Chronic migraines can be profoundly disabling. If you experience 15+ migraine days per month, or severe migraines preventing functioning on significant days, you may qualify for PIP. The key is describing unpredictability and severity.
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Preparing Food (Activity 1) – During attacks: cannot stand, light and smell sensitivity, nausea, cognitive impairment. Between attacks: fear of triggers in the kitchen. If you cannot reliably cook on more than 50% of days, this scores.
Managing Therapy (Activity 3) – Daily preventatives (beta blockers, topiramate, amitriptyline, CGRP injections) and acute medication (triptans, anti-sickness) count as managing medication, not therapy. If you need an aid such as a dosette box or alarms, or someone to prompt or help you take them or to watch for medication overuse, that is descriptor 3b for 1 point however long it takes. Neurology appointments and Botox at the clinic are not home therapy and do not score.
Engaging with People (Activity 9) – Cancelling plans unpredictably. Avoiding triggers (bright lights, loud noise, alcohol). Social isolation from chronic nature. Depression.
Planning Journeys (Activity 11) – Unpredictability means you cannot guarantee completing any journey. Visual aura affecting driving. Sensitivity to light, motion, noise on public transport.
Moving Around (Activity 12) – During attacks: unable to walk. Vestibular migraines cause severe vertigo. Between attacks: medication drowsiness.
The Descriptors a Migraine Attack Reaches
On an attack day a migraine can stop almost any activity, but two carry most claims: engaging with people (you cancel, isolate and cannot tolerate light or noise) and preparing food (you cannot stand, and light, smell and nausea make a kitchen impossible). Here is how the points work, remembering the test is whether you can do each one reliably on the majority of days.
Activity 9: Engaging With People (daily living)
- Can engage with other people unaided 0
- Needs prompting to be able to engage with other people 2
- Needs social support to be able to engage with other people 4
- Cannot engage with other people due to overwhelming psychological distress 8
Frequent attacks force you to cancel plans at no notice, avoid bright or loud places, and withdraw, often with low mood from the unpredictability. Where you need a trusted person to manage contact that is descriptor (c) for 4 points. See Activity 9 in detail, and where light and noise stop you leaving the house, Activity 11 journeys.
Activity 1: Preparing Food (daily living)
- Can prepare and cook a simple meal unaided 0
- Needs to use an aid or appliance to prepare or cook 2
- Cannot cook a simple meal using a cooker but can use a microwave 2
- Needs prompting to prepare or cook a simple meal 2
- Needs supervision or assistance to prepare or cook a simple meal 4
- Cannot prepare and cook food 8
During an attack you cannot stand at a hot cooker safely, and light, smell and nausea make cooking impossible. If on the majority of days you can only manage a microwave, need someone to take over, or cannot cook at all, descriptors (b) to (f) apply for 2 to 8 points. See Activity 1 in detail.
How much is YOUR PIP worth?
Describe a Typical Month, Not a Good Day
Migraine claims fail when the form is filled in between attacks. The DWP needs the full picture: how many attack days a month, how long each lasts, the recovery (postdrome) days after, and what you cannot do across all of them.
The Unpredictability Argument
Write: "My migraines are unpredictable. I cannot guarantee that I will be able to prepare food, wash, dress or leave the house on any given day because a migraine attack can strike without warning and leave me unable to function for [X] hours/days."
What Evidence Helps?
- Neurologist letters
- Headache diary
- Medication records
- Botox records
- Partner statement
Chronic vs Episodic Migraines for PIP
PIP distinguishes between how often you're affected, not your diagnosis. If you have migraines on 15+ days per month (chronic migraine), you're affected on most days by definition. Even with 8-10 migraine days per month, the recovery days between attacks may push you over the 50% threshold when you account for prodrome (warning phase) and postdrome (hangover phase) on either side of each attack.
Migraine Medication and PIP
Your medication regime counts under Activity 3, but not by the hour. Since 2017 taking or administering medication, including a monthly CGRP self-injection, is "managing medication", not therapy, so the time it takes does not matter. If you need an aid or appliance (a dosette box, alarms) or prompting, supervision or assistance from another person to take preventatives and triptans at the right times, or to watch for medication overuse, that is descriptor 3b for 1 point. The 2 to 8 point descriptors (3c to 3f) are only for hours of another person's help with prescribed therapy done at home, and Botox and neurology appointments at a clinic do not count at all.
Side effects are equally important. Topiramate causes cognitive problems ("dopamax"), word-finding difficulty and tingling. Beta blockers cause fatigue and dizziness. Amitriptyline causes drowsiness. These side effects affect activities BETWEEN migraines and should be described separately.
Migraine Diary as PIP Evidence
A migraine diary is one of the strongest pieces of evidence for a migraine PIP claim. Record for 4 weeks: date, severity (1-10), duration (hours), triggers, medication taken, what you couldn't do, recovery time needed the next day. This objectively shows frequency and functional impact.
Driving Restrictions
If your migraines include aura, the DVLA has specific rules about driving. If you've been told not to drive, or you voluntarily don't drive because of migraine risk, this is powerful evidence for Activity 11 (planning journeys). You cannot independently follow journeys if you can't drive and public transport triggers attacks (bright lights, motion, noise).
Migraine Types and PIP
- Episodic migraine without aura: Standard form. PIP-qualifying if frequent enough.
