If migraines, cluster headaches, or tension-type headaches (TTH) are preventing you from being able to work, this article contains essential information that can help you prepare to file a winning claim for disability benefits. We will answer the question, “Is migraine a disability in Canada?” and provide step-by-step guidance on how to get approved for disability benefits in Canada. Winning Migraine Disability: Canada Short & Long-Term Disability is part of our series looking at disability benefits and medical conditions.
To learn more about other conditions that qualify for benefits, check out the articles linked below:
Is a migraine a disability in Canada?
Are migraines a disability? Yes, migraines and headache disorders are considered disabilities in Canada. People with these conditions can also qualify for disability benefits programs such as CPP disability, long-term disability (LTD) insurance benefits, workers’ compensation, the disability tax credit, and provincial disability benefit programs.
These programs don’t approve people based on their diagnosis, rather they approved people who can prove they meet all the qualifying criteria. For example, with programs such as CPP and long-term disability.
Applying for and winning short or long-term disability benefits for migraine and headache disorders in Canada can pose serious challenges.
Because headache disorders don’t always appear as abnormalities on CT scans and MRIs, doctors don’t always correctly diagnose them, and insurers often deny claims on that basis.
If your migraine claim has been denied for this reason or any other for that matter, you may want to consider working with a long term disability lawyer. Click on the button below to learn more about how Resolute Legal can assist you.
Migraines disability: You are not alone
Around four million Canadians suffer from migraines and other debilitating headache disorders. Severe headaches are so disruptive to quality of life that the World Health Organization (WHO) has classified them as one of the top 20 causes of disability worldwide.
Headache disorders also come with severe costs for patients and their families. In addition to the physical pain, migraines and chronic headaches come with social and financial costs and reduced quality of life. Sufferers are often unable to work, which results in a significant financial burden. Additionally, headache disorders frequently prevent sufferers from leading a full social life and can put a strain on family relationships.
Chronic headaches have been linked to an increased likelihood of clinical depression. Additionally, the fear of migraine or cluster headache attacks can cause significant stress and anxiety for the sufferer.
Types of migraines, cluster headaches, and tension-type headaches
Debilitating headaches come in several types. These are some of the most common.
Migraine headaches
Migraine headaches are a primary headache disorder (meaning they are not caused by an underlying disease as is the case with secondary headache disorders) that usually emerges in adolescence and increases in severity with age.
The two most common types of migraines fall under two categories: migraine with aura (complicated migraine) and without aura (common migraine). Migraines with aura refer to the visual disturbances that accompany a migraine. These visual disturbances include:
- Visual symptoms such as seeing wavy lines, shapes, dots or flashes
- Blurry vision or blind spots
- Temporary loss of vision
- Tingling or numbness in your arms and legs
- Weakness on one side of the body
- Changes to your sense of smell, taste or touch
Migraines are caused by inflammation of the blood vessels and nerves in the brain. Migraines are recurrent headaches that come on quickly in the form of “attacks” and often affect sufferers for their entire lives.
Symptoms of migraines include a headache of moderate to extreme severity, nausea and sometimes vomiting, and pain that tends to be localized on one side of the head. They can last anywhere from a few hours to a few days. Physical activity and light tend to aggravate the symptoms. Some sufferers experience warning symptoms such as visual disturbances, a subcategory of a migraine known as a migraine with “aura.”
Is migraine with aura a disability?
Yes, migraine with aura is considered a disability in Canada. However, in order to get approved for disability benefits, you must have strong medical evidence and proof of work-related limitations.
Cluster headaches
Cluster headaches are also a primary headache disorder and are quite rare, affecting fewer than one in 1000 adults. Men are six times as likely as women to suffer from cluster headaches, and the disorder is most likely to affect adults.
The disorder consists of recurring, extremely painful headaches that are very short in duration. The headaches are localized near the eye on one side and are accompanied by eye redness and tearing. Cluster headaches may be episodic or chronic.
Are cluster headaches a disability?
Yes, cluster headaches are considered a disability. Like all other headache and migraine conditions, they do qualify for disability payments. However, the claimant must prove that they meet all of the program’s qualifying criteria. For example, with CPP disability, you must demonstrate that your headaches prevent you from working.
