Migraines, Headache Disorders and Long-term Disability Claims

Migraines are a common form of headache disorder that can be physically and mentally debilitating. Headache disorders also include tension-type headaches and cluster headaches. They affect a person’s ability to focus and concentrate, and the pain and symptoms can often be exacerbated by light and sound. Migraines may even prevent a person from working and may entitle an individual to long-term disability benefits.

Read on to learn more about migraines and headache disorders, and how you can get the help you need if your long-term disability claim is denied in Canada.

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What is a Migraine?

Migraines are a type of headache disorder that include recurring headaches that are moderate to severe and can last from a few hours to a few days. Migraines affect between 1-4% of the global population, typically affecting individuals age 35-55, and are about 3 times more common among women than men. Migraines can occur from anywhere between once a week to once a year. Individuals who report having migraines also report other symptoms such as sensitivity to light, sound, and smell, as well as nausea, vomiting and light-headedness.

The exact causes of migraines and headaches are unknown, but they can be triggered by physiological as well as external events, such as changes in hormones, weather, or exposure to food additives, alcohol, caffein, and physical exertion. Overstimulation of the senses, such as bright lights, loud noises, or strong smells can cause the pain to worsen. An increase in stress levels, or emotional or mental health issues such as depression and anxiety can also trigger or worsen an attack.

What are the types of Headache Disorders?

Headache Disorders can include the following conditions:

Migraines

Migraines and headaches are a primary disorder, meaning they are not caused by another more severe underlying condition. Incidents of migraine are often called ‘attacks’ because they can come on abruptly. They typically cause a strong pain on one side of the head and can be accompanied or preceded by visual disturbances known as ‘aura’. Symptoms, or pain, caused by the migraine can be exacerbated by sensory stimulation (light, sound, smell, and touch), as well as physical or mental exertion. This is why migraines can be so detrimental to functioning normally – nearly any type of activity can cause severe pain to a sufferer when they are experiencing a migraine.

Cluster headaches

Cluster headaches are also a primary headache disorder. Unlike migraines these more commonly affect men than women. They are characterized by short but intensely painful headaches, with the pain usually occurring near or behind the eyes. They can occur at irregular intervals, but may also be chronic, like migraines.

Tension-type headaches (TTH)

Tension-type headaches are usually caused by stress or tension in the neck. For this reason they are not a primary disorder, but are a result of stress and muscle tension.  Although more difficult to prove, these headaches can also be triggered by anxiety, fatigue, depression, and poor posture. They can occur chronically and can be just as debilitating as migraines and cluster headaches.

Why are claims for migraines and headache disorders denied?

They Claim You Have Insufficient Medical Documentation

Headaches and headache disorders are not an easily explained medical condition. Headache disorders such as migraines can be considered an invisible illness and is resistant to most objective medical testing. The most common reason for claims being denied is insufficient medical evidence. Because there is a general lack of understanding when it comes to headache disorders, and insurance companies are often skeptical about claims regarding migraines. It can be difficult to measure and diagnose by objective medical testing, Headache disorders are not well understood and cannot be identified with MRI or CT scans (but these tests can be used to rule out other conditions).

You Are Not Yet Receiving the Appropriate Treatment

Another reason for claims being denied is that not enough treatment options have been tried, or that the provider claims that you have not sought appropriate treatment. Because migraines and headache disorders are under-diagnosed, often individuals go without appropriate treatment. It may also be that the insurance company wants you to pursue treatment while continuing working.

How to improve your chances of getting your benefits approved

Proper diagnosis and treatment

It is always a good idea to be proactive about your health. While migraines can not necessarily be diagnosed with a specific test, your doctor can pursue other tests to rule out any other illness or condition. CT scans and MRIS can help provide medical evidence of neurological disorders and bolster a claims credibility while ruling out other illnesses. It is important that your doctor follow standard diagnostic protocols.

Because migraines are a neurological condition, your doctor may refer you to a specialist, such as a neurologist. The neurologist will confirm your diagnosis and may recommend a treatment plan. They also may prescribe medications. It is important that you take medications as prescribed, and outline this to the insurance company. If you are referred to any other specialist, be sure to follow-up and document your visits. As much as possible, follow their guidance on treatment and any additional therapies they recommend.

Keep records of your treatment journey

Be sure to keep medical records, and these need to contain records of tests results. It is also a good idea to keep a diary or record of your migraines, including frequency and severity. Record the date and how you felt and were impacted by your symptoms, whether you were able to work, or what your functional limitations were while you were having a migraine attack. A journal of your migraines, however subjective, will still provide evidence of your suffering. A record of the series of migraines you experience and how it impacted you will lend credibility to your claim.

Was your LTD Claim Denied?

Contact the disability lawyers at Samfiru Tumarkin LLP if your legitimate long-term disability claim for migraines or headaches is denied by the insurance company.

Don’t walk way from your rights. That is what the insurance company wants you to do. They may also encourage you to appeal the denial. Do not go through the insurance company’s appeals process! In most cases, your appeal will be unsuccessful, and your insurer will use this tactic to run out the clock on your time limit to file a claim for full compensation.

If your disability claim is denied in Canada, you need to contact the experienced long-term disability lawyers at Samfiru Tumarkin LLP immediately at 1-855-821-5900 for a FREE CONSULTATION. We will review the facts of your situation, tell you if you have a case, and take the fight to the insurance company on your behalf. Don’t let them walk away with the money that they owe you in your time of need.

Get the advice you need, the compensation you deserve.

Additional Resources

• Migraine Canada
• The Migraine Trust
• The World Health Organization
• Mayo Clinic