Chronic Migraine and the Workplace: My Journey to Getting Accommodations

My Relationship With Migraine

My migraine severity and level of disability have changed over the years.  As a teenager, when I first began experiencing migraine attacks, the people around me often dismissed them. I didn’t have anyone to recognize how unusual it was to be in that much pain or to advocate for accommodations at school on my behalf. Even as an adult, I didn’t ask for accommodations until I was nearly nonfunctioning. Despite encouraging others to advocate for themselves, I struggled with my own self-doubt. I was overwhelmed by thoughts like “it’s not that bad,” or “you’re not disabled enough,” which kept me from asking for help sooner. Not only that, but I was also battling the emotional toll of going from being a top performer at my job to struggling to even log in for the day.

I didn’t know how to adjust from being reliable and dependable to being absent, and it was really affecting my mental health. That year, my migraine attacks had rapidly progressed from episodic to chronic daily attacks. The more pain I was in, the more my mental health took a nosedive. I struggled to even get out of bed despite working from home at that time.

Seeking Help

At the time, I was in such a bad state that I needed to take medical leave because none of the medications I was on were working, and my actual work wasn’t getting done. More than anything, I was scared of losing my job and health insurance. I was extremely lucky at the time that my employer was paying 100% of my PPO health insurance premium. So, I decided to take a Family Medical Leave of Absence (FMLA) for the maximum 12 weeks and applied for short-term disability to have some income. I used that time to find the right headache specialist, better medications that lessened the burden, and spoke to my therapist and psychiatrist to get into a better headspace. 

Job Accommodations

Before returning to work, I knew I would need to ask for accommodations. I utilized the Job Accommodation Network (JAN) to explore the process of requesting accommodations and which accommodations exist for those with chronic migraine with aura. Then, I contacted Human Resources to ask about the process for requesting accommodations, since it can vary from workplace to workplace. My employer at the time had their own form that needed to be completed called “Professional Evaluation and Documentation of Disability and Need for Accommodation.” 

I requested to either work from home or the following in-office accommodations: 

•     Fragrance-free environment (or as close to fragrance-free as possible)
•     Access to the freezer for ice packs
•     Request a desk away from the noisier area
•     Natural lighting (non-fluorescent lighting)
•     Time off from phones during an attack to avoid exacerbating symptoms

These are some of the accommodations that were most helpful for me. Additional workplace accommodation options are listed later in the blog. 

Luckily, my headache specialist completed the forms quickly and faxed them to my employer.

My headache specialist’s handwritten description of my disability. The note reads, “Pt w/ severe chronic migraines, pt is unable to perform work functions due to pain, blurry vision, and dizziness during active flare-ups.”

Image # 2 Description: My headache specialist’s handwritten description of my requested accommodations. The note reads, “Patient recommended to work from home OR following accommodations made in-office: fragrance-free environment, access to freezer for ice-pack storage, desk locations away from noisier areas, natural lighting, ability to take breaks during active migraine.”

During the approval process for my requested accommodations, I was forced to utilize my sick and vacation time anytime I needed to leave early for an attack or a doctor’s appointment. I was using up my time off almost as quickly as I earned it.  Eventually, HR allowed me to use my requested accommodations while they continued processing the request. This was because I complained that it wasn’t fair to expect me to continue using that accumulated time when my doctor had provided a letter outlining what I needed months prior. After four months, human resources finally processed my request, explaining that it had been delayed because they were handling a large number of accommodation requests in the order they were received.

Understanding Your Rights: Americans with Disabilities Act & Workplace Accommodations

Navigating accommodations can feel overwhelming, but it’s important to know that the law is on your side. Under the Americans with Disabilities Act (ADA), individuals with disabilities are protected from workplace discrimination. Migraine, including vestibular migraine, hemiplegic migraine, and other types, may qualify as a disability if it substantially limits major life activities such as working, concentrating, or seeing. Employers are required to provide reasonable accommodations to help employees perform their necessary job functions.

Examples of Workplace Accommodations for Migraine

While I requested only a few accommodations, there are many options you can discuss with your employer. Examples include:

• Flexible scheduling
• Modified break schedules
• Telework, hybrid, or work-from-home options
• Restructuring job duties so that demanding tasks are done when energy and focus are highest
• Permission to use noise-canceling earbuds or headsets
• Migraine glasses or tinted lenses
• Sound machines or white noise machines
• Blue-light–blocking or anti-glare screen protectors
• Scheduled screen breaks
• Emotional support animals (when permitted)
• Permission to rest in a dark, quiet room
• Intermittent leave for severe attacks
• Adjustable or sit-stand desks
• Private workspace options

Many of these accommodations are simple, low-cost, and can make a big difference in maintaining productivity and well-being for people with migraine. For more information, click here.

View the example of my medical accommodations letter here.

Present Day

After my difficult experience applying for accommodations, I moved on to two other workplaces, and both processed accommodation requests without any issues.

Over the years, after trying more than 50 different medications and treatments and working with two headache specialists, I have found a combination of multimodal therapies and self-advocacy strategies that have significantly reduced the burden of living with chronic migraine with aura. If there’s one thing I’ve learned, it’s to ask for the accommodations and support you need. Don’t be afraid to advocate for yourself.

Author

Kelsey Feng (they/them) is a chronic illness and migraine advocate, a certified Community Health Worker, and a Patient Leader committed to amplifying patient voices and advancing health equity. Active in national advocacy since 2021, they have played a meaningful role in shaping key conversations around migraine awareness, policy, and care.

Kelsey is the recipient of the Migraine Warrior Award from Miles for Migraine and was nominated for Rookie of the Year by WEGO Health in 2022. They have served on multiple patient advisory councils and represented patient perspectives at national advocacy events such as Headache on the Hill and the Fibromyalgia Day of Advocacy. Their work centers on improving healthcare access, quality, and visibility for people living with migraine and other chronic illnesses. You can find more about their work on Instagram as @kelseysmigraine.