Migraines in the workplace: Your ADA rights and employer obligations

The Americans with Disabilities Act (ADA) is a federal law. It requires employers to provide workplace accommodations for people with qualifying medical conditions. As a manager or human resources professional, you likely know the law’s basic requirements. However, understanding which health conditions the ADA classifies as disabilities can be tricky.

Nobody likes dealing with headaches, but does the ADA cover them? What about chronic migraines? People often confuse standard headaches with migraines. However, they differ, and laws like the ADA may treat them differently.

Navigating the ADA accommodation process can be confusing whether you’re an employee suffering from migraines or trying to understand your duty to accommodate a coworker with them. Learn what obligations employers have and how employees can request accommodations. We have also listed some standard ADA migraine accommodations to consider.

What are migraines?

Migraines, a neurological disorder, causes severe headaches. The National Institute of Neurological Disorders and Stroke describes migraines as “a headache characterized by recurrent attacks of moderate to severe throbbing and pulsating pain on one side of the head.” Many migraine sufferers also experience nausea or vomiting during a migraine.

Some migraine sufferers experience migraines with aura, marked by the onset of visual disturbances such as flashing lights, blind spots, the appearance of waves, or zig-zags before the actual migraine headache. The aura phase typically lasts less than one hour.

The American Migraine Foundation reports that 39 million Americans deal with migraines and that the condition is the second largest cause of global disability. Due to the prevalence of migraines, it should be no surprise that it’s a common condition for employers to receive reasonable accommodation requests.

Are migraines covered under the ADA?

Migraines can be covered as a disability under the ADA and qualify for reasonable accommodations. The Americans with Disabilities Act defines a disability as a physical or mental health impairment that substantially limits one or more major life activities.

Major life activities include seeing, walking, hearing, working, concentrating, speaking, and primary bodily functions. Migraines often qualify as a disability because the symptoms frequently disrupt these activities. Migraine symptoms commonly interfere with vision, working, cognitive function, balance, mobility (due to lightheadedness or dizziness), and digestive function.

Individuals with a qualifying condition like migraines have a right to specific protections. These rights include protection against discrimination based on disability. They also have a right to reasonable accommodations that help them do their job. Accommodations could include policies, processes, tools, equipment, or schedule adjustments.

Possible ADA workplace accommodations for employees with migraines

The below are a sampling of accommodations that migraine sufferers commonly find helpful. As with any disability, reasonable accommodations should be handled on a case-by-case basis based on the employee’s individual symptoms, needs, and job duties.

Providing a quiet, dimmed work area

Fluorescent lights and noise can trigger or worsen migraine attacks. Open office floor plans aren’t ideal for many migraine sufferers. Employees experiencing current or approaching migraine attacks benefit from access to a quiet space with adjustable lighting. Conference rooms often serve this purpose well.

Accommodating light or sound sensitivities at employee workstations

You can also make accommodations at their existing workspace to limit sound and light issues. Providing or authorizing noise-canceling headphones while engaging in independent work can help with noisy offices.

If overhead lights are an issue, employers can consider changing the bulbs or adding a filter over the lights to make them dimmer or less harsh. Employers can also install glare filters on work computers, as screens and screen lighting are often migraine triggers.

Limiting fragrances in the workplace

Strong scents or fragrances can be a migraine trigger for some people. Many workplaces have enacted some form of fragrance-free workplace policy to help those with fragrance sensitivities, including migraine sufferers. This includes asking employees to limit perfumes or strongly scented lotions and removing plug-in air fresheners from the office.

Offering flexible work schedules

Working during a migraine attack can be tricky. Everyone experiences different symptoms and severities, but many people are not able to complete their regular job duties while dealing with a migraine. If someone is experiencing photophobia (aka light sensitivity) during a migraine, for example, it may be challenging to work on a screen. A potential ADA accommodation could be to offer a flexible schedule or allow employees to take extra time off when a migraine hits.

