Migraine headaches are the most common form of a vascular headache, which is an abnormal function of the brain’s blood vessels that causes pain. There are several different types of migraines that have different symptoms associated with them. Examples of migraines include:
- Classic Migraines: Classic migraines are one of the most common types of migraines. They involve an aura 10-30 minutes before the migraine. Auras can consist of flashing lights, seeing zig-zag lines, or even temporary vision loss. Symptoms that may be associated with the classic migraine include throbbing or pounding felt in the forehead, temple, or jaw; difficulty with speech; weakness of an arm or leg; and confusion. A classic migraine attack could last up to two days.
- Common Migraines: Common migraines are another of the most common types of migraines. They differ from classic migraines because an aura does not precede the attack. However, these symptoms may occur prior to the migraine: mental vagueness, mood changes, fatigue, retention of fluids, diarrhea and increased urination, and nausea and vomiting. Common migraines may last up to four days.
- Hemiplegic Migraines: Hemiplegic migraines include symptoms such as temporary paralysis on one side of the body, vision deficits, and vertigo, which occur 10 – 90 minutes prior to the start of the migraine.
- Ophthal Moplegic: Ophthalmoplegic migraines include vision problems, such as double vision.
- Basilar Artery Migraines: Basilar artery migraines are characterized by a disturbance of a major brain artery. Symptoms may include vertigo, poor muscle coordination, and double vision.
- Benign Exertional Headache: Benign external headaches are migraines that are brought on by running, lifting, sneezing, or bending. The headache normally subsides after several minutes.
- Status Migrainosus: Status migrainosus is a severe migraine that can last 72 hours or longer and often results in hospitalization.
- Headache-free Migraine: Headache-free migraines are characterized by symptoms such as visual problems, nausea and vomiting, and constipation or diarrhea, but consist of no head pain.
Migraines and the Americans with Disabilities Act
The ADA does not contain a list of medical conditions that constitute disabilities. Instead, the ADA has a general definition of disability that each person must meet. A person has a disability if he/she has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or is regarded as having 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:
- What limitations is the employee experiencing?
- How do these limitations affect the employee and the employee’s job performance?
- What specific job tasks are problematic as a result of these limitations?
- What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
- Has the employee been consulted regarding possible accommodations?
- 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?
- Do supervisory personnel and employees need training?
Situations and Solutions:
An employee who works in a cubicle setting was experiencing migraine headaches that were triggered by the noise level; she was located in a high traffic area by the copy machine.
The employer accommodated this employee by moving her to an area with less traffic and providing an environmental sound machine.
An accountant had a migraine headache about twice a week, which prevented him from coming to work.
As an accommodation, the employer allowed this employee to work for home when he had a migraine headache. If his migraine was too severe to work from home, the employee was allowed to use comp time.
A computer programmer experienced migraines that were triggered by the noise level in his cubicle and the overhead fluorescent lighting.
As an accommodation, his employer provided him with a noise canceling headset, disabled the fluorescent light above his cubicle, and provided natural task lighting.
A journalist had difficulty recovering from shingles.
She was experiencing chronic migraines and depression from six weeks of shingles, which manifested around her right eye. Her employer granted her extended leave to work on her recovery.
A police officer experienced migraines that were triggered by fragrances.
The employer allowed the employee to work a modified schedule and assigned them to low volume areas where it would be less likely that the individual would come into contact with people wearing fragrances.
An assembly line worker’s migraines were triggered by various fragrances.
The employees around him often wore overwhelming perfumes that caused him to have a migraine. As an accommodation, the employer asked other employees to voluntarily refrain from wearing fragrances. The employee was also moved to a part of the assembly line where the fragrances were not as strong.
A human resource representative had migraines several times a month, which prevented her from working.
As an accommodation, the employer provided unpaid flexible leave after all of her paid leave was exhausted.