter more than test results.
When symptoms continue despite treatment, the SSA may award your disability benefits. Many people with primary headache disorders cannot sustain competitive employment. Proper documentation connects symptoms and treatment to work limitations. This evidence can be critical to winning disability benefits.
WHAT SSR 19-4P IS AND WHY IT MATTERS
SSR 19-4p is a Social Security Ruling that applies to both SSDI and SSI claims. The ruling addresses how the SSA must evaluate primary headache disorders like migraines. Before this ruling, many claims were denied simply because imaging studies were normal. The SSA often dismissed headaches as a passing condition that is not severe enough to prevent work.
This ruling makes clear that normal MRIs or CT scans do not damage your headache claim. Social Security must rely on medical signs, treatment history, and consistent reporting of symptoms. SSR 19-4p forces judges to follow medical standards used by treating providers. This change gives you a fairer evaluation under disability law.
HOW THE SSA EVALUATES HEADACHE DISORDER CASES
Under SSR 19-4p, Social Security must first determine whether a primary headache disorder is a severe medical condition. This is done through medical records, physical exams, and documented symptoms over time. Doctors do not need to identify a structural brain problem for the condition to qualify. Consistency and credibility in the medical evidence are critical to you winning your case.
Once you prove you have a severe medical condition at step two of the review process, then the SSA must determine how often you have headaches. Judges must consider how often headaches occur, how long they last, and how intense they become. They must also evaluate the side effects of medications. SSR 19-4p requires the SSA to focus on functional limitations, not just diagnoses. They use your medical evidence to determine how often your headache disorder would interfere with your ability to work.
CAN YOU GET SSD BENEFITS FOR HEADACHE DISORDERS?
If you suffer from primary headache disorders, you can apply for Social Security Disability Insurance (SSDI) benefits and Supplemental Security Income (SSI) benefits. To determine if your headaches are severe enough to qualify for SSD benefits, the SSA will use Social Security Ruling 19-4p.
Under this ruling, the SSA will consider whether your headache equal listing 11.02 for epilepsy. Headaches, like seizures, interfere with your ability to function during a normal workday. Therefore, the SSA is making a comparison between the frequency of your headaches to seizure activity.
Therefore, you must be able to show that you have severe headaches at least once a week for at least three months in a row. Or you must show that they occur at least once every two weeks for three months in a row. You must also have this level of headache frequency despite treatment from your doctor. Additionally, to equal the listing you must have a severe limitation in at least one of the following areas:
- physical function (such as standing)
- understanding and using information
- dealing with others, like other workers, supervisors, and the public
- ability to concentrate and complete tasks
- adapting to change
- managing your emotions
- taking care of yourself
It is your burden to prove that you meet this criteria.
WE CAN HELP FILE YOUR SSD APPLICATION
While many people apply for benefits on their own, we do not think it is the best course of action. The SSA is looking for particular information to see if you can be paid benefits. Why not start with hiring a lawyer?
Your lawyer can submit your information for you. This may shorten the waiting time for a decision. However, even if you hire a lawyer to help submit your application, you may still receive a denial. Most people receive a denial after the initial application. Do not give up. Additionally, if you receive a denial, make sure you file a timely appeal within 60 days from the date on your denial letter.
If the SSA denies your claim for headaches, then you can file an appeal. You’re likely to win your Social Security benefits on appeal rather than at the initial application stage. Hiring a lawyer to help with your appeal improves your odds of winning benefits.
PROVING YOU CANNOT WORK DUE TO PRIMARY HEADACHE DISORDERS
Winning disability benefits requires proving that headaches prevent full time work. SSR 19-4p emphasizes the importance of proving your residual functional capacity (RFC). Your RFC is what you can do despite your headaches. It includes how often you would miss work and due to headaches, how often you would be off task at work. You will need to prove that when you have a headache you need to lie down in a dark room. If you throw up, get dizzy, or lose vision during your headaches, then you will need to include these symptoms. Your RFC must show that competitive employment is impossible.
Social Security must consider how headaches affect concentration, pace, and attendance. Even if a person can work sometimes, unpredictable headaches can lead to excessive absences. SSR 19-4p supports arguments that being absent, late to work, or taking extra breaks proves you cannot work. This is often the key to winning your disability case.
WHY HEADACHE DISORDER CLAIMS STILL GET DENIED
Despite SSR 19-4p, many primary headache disorder claims are still denied. Social Security often claims the evidence is not consistent with your statements and complaints. Gaps in treatment or vague medical notes can weaken otherwise valid claims. Additionally, judges may not understand how disabling headaches can be.
Another common problem is failure to connect symptoms to work limitations. Medical records may describe pain but not explain functional impact. SSR 19-4p requires this analysis, but you must ensure the evidence supports it. Without strong medical records, your disability claim will be at risk.
Medical records are the best evidence, because they will show if your doctor supports your claim for benefits. Your attorney will be able to give your doctor specific forms to fill out that will prove you cannot work. Learn what you need from your doctor to prove your SSD case. Additionally, your attorney can collect all of your records. Collecting medical records is not easy. We prefer it when our clients collect their own medical records, because they usually get them from their doctor for free. However, if you cannot do it, we can.
HOW LEGAL REPRESENTATION HELPS YOU WIN BENEFITS
A disability lawyer with experience understands how to apply SSR 19-4p correctly. Your lawyer helps ensure medical evidence addresses the frequency and severity of your headaches. Also, your records should discuss your functional limits. For example, how often are you having headaches? How long does it take to recover? Do you need botox shots? Does your medication have severe side effects? How often are you in the emergency room with headache disorders?
Your attorney must know how to challenge SSA’s denials and obtain the correct medical evidence to support your claim. A strong legal argument can show why headaches prevent your ability to work. That is why it is important to hire an SSD law firm with decades of legal experience. We have been in business for over 30 years. During that time was have won over 20,000 SSD claims for our clients.
Your case should focus on your attendance, productivity, and absences from work due to headaches. SSR 19-4p gives skilled advocates powerful tools to secure your SSD benefits. With the right approach, many primary headache disorder claims succeed.
WE WILL HELP YOU WIN BENEFITS FOR HEADACHE DISORDERS
If you are suffering from primary headache disorders, then you may be wondering whether the SSA will approve your claim for benefits. If so, then call our law firm. We are the only law firm helping SSD and SSI clients in Utah, Nevada, Idaho, and California with over 30 years of legal experience. For instance, we are the top SSD lawyer in the state of Utah.
You can hire us for free (no money down), because we offer a free review of your case. Also, we work for free until we win your case. You do not have to pay an attorney fee until we win your benefits. If we don’t win your case, then you never owe an attorney fee. Learn about attorney fees in SSD cases.
We are also among the top SSD lawyers in the state of Nevada. Find out about our Nevada legal experience. We also help clients in many other states. We also have clients in Idaho, Colorado, and California. Idaho SSDI benefits information is available. Likewise, we have information about Colorado SSD benefits . Finally, learn about California SSD benefits information. Wherever you live, we can help you get your SSDI benefits. We want to fight for the benefits the SSA owes you under the law.