Employees can also qualify for and use intermittent FMLA leave for migraines if they need to call out or leave early due to migraines. The Family and Medical Leave Act provides up to 12 weeks off per 12-month period for employees who need time off due to a serious health condition. This can be taken intermittently, meaning the days may be spread out and used as needed rather than as one extended leave of absence.

Allowing remote work

Some migraine sufferers may also benefit from an accommodation that allows them to work from home when needed. People have greater control over their home environment than their in-person work environment. This allows them to work more efficiently at home during a migraine episode.

Many migraine sufferers also find that they have stronger migraine symptoms in the morning. If someone wakes up and experiences migraine symptoms, particularly a migraine aura, commuting to work can be challenging or unsafe. After all, it’s very dangerous to get behind the wheel if you’re experiencing visual disturbances, and also probably a bad idea to get on a train or subway system if you’re nauseous or vomiting. Roadways and public transit are also full of bright natural or fluorescent lights and loud sounds that could worsen a migraine.

Providing additional breaks

Screens often trigger migraines, so employees prone to them can benefit from frequent breaks during computer work. Short hourly breaks from screens and typing help employees with migraines and other conditions, as medical professionals often recommend.

The American Migraine Foundation also recommends specific lifestyle changes that can minimize migraine symptoms and attacks, including staying hydrated, decreasing stress, and eating more frequently throughout the day to stabilize blood sugar. As such, added breaks for snacks and water or to rest and get some fresh air can help migraine sufferers manage symptoms throughout the work day.

Reassignment to a different role

If the employee’s current job duties often trigger migraines, the employer and employee should explore reassigning the employee to a different, more suitable position. However, employers and employees typically consider reassignment a last resort. They only consider it when no other accommodation allows the employee to complete their essential job duties comfortably.

How should employees request ADA accommodation for migraines

Many employers have established procedures for making an ADA accommodation request. However, some small businesses may not have as much experience with ADA issues. Businesses should include an accommodation form or request procedure in their company handbook or employee portal. This helps employees understand how to start the process. If your employer doesn’t have a straightforward procedure, here are some steps you can expect when requesting ADA accommodations for migraines.

Making the initial request

The Equal Employment Opportunity Commission (EEOC) highlights a requirement. The employee or their representative must notify the employer of their need for workplace accommodation due to a medical condition. Representatives may include doctors, legal counsel, family members, or other parties who know the individual’s accommodation needs. The employee does not need to mention the ADA specifically, use the phrase “reasonable accommodation,” or make the request in writing to begin the process.

Complete the request in writing or through a provided form to create a paper trail for both parties. As an employer, you must still respond to verbal requests. If you receive a verbal request for accommodation, follow up with a written memo. This memo should confirm the request and outline the next steps (such as submitting a request form or doctor’s note). Employees can also create a paper trail in this way if they need to take action later due to discrimination or other ADA violations.

Providing documentation

One thing to keep in mind when requesting accommodations for migraines is that it is an invisible illness. Under the ADA, employers are allowed to request a note from a medical provider if the employee’s need for accommodation isn’t apparent.

This note doesn’t need excessive detail about the employee’s diagnosis or private medical information. However, it should confirm the employee’s need for accommodations and might include functional limitations. For example, a person with migraines might need to limit continuous screen time and take a 60-minute break from the computer every hour. The employer, armed with this knowledge, could explore several options. These options include offering short hourly breaks or changing the employee’s tasks to reduce screen time.

Some people may find it helpful to discuss their migraine disorder with their doctor or neurologist before talking to their employer. Doctors who often treat migraines are an excellent resource for understanding helpful accommodations. A conversation with your doctor can clarify what you should ask for when speaking with your employer. If you are nervous about requesting accommodations, a doctor’s note can give you confidence in asserting your right to them.

Determining accommodations

Finalizing specific accommodations should be a collaborative effort between the employer and the employee. You and your employer will collaborate to find a suitable accommodation. This accommodation will meet your needs while avoiding excessive costs or difficulties for the company. Remember to advocate for yourself to ensure the chosen accommodations truly meet your needs.

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