Tension-type headaches (TTH)
The most common headache disorder, TTH, affects at least 1% of adults. It often begins in adolescence and affects women more often than men. TTH can be caused by stress or muscle tension in the neck. TTH can be episodic or chronic, with chronic TTH being much more debilitating.
Is tension-type headaches a disability?
Yes, similar to cluster headaches, tension-type headaches are considered a disability in Canada. However, to qualify for disability payments such as CPP disability and long-term disability benefits, you must show that your condition prevents you from working and meet all other qualifying criteria, such as contribution requirements.
Which disability benefits for migraines and headache disorders do I qualify for?
Canadians who find themselves unable to work due to headache disorders can seek benefits from a variety of disability programs, such as
- CPP disability benefits
- Long-term disability insurance benefits
- short-term disability
- Employment Insurance (EI)
- Workers’ Compensation
- Disability Tax Credit
- Provincial disability benefit programs
- Veterans Affairs Canada
CPP disability benefits for headaches
The Canada Pension Plan (CPP) is a federal government program designed to replace earnings lost due to disability, death, or retirement. The plan is available in all provinces other than Quebec, where the Quebec Pension Plan (QPP) offers a similar program. All workers over the age of 18 in Canada contribute to the Canada Pension Plan out of their earnings. To qualify for disability benefits, patients must meet three criteria:
- The disability must be “severe,” meaning that it prevents you from engaging in sustained paid work of any kind, and it must be “prolonged,” which means that it is a long-term disability that is either unlikely to be resolved or will result in death
- The patient must be under the age of 65
- The patient must have contributed to the fund for 4 of the last six years OR 3 of the last six years if you have contributed for 25 years or more.
The eligibility requirements may seem simple, but in reality, the majority of disability claims filed with the CPP disability end up being rejected. Unfortunately, being disabled and credible isn’t always enough. However, those who are serious about obtaining disability benefits or who have recently had a claim denied do have options.
Contact our team today if your CPP disability application has been denied and you’re looking to work with an experienced CPP lawyer.
Long term disability for migraines
Group disability insurance programs are common benefits employers offer to workers in Canada. They usually pay a set percentage of your income in the event that you become disabled and find yourself unable to work.
Benefits are paid out until you return to work or until you die or reach age 65. Group disability policies come in two varieties:
Any Occupation. In this policy, you are required to prove that you cannot perform any type of work in order to receive benefits.
Own Occupation. Far preferable, these policies provide benefits once you prove you cannot perform the job you had when you became disabled.
You can also purchase an individual disability insurance policy if your employer does not offer one if you are self-employed or if the benefit amount of your policy does not meet the level of income you would need if you were to become disabled.
Winning long term disability benefits when you are covered by a group or individual insurance policy can be just as difficult as securing benefits from the CCP. Private insurance companies exist to make a profit while paying disability benefits comes at the expense of their bottom line, which means they will often go to great lengths to deny your claim.
If you’re applicant has been denied, check out our article denied long term disability help and consider booking a free consultation with our team. We have helped thousands of Canadians win back the benefits they deserve, and we are confident we can help you, too. Click on the button below to get started today.
Short term disability for migraines
If you have long-term disability insurance benefits, you will likely have short-term disability coverage. However, it isn’t a guarantee — always check your benefits booklet before making any assumptions.
Short-term disability is meant to cover shorter absences from work, hence the name. The length of the benefit period differs depending on the plan. For most plans, the maximum benefit period is 17 weeks, though it can extend up to 52 weeks in some cases. If your illness persists past the benefit period, you can apply for LTD insurance benefits if you have it or another long-term benefit such as CPP disability.
To learn more about the application process and eligibility, check out Short term Disability in Canada.
If your application get’s denied, you can appeal it. To learn more about this process, check out Reasons short-term disability can be denied and short term disability attorneys.
Employment Insurance (EI) Sickness
EI Sickness is available to workers who are unable to work due to illness or disability. EI sickness benefits provide temporary income replacement for individuals unable to work due to injury or illness. These benefits are funded by the federal government through the Employment Insurance (EI) program.
To qualify for EI sickness benefits, your income must decrease by at least 40% due to your illness or disability, you must be employed by a qualifying employer, and you must have accumulated 600 hours of insurable employment.
If approved, you will typically receive 55% of your average insurable weekly earnings, up to a maximum of $668 per week. These benefits can be received for up to 26 weeks.
