Employees with 

Migraine Headaches 

Accommodation and Compliance Series
Practical Solutions • Workplace Success 

2 

Preface 

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Updated 03/23/10. 
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JAN’S ACCOMMODATION AND COMPLIANCE SERIES

Introduction

JAN’s Accommodation and Compliance Series is designed to help employers determine 

effective accommodations and comply with Title I of the Americans with Disabilities Act 

(ADA). Each publication in the series addresses a specific medical condition and 

provides information about the condition, ADA information, accommodation ideas, and 

resources for additional information. 

The Accommodation and Compliance Series is a starting point in the accommodation 

process and may not address every situation. Accommodations should be made on a 

case by case basis, considering each employee’s individual limitations and 

accommodation needs. Employers are encouraged to contact JAN to discuss specific 

situations in more detail. 

For information on assistive technology and other accommodation ideas, visit JAN's 

Searchable Online Accommodation Resource (SOAR) at http://askjan.org/soar. 

Information about Migraine Headaches 

How prevalent are migraine headaches? 

According to the National Headache Foundation, an estimated 28 million Americans 

have migraine headaches. The World Health Organization considers migraines to be 

one of the most debilitating diseases in the world. In addition, an estimated 14 million 

Americans have undiagnosed migraine headaches (Lawrence, 2004). 

Migraines are the second most prevalent headache syndrome in the United States. 

Statistics show that 157 million workdays each year are lost due to the severity of 

migraine headaches (Fackelmann, 2005).

Migraines are more prevalent in women, affecting women three times more than men. 

Estrogen levels are a key trigger for increased migraines in women, but how the 

changes trigger migraines is unknown. Women often report that their migraine occurs 

during or right before the onset of their menstrual cycle. In addition, some women 

experience migraines during pregnancy or menopause. Contraceptives and hormone 

replacement therapies have also been shown to cause more severe migraines (Mayo 

Clinic, 2005). 

What are migraine headaches? 

Migraine headaches are the most common form of a vascular headache, which is an 

abnormal function of the brain’s blood vessels (UVA Health, 2004). There are several 

different types of migraines that have different symptoms associated with them. 

Examples of migraines include: 
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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 2 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 4 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: Ophthal Moplegic 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 (UVA Health, 2004). 

What causes migraine headaches? 

No one knows for certain what causes Migraine Headaches. Some doctors believe that 

they are due to changes in brain chemistry, which causes blood vessel dilation and 

inflammation. Research has shown that almost all individuals with migraines have a 

close relative who also has migraines (Mayo Clinic, 2005). 

Although the direct cause of migraines is unknown, they are often a result of 

controllable and uncontrollable triggers. Examples of controllable triggers include 

lighting, smells, smoke, noise, disrupt in sleep patterns, and certain foods. Examples of 

uncontrollable triggers are weather, air pressure, and menstrual cycles. Often, when 
Practical Solutions • Workplace Success 

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addressing accommodations it is important to talk with the employee about the triggers 

associated with the onset of the headache (Fackelmann, 2005). 

How are migraine headaches treated? 

As of today, there is no cure for migraines. Often, individuals with migraines look at 

treating or preventing the migraine. Preventive medications are used to reduce the 

number of attacks for individuals that have two or more migraines a month. Examples 

of some of the prescribed medications are Beta-blockers, Anti-depressants, and 

Divalproex Sodium. Many individuals who take preventive medications also take 

medication to treat the severity of the migraine (Lawrence, 2004). 

Migraines and the Americans with Disabilities Act

Are migraine headaches disabilities under the ADA? 

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 such an impairment. According to the Equal Employment Opportunity 

Commission (EEOC), having migraine headaches is an impairment. Therefore, people 

with migraine headaches who are substantially limited in a major life activity will have a 

disability under the ADA. 

For more information about how to determine whether a person has a disability under 

the ADA, visit http://askjan.org/corner/vol02iss04.htm. 
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Accommodating Employees with Migraine Headaches 

(Note: People with migraine headaches 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 migraine headaches 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 with migraines 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. Has the employee with migraines been consulted regarding possible 

accommodations? 

6. Once accommodations are in place, would it be useful to meet with the employee 

with migraines to evaluate the effectiveness of the accommodations and to determine 

whether additional accommodations are needed? 

7. Do supervisory personnel and employees need training regarding migraine 

headaches? 