- Migraine with aura: Visual disturbance precedes pain. DVLA notification required.
- Chronic migraine: 15+ headache days/month with 8+ migraine days. Most likely to qualify.
- Hemiplegic migraine: Temporary one-sided weakness. Often misdiagnosed as stroke.
- Vestibular migraine: Vertigo predominant. Affects Activity 12 mobility.
- Status migrainosus: Migraine over 72 hours. Emergency.
- New Daily Persistent Headache (NDPH): Constant headache from a specific date.
- Cluster headache: Severe one-sided headache in clusters. Suicide headache.
- Medication overuse headache: Caused by frequent pain medication use.
Migraine Treatment Options
- Acute (during attack): Triptans (sumatriptan, rizatriptan, eletriptan), NSAIDs, paracetamol, anti-sickness (metoclopramide, prochlorperazine).
- Preventative oral: Topiramate, propranolol, amitriptyline, candesartan, sodium valproate.
- Botox injections: Every 12 weeks for chronic migraine. NHS criteria - 15+ headache days/month, failed 3+ preventatives.
- CGRP monoclonal antibodies: Erenumab (Aimovig), fremanezumab (Ajovy), galcanezumab (Emgality) - monthly self-injection. NICE-approved for chronic migraine failing 3+ preventatives.
- Gepants (CGRP receptor antagonists): Rimegepant, ubrogepant - newer acute and preventative options.
- Lasmiditan: Newer acute treatment without vasoconstriction.
- Occipital nerve blocks: Specialist injections.
- Sphenopalatine ganglion blocks: Specialist treatment.
- Greater occipital nerve stimulation: Implanted device.
Why Chronic Migraine Qualifies for PIP
The WHO ranks severe migraine in the top 10 most disabling conditions globally. NICE recognises chronic migraine as significantly disabling. Functional impact is comparable to chronic kidney disease, severe asthma or active rheumatoid arthritis. The DWP should not dismiss it.
Calculating Affected Days
To meet "majority of days":
- Migraine day itself (1 day)
- Prodrome (1 day before with warning signs)
- Postdrome / "migraine hangover" (1 day after - exhaustion, brain fog)
- Total per migraine = 3 affected days
- 8 migraines/month x 3 days = 24 affected days = 80% of month
- 10 migraines/month x 3 days = 30 affected days = 100%
Specific Triggers and Avoidance
- Light (especially bright/fluorescent)
- Sound
- Smells (perfume, cooking, chemicals)
- Weather changes (barometric pressure)
- Hormonal cycles (menstrual migraine)
- Food triggers (chocolate, cheese, red wine, MSG)
- Stress (or post-stress relaxation)
- Sleep changes (too much or too little)
- Dehydration
- Skipped meals
If trigger avoidance limits your life - cannot use public transport (bright lights), cannot eat out (smells, food triggers), cannot work in fluorescent office - this affects Activities 9 and 11.
Frequently Asked Questions
Can you get PIP for migraines?
Yes. PIP has no list of qualifying conditions, so migraines can qualify when they affect how you carry out everyday activities. What counts is not the diagnosis but the functional impact: how often attacks happen, how long they last, and whether you can do things safely, to an acceptable standard, repeatedly and in a reasonable time. Chronic migraine (15 or more headache days a month) is most likely to score, but frequent episodic migraine can too once the prodrome and recovery days are counted.
Can you claim PIP for chronic migraines?
Yes, and chronic migraine is often one of the stronger migraine claims because the frequency usually meets the majority-of-days test. If your attacks, including the build-up and the wiped-out recovery afterwards, affect you on more than half the days, you can score points on the activities they touch. Always describe your worst days, keep a migraine diary as evidence, and explain what you cannot do reliably during and around an attack.
I only get migraines 8 times a month. Is that enough?
Possibly. Count not just the migraine day but the prodrome day before (when you feel "off" and can't function normally) and the postdrome day after (when you're wiped out). 8 migraines with 1-day prodrome and 1-day postdrome = 24 affected days per month. That's well over 50%.
The assessor said "migraines are common and most people manage."
Challenge this at Mandatory Reconsideration. Chronic migraine is a neurological condition recognised by NICE and the WHO as a significant disability. "Common" doesn't mean "not disabling." The assessor's job is to assess YOUR migraines, not migraines in general.
I have Botox every 12 weeks - what does this mean?
NHS Botox eligibility requires chronic migraine plus failure of 3+ preventatives. Being on Botox is strong evidence of severe, treatment-resistant migraine. Continue claiming.
CGRP injections work but they are not licensed - can I claim?
CGRP injections (Aimovig, Ajovy, Emgality) are NICE-approved. Their effectiveness for you indicates how disabling your migraines would be without them. If symptoms recur if dose is missed, this shows ongoing need.
My migraines started after a head injury - any different?
Post-traumatic headache is recognised. Often combined with other post-concussion symptoms (cognitive, mental health). May qualify based on broader impact.
I have hemiplegic migraine - what should I claim?
Hemiplegic migraine causes temporary stroke-like symptoms. DVLA driving prohibition typical. Strong PIP claim across Activities 7, 9, 11, 12 during episodes plus prevention/treatment burden.
What about menstrual migraines?
Pure menstrual migraine occurs only with periods - 5-7 days/month. May not meet majority test alone. Often combined with non-menstrual migraine to total 15+ headache days/month, qualifying as chronic.
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