Workers compensation
Workers compensation benefits are designed to support workers who suffered a work-related injury or illness.
In Canada, each province and territory has its own workers’ compensation board that manages the administration of workers’ compensation benefits (e.g., WSIB in Ontario).
To be eligible for workers’ compensation benefits Canada, you must be employed by a covered employer and have experienced a work-related injury or illness. If you qualify, you can receive disability income payments until age 65 and sometimes beyond. Additionally, you may be entitled to other benefits, such as coverage for health care and equipment expenses, as well as compensation for pain and suffering.
Migraine disability tax credit in Canada
Another benefit available to Canadians is the Disability Tax Credit (DTC). This benefit is a non-refundable tax credit designed to help ease the financial burden for people with disabilities or their supporting family members. To be eligible for the program, your condition, such as migraines or headaches, must impact your daily activities for an extended period of time.
To learn more about how to win migraine disability tax credit in Canada, check out our Online Guide to the Disability Tax Credit.
Provincial support benefits
Each province in Canada has its own disability benefit program. The qualifying criteria and application processes differ for each program, so visit your province’s website to learn more.
Provincial disability benefits:
- Ontario Disability Support Program (ODSP)
- Disability Assistance BC
- Assured Income for the Severely Handicapped (AISH)
- Saskatchewan Assured Income for Disability (SAID)
- Manitoba’s Employment and Income Assistance Program (EIA)
- New Brunswick Disability Support Program
- Québec Pension Plan and Government of Quebec, Services for Persons with a Physical or Intellectual Disability or an Autism Spectrum Disorder (ASD)
- Government of Newfoundland and Labrador, For Persons with Disabilities
- Government of Nova Scotia Disability Support Program
- Government of Northwest Territories Programs and Services for Persons with Disabilities Inventory
- Government of Nunavut Income Assistance
- Government of Yukon Services for People with Disabilities
Veterans Affairs Canada
If you are a veteran who developed headaches and migraines due to a service-related injury, you may be eligible for disability benefits from Veterans Affairs (VA) Canada.
In order to get approved, you must be able to provide medical evidence documenting your diagnosis of a headache or migraine disorder and the injury or event that caused it.
When preparing a migraine disorder VA claim, veterans should be thorough in gathering their medical records and acquiring statements from treating physicians that detail the nature of their condition and its service-related aspects.
The claim should also include a detailed account of how migraine disorder impacts their daily life and ability to work. VA benefits are rated based on the severity of the disability, and the level of impairment caused by migraine disorder can influence the amount of compensation received.
If a veteran’s initial migraine disorder VA claim is denied, they have the option to file an appeal. It’s crucial for veterans to be aware of timelines and procedures for filing an appeal and consider seeking assistance from veterans’ service organizations, which offer resources and guidance in navigating the VA benefits system.
For further guidance and support for any of the above benefits, contact our team today for more information.
How to win disability benefits for migraine and headache disorders
Unfortunately, headache disorders such as chronic migraines and cluster and tension-type headaches are often underdiagnosed and under-treated, which leads to patients going without necessary treatment and can lead to disability claims being denied.
It is important to remember that CCP and insurance company administrators are looking for reasons to deny your claim. The most common reasons claims are denied are that the agency reviewing the claim decides there isn’t sufficient proof that a headache disorder is debilitating enough to warrant disability benefits or that the patient has not explored every possible treatment option before submitting a disability claim.
Shore up your claim by making sure you have covered all the points administrators will be looking at when evaluating your application for disability benefits:
Proper diagnosis
What were you diagnosed with? And how did your doctor reach that diagnosis? Insurance claims adjusters usually place a lot of emphasis on CT scans and MRIs, which often do not indicate any abnormalities despite the intense pain the patient suffers on a regular basis. Therefore, your doctor must follow proper diagnostic protocols and ensure that your medical records contain the results of any and all tests necessary to rule out other conditions.
Make sure that your doctor keeps detailed records of your condition and treatment and follows proper diagnostic and treatment protocols. It may also be helpful to keep a diary or journal of your symptoms, the extent to which they disrupt your activities and the treatments you employ.
A diary or journal can be helpful both in helping your doctor arrive at a diagnosis and in demonstrating the degree of impairment a headache disorder causes.
Show that your headache disorder is disabling
Claims administrators will be looking for evidence that will help them decide whether your headache disorder is actually debilitating to the point that it prevents you from working.