Accommodation Ideas: 

Lighting Triggers: 

 Add fluorescent light filters to existing fluorescent lights to create a more natural 

lighting 

 Change lighting completely 

 Provide an anti-glare filter for computer monitor 

 Provide a liquid crystal display monitor that has a better refresh rate 

 Move employee to a private area to allow for personal adjustment to appropriate 

lighting 

 Allow the employee to wear sunglasses or anti-glare glasses in the work area 

 Allow telework 
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Noise Triggers: 

 Move employee to a more private area or away from high traffic areas 

 Provide an environmental sound machine to help mask distracting sounds 

 Provide noise canceling headsets 

 Provide sound absorption panels 

 Encourage coworkers to keep non-work related conversation to a minimum 

Smell/Fragrance Triggers: 

 Implement a fragrance-free policy 

 Request that employees voluntarily refrain from wearing fragrances 

 Allow telework 

 Move the employee to an area where the fragrances are not as strong 

 Allow a flexible schedule 

 Provide air purification systems 

Other: 

 Provide flexible leave when the employee is experiencing a migraine 

 Allow the employee to telework when the employee is experiencing a migraine 

 Do not mandate attendance at after-hours social functions if an employee is 

affected by a disruption in sleep patterns 

 Provide the employee with a dark, private area to go to when experiencing a 

migraine 

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. 

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 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. 

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 
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refrain from wearing fragrances. The employee was also moved to a part of the 

assembly line where the fragrances were not as strong. 

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. 

Products: 

There are numerous products that can be used to accommodate people with limitations. 

JAN's Searchable Online Accommodation Resource (SOAR) at http://askjan.org/soar is 

designed to let users explore various accommodation options. Many product vendor 

lists are accessible through this system; however, upon request JAN provides these 

lists and many more that are not available on the Web site. Contact JAN directly if you 

have specific accommodation situations, are looking for products, need vendor 

information, or are seeking a referral. 
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Resources 

Job Accommodation Network 

West Virginia University 

PO Box 6080 

Morgantown, WV 26506-6080 

Toll Free: (800)526-7234 

TTY: (877)781-9403 

Fax: (304)293-5407 

jan@askjan.org 

http://askjan.org 

The Job Accommodation Network (JAN) is a free consulting service that provides 

information about job accommodations, the Americans with Disabilities Act (ADA), and 

the employability of people with disabilities. 

Office of Disability Employment Policy 

200 Constitution Avenue, NW, Room S-1303 

Washington, DC 20210 

Toll Free: (866)633-7635 

TTY: (877)889-5627 

Fax: (202)693-7888 

http://www.dol.gov/odep/ 

The Office of Disability Employment Policy (ODEP) is an agency within the U.S. 

Department of Labor. ODEP provides national leadership to increase employment 

opportunities for adults and youth with disabilities while striving to eliminate barriers to 

employment. 

American Academy of Neurology 

1080 Montreal Avenue 

St. Paul, MN 55116 

Toll Free: (800)879-1960 

Direct: (651)695-2717 

Fax: (651)695-2791 

memberservices@aan.com 

http://www.aan.com/ 

The American Academy of Neurology (AAN) provides valuable resources for medical 

specialists worldwide who are committed to improving the care of patients with 

neurological diseases. 
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American Headache Society 

19 Mantua Road 

Mt. Royal, NJ 08061 

Direct: (856)423-0043 

Fax: (856)423-0082 

ahshq@talley.com 

http://www.ahsnet.org/ 

A professional society of health care providers dedicated to the study and treatment of 

headache and face pain. 

Migraine Mentors Program 

National Headache Foundation 

820 North Orleans 

Suite 217 

Chicago, IL 60610 

Toll Free: (888)643-5552 

http://www.migrainementors.com/atwork.asp 

Migraine Mentors is an online resource for women suffering from migraine headaches. 

The program was founded to recognize the special needs of female migraine sufferers 

and influence the development of peer-based support programs for women and their 

families. 
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References 

Equal Employment Opportunity Commission. (1992). A technical assistance manual on 

the employment provisions (title I) of the Americans with Disabilities Act. 

Retrieved September 5, 2008, from http://askjan.org/links/ADAtam1.html 

Fackelmann, K. (May 11, 2005). Help for migraines has arrived: Diagnosis is the first 

step toward relief. USA Today. Retrieved August 21, 2005, from EBSCOhost 

Academic Search Elite database: http://www.usatoday.com 

Lawrence, E.C. (2004, November). Diagnosis and Management of Migraine 

Headaches. Southern Medical Journal, 97(11), 1069-1077. Retrieved August 21, 

2005, from EBSCOhost Academic Search Elite database: http://www.sma.org 
Practical Solutions • Workplace Success 

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This document was developed by the Job Accommodation Network, funded by a 

contract agreement from the U.S. Department of Labor, Office of Disability Employment 

Policy (DOL079RP20426). The opinions expressed herein do not necessarily reflect the 

position or policy of the U.S. Department of Labor. Nor does mention of trade names, 

commercial products, or organizations imply endorsement by the U.S. Department of 

Labor.