Migraine Headaches May be Assessed as Medical Equivalent of Seizures

Disability claimants are awarded if their medical conditions meet, or are the medical or functional equivalent, of published medical criteria known as “listings.” It requires an opinion statement from a doctor to establish medical equivalence. Unfortunately, there is no listing for migraine headaches.

Our firm recently successfully argued that a claimant with migraine headaches was the medical equivalent of meeting the listing for seizure disorders. That listing calls for grand mal seizures occurring on a monthly basis in spite of prescribed treatment.

We pointed out authority from the Social Security Administration that recognizes that migraine headaches are neurological events. The claimant in our case had an abnormal brain MRI that displayed white matter. This qualified as objective evidence, so we did not have to rely entirely on the claimant’s complaints of pain (which would have been impermissible). Her treatment notes described associated phenomena, such as aura, photophobia, vomiting, and nausea; all clinical signs recognized as establishing migraines. Her notes also documented the frequency of the migraines as occurring more often than monthly.

At our request, the Court hired a neurologist to testify as a medical expert, and he testified that the claimant’s migraine headaches were the functional and medical equivalent of seizures occurring monthly, in spite of prescribed treatment.

Beware, however, that tension headaches, as opposed to migraines, are not necessarily neurological in origin, and cannot merit this treatment. Also, there always must be objective evidence of an abnormality that could reasonably be expected to produce the symptoms.