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Accommodation and Compliance: Migraines

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About Migraines

Migraines are recurring primary headaches that can cause severe throbbing or pulsing pain, and often come with additional symptoms such as nausea, light and noise sensitivity, weakness, and fatigue. The two most frequently discussed types of migraines in the literature are migraine with aura and migraine without aura. Migraines have no known cause, but are influenced by genetics, stress, diet, environment, medications, and more.

  • Migraine with aura — less common; are accompanied by additional neurological symptoms usually related to visual disturbances
  • Migraine without aura — the most common; 70-90% of those who experience migraines will not have an aura

The four phases of migraines.

  • Prodome. This phase starts up to 24 hours before the migraine. Early signs and symptoms include food cravings, unexplained mood changes, uncontrollable yawning, fluid retention, and increased urination.
  • Aura. If auras are present, they might include flashing or bright lights or zig-zag lines. Muscle weakness or a feeling of being touched or grabbed may occur. An aura can happen just before or during a migraine.
  • Headache. A migraine usually starts gradually and then becomes more severe. It typically causes throbbing or pulsing pain, often on one side of the head. But sometimes a migraine can occur without a headache. Other migraine symptoms may include
    • Increased sensitivity to light, noise, and odors
    • Nausea and vomiting
    • Worsened pain when moving, coughing, or sneezing
  • Postdrome (following the headache). Symptoms may include exhaustion, weakness, and confusion after a migraine. This can last up to a day.



Migraines and the Americans with Disabilities Act

The ADA does not contain a definitive list of medical conditions that constitute disabilities. Instead, the ADA defines a person with a disability as someone who (1) has a physical or mental impairment that substantially limits one or more "major life activities," (2) has a record of such an impairment, or (3) is regarded as having such an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).

Accommodating Employees with Migraines

People with migraines may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with migraines will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.

Questions to Consider:

  1. What limitations is the employee experiencing?
  2. How do these limitations affect the employee and the employee’s job performance?
  3. What specific job tasks are problematic as a result of these limitations?
  4. What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
  5. Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
  6. Do supervisory personnel and employees need training?

Accommodation Ideas:

Situations and Solutions:

The following situations and solutions are real-life examples of accommodations that were made by JAN customers. Because accommodations are made on a case-by-case basis, these examples may not be effective for every workplace but give you an idea about the types of accommodations that are possible.

Events Regarding Migraines