- How frequent are your headaches?
- How severe are they?
- How many times have you visited the hospital due to your migraines, cluster headaches, or tension-type headaches?
Your medical records must demonstrate that the headaches occur often enough and with enough severity to prevent you from working.
Explore all treatment options
In order to help ensure that your claim is taken seriously, your doctor must follow accepted treatment protocols for your headache disorder, and you must be able to demonstrate that you have tried a variety of treatments and medications that have not resulted in enough of an improvement to allow you to return to work.
Treatments for migraine and other headache disorders can include:
- a variety of different pain medications
- medications that aim to prevent migraines
- anti-nausea medications
- anti-depressants and beta-blockers that help with migraine symptoms
Without detailed medical records of the treatments you have tried, claims administrators will attempt to deny your claim for lack of evidence that you have done everything you can to treat your headache disorder and return to work.
Evidence of work-related limitations
The most common reason for a denial of benefits is the perception that “You didn’t try.” To win benefits, you need to demonstrate more than just an inability to do your job; you must show that you actively sought help from your employer to stay employed. This could involve requesting reduced hours, lighter duties, or a change in roles within the company. If your job involves medium or heavy labour, you must attempt a position with lighter or sedentary duties.
To strengthen your case, you need to provide evidence of your efforts to remain at work. This evidence can include:
- Medical records detailing your attempts to work.
- Employment records showing the positions you tried and the accommodations made.
- A written statement from you outlining your work efforts.
- Signed statements from your employer or co-workers describing their observations of your struggle to work.
Presenting strong evidence of your attempts to stay employed significantly improves your chances of winning benefits. Conversely, having little or no evidence of your efforts greatly diminishes your chances of approval.
Credibility is key
When seeking disability benefits for headaches and migraines, maintaining complete honesty throughout the process is crucial. Credibility is paramount when making a legal claim for disability benefits related to headaches and migraines.
Any exaggerations or inconsistencies in descriptions of pain or disability can damage credibility, even if they result from honest mistakes.
Actions that undermine credibility:
- Contradicting medical records or earlier statements.
- Making excuses or blaming others for problems.
- Criticizing other parties involved in the claim (even if justified).
- Filing complaints against professionals perceived as negative, biased, or unprofessional.
- Using aggressive, sarcastic, or confrontational tones in your claim or testimony.
- Blocking or stalling reasonable requests for information.
- Arguing with doctors over your diagnosis instead of focusing on the disability
- Acting like a medical expert.
Actions that enhance credibility:
- Ensuring your statements align with medical records.
- Taking responsibility for errors or problems with your claim (not blaming others).
- Being cooperative and respectful toward everyone involved in the claim.
- Accepting expert advice and opinions.
- Making good faith efforts to follow all reasonable advice, even if you disagree with it.
- Demonstrating obvious efforts to continue working despite your condition.
Even if you do everything right and submit what you think is a bulletproof claim, sometimes your application will still be denied. This is unfortunate, but you still have options! Schedule a free consultation with our team to learn more about how we can help you get back the benefits YOU deserve.
What to do after a denial of disability benefits for migraines and headache disorders
You’ve filled out the forms, and you’ve compiled as much evidence as you could, and yet, the letter you get in the post informs you that you have been denied disability benefits for migraines or headache disorders.
Despite your pain, you find yourself forced back into the working world to provide for yourself and your family.
This is a tough time. I’ve seen it over and over again with my clients. Being told that your condition doesn’t warrant financial support only adds humiliation and frustration to your exhaustion. On top of that, forcing yourself back to work can have devastating consequences on your physical and mental health.
The good news is that you don’t have to accept this as a harsh reality simply. You can appeal the insurance company’s decision instead. I have years of experience with disability benefits claims, including many cases involving headaches and migraines. I know what you are going through, and I’m confident I can help you. You have a choice. Don’t let the insurance company deny you the support you are entitled to by law. Book a free consultation today by filling out the form at the bottom of the page or by calling (888) 480-9050.
Where are we located? Resolute Legal is a national law firm assisting clients across the country. Over 90% of our services are provided from home, so you won’t need to worry about traffic. Click on our service areas below to find out more:
Service areas:
Office locations:
Next step – Get your free books
Start making better decisions today. Subscribe to our email newsletter to download free copies of our books on winning disability claims.
