A migraine attack is a valid and often necessary reason to miss work, countering the common misconception that it is simply a severe headache. Migraine is recognized as a complex neurological disorder that causes significant functional impairment, making it virtually impossible to perform typical job duties effectively. The World Health Organization classifies migraine as one of the world’s most disabling conditions. Over 90% of sufferers report that an attack interferes with their daily activities and work life.
Migraines as a Valid Disabling Condition
Migraine is characterized by four potential phases, but the attack phase is what primarily renders an individual incapable of working. The attack itself typically lasts between four and 72 hours if untreated. This period is marked by severe, often throbbing or pulsating head pain that can affect one side of the head.
The pain is accompanied by other debilitating symptoms that impair concentration and mobility. These include photophobia (extreme sensitivity to light) and phonophobia (hypersensitivity to sound). Many sufferers also experience nausea, sometimes leading to vomiting, which makes sitting at a desk or interacting with others extremely difficult.
During an attack, an employee who attempts to work experiences diminished effectiveness, a concept known as presenteeism. Research suggests that people working during a migraine attack are less than half as effective as usual, making their presence unproductive. The functional limitations extend to cognitive tasks, including difficulty with memory, decision-making, and overall processing speed.
Immediate Communication and Workplace Protocols
When a migraine attack begins, timely and clear communication with the employer is essential. Employees should adhere to the company’s established sick leave or call-out procedure, notifying a direct manager or designated human resources representative. This notification should happen as soon as the need for absence is determined, whether before the workday begins or immediately upon experiencing symptoms at work.
The message should be direct and professional. It is helpful to state that a diagnosed migraine attack is preventing work and to provide an expected time of return, or at least an update on when a follow-up communication will occur. Employees should also briefly mention if they have a plan for covering urgent tasks or a coworker who can take over their responsibilities during the absence.
For short-term or acute absences, a doctor’s note may be required, depending on the company’s policy for sick leave usage. Proactive communication with a healthcare provider to secure a general letter explaining the nature of the condition can be beneficial. This documentation validates the medical necessity of the absence.
Legal Protections for Chronic Migraine Sufferers
For individuals who experience frequent or chronic migraines (defined as 15 or more headache days per month), specific legal frameworks offer employment protections. The Americans with Disabilities Act (ADA) may cover severe, recurring migraines if they substantially limit major life activities, such as working or concentrating. If an employee qualifies, the employer is legally obligated to provide “reasonable accommodations” to enable job performance.
Reasonable accommodations could include flexible scheduling, such as the option to start later or work from home during milder episodes. Adjustments to the physical workspace are also common, like providing a quiet work area, using anti-glare screens, or reducing exposure to fluorescent lighting and strong scents, which are common migraine triggers. The formal process involves engaging in an “interactive process” with the employer, usually requiring medical certification.
The Family and Medical Leave Act (FMLA) is another protection that allows eligible employees to take job-protected, unpaid time off for a serious health condition, including chronic migraines. This leave can be taken intermittently, meaning in blocks of time as needed for flare-ups, such as calling out for a full day or leaving work early. To use FMLA, an employee must meet eligibility requirements and submit medical certification confirming the need for intermittent leave.