A number of our forum members have had problems where insurance companies denied their Migraine-related disability claims. Sometimes the reason the insurers give is that they do not see evidence of disability in the medical records. For those of us who suffer with Migraines most days, this seems ridiculous! It's obvious, isn't it? You can't work with a severe Migraine. You certainly shouldn't work with a severe Migraine. Your judgement is impaired, your vision may be impaired, your reasoning and depth perception may be impaired, not to mention the blinding pain and nausea.

I am not defending the insurance companies - the World Health Organization recognizes Migraine as one of the 20 most disabling conditions world-wide, and disability insurers should recognize that as well. However, they don't, necessarily. And what's more, headache specialists and other doctors who treat Migraineurs aren't always familiar with the ways of disability insurers.

If you had a severe accident and applied for disability, the orthopedist or physical therapist or other medical professional who treated you would likely be familliar with the disability application process and would fill your records with references to your levels of functioning and levels of impairment. Your headache specialist may not have this orientation. You can help your doctor help you!

This site is a treasure-trove of information on how to be an informed patient and self-advocate; I want to add a little more.  Be sure when you are meeting with your doctor to tell him or her how much work you have missed, or how many days you have been unable to function, or how much of each day you function. Go into detail, and ask him or her to put it in your record. You don't want to have to appeal an insurance application because there was nothing in the record! These are your medical records, and your doctor should record that information if you make the request. Many doctors will ask, but if they don't, be sure to tell them.

You can also create a record yourself. We all know keeping a Migraine diary is a good idea to help us track Migraine frequency and severity, learn our triggers and see how our treatments are helping us; you can also use your diary to track and keep a record of your disability. Record how "able" you are on a given day - you could color code, or use a number scale to indicate whether you were fully functioning, barely functioning, or down for the count.

By being prepared ahead of time, and helping your doctor help you, you may be able to make a stronger case.