Migraine and Work: When Should You Take a Sick Day?

Migraines aren't just bad headaches — they're a neurological condition that can make working impossible. Here's when to take a sick day, how to communicate with your employer, and when you need documentation.

Migraine and Work: When Should You Take a Sick Day?

Migraines affect approximately 8.3% of Canadians — that's nearly 3 million people. Unlike a tension headache that you can push through with Advil, a migraine is a neurological event that can completely incapacitate you for hours or days.

Yet many migraine sufferers feel guilty about calling in sick because their condition is "just a headache." Here's why that thinking is wrong and when you should absolutely stay home.

Migraine Severity and Work Capacity

| Phase | Symptoms | Can You Work? |
|---|---|---|
| Prodrome (hours before) | Mood changes, food cravings, neck stiffness | Usually yes, but reduced capacity |
| Aura (15-60 min) | Visual disturbances, numbness, speech difficulty | No — especially if driving/operating machinery |
| Attack (4-72 hours) | Severe head pain, nausea, light/sound sensitivity | No |
| Postdrome (24-48 hours) | Fatigue, confusion, "hangover" feeling | Possibly, at reduced capacity |

When to Call in Sick

Definitely stay home if:

  • You're in the attack phase (throbbing pain, nausea, sensitivity)

  • You're experiencing aura (visual disturbances, numbness)

  • You cannot tolerate light or sound (most workplaces have both)

  • You're vomiting

  • Your prescribed medication causes drowsiness

  • You drive to work and have visual disturbances


You might be able to work if:
  • You're in the prodrome phase and can manage symptoms

  • You're in the postdrome phase with only mild fatigue

  • You work from home and can control your environment (dark, quiet)

  • Your migraine is mild and responds quickly to medication


Migraines as a Disability

Under Canadian human rights law, chronic migraines can constitute a disability. This means:

  • Your employer has a duty to accommodate your condition

  • You cannot be fired or disciplined for migraine-related absences (up to undue hardship)

  • Reasonable accommodations might include: flexible scheduling, ability to work from home during attacks, reduced screen brightness, quiet workspace


Important: To access disability accommodations, you typically need medical documentation confirming your diagnosis. This is different from a simple sick note — it's a letter from your physician confirming chronic migraine as a medical condition.

Communicating with Your Employer

What to say when calling in:
"I'm experiencing a migraine and am unable to work today. I expect to return [tomorrow/in 2 days]."

You do NOT need to:

  • Describe your symptoms in detail

  • Justify why a "headache" prevents you from working

  • Apologize excessively

  • Provide real-time updates on your condition


Sick Notes for Migraines

Migraines present a unique documentation challenge because:

  • They're invisible (no outward signs)

  • They're episodic (you may be fine the next day)

  • They're often dismissed as "just headaches"

  • You may be too incapacitated to visit a clinic during an attack


Online sick notes are particularly useful for migraines because:
  • You don't need to leave your dark, quiet room

  • You don't need to stare at a screen for a video call

  • You can complete a form at your own pace

  • You don't need to drive while experiencing visual disturbances


Frequency and Pattern Considerations

If you experience frequent migraines (2+ per month), consider:

1. Getting a diagnosis letter — A one-time letter from your doctor confirming chronic migraine, which you can provide to HR
2. Requesting formal accommodations — Work-from-home options during attacks, flexible scheduling
3. Tracking your patterns — Document frequency to support accommodation requests
4. Preventive treatment — Discuss prophylactic medications with your doctor

Frequently Asked Questions

Can my employer fire me for frequent migraine absences?
Not if migraines constitute a disability under human rights law. Your employer must accommodate to the point of undue hardship. However, you need medical documentation supporting your condition.

Do I need a sick note every time I have a migraine?
This depends on your employer's policy and your province's employment standards. If you have a diagnosis letter on file, many employers waive the per-incident note requirement.

Can I get a sick note during a migraine attack?
Yes — online form-based services don't require phone calls or video visits, making them accessible even during severe attacks when light and sound sensitivity make communication difficult.

Sources

  • Migraine Canada — Workplace Rights and Accommodations

  • Canadian Human Rights Commission — Duty to Accommodate

  • Statistics Canada — Migraine Prevalence in Canada