Pain syndromes are conditions that are mainly classified by their chronic symptoms relating to aches and pains. Chronic pain can make it difficult or even impossible to work. However, because pain can often be a subjective symptom, disability insurance companies are often quick to deny claims. You may be experiencing immense pain on a daily basis, but there isn’t an objective way to quantify it. While it can be a challenge to receive approval for pain-related conditions, your disability attorney can help you through the claim process, which can increase your likelihood of success. An experienced disability attorney can help you navigate the tedious process of the long-term disability insurance claim process. Together, you may be able to get the benefits you deserve.
What is Chronic Pain?
Chronic pain is defined as persistent pain. It may be constant or come and go. But overall, the pain is consistent and perpetual. Some chronic pains are caused by injury. Some suffer from diseases or conditions that may lead to chronic aches and pains. For some conditions, it is damage to nerve cells that cause painful symptoms. Chronic pains can persist for months or even years with little to no reprieve.
Types of Chronic Pain Conditions
There are many conditions and injuries that can lead to lasting, painful symptoms. Many of these can lead to disability. Below, we will list a few common conditions that can be debilitating because of chronic pain and other symptoms. While not an exhaustive list, these are fairly common for long-term disability insurance claims.
Chronic Fatigue Syndrome
Chronic Fatigue Syndrome (CFS) is a condition where the individual suffers from extreme fatigue on a near-daily basis. Generally, the cause of this fatigue is unexplained. Muscular aches and pains are common symptoms of this condition. CFS can be truly debilitating because a combination of chronic fatigue and painful muscle aches can make it difficult to have the energy to do anything.
Complex Regional Pain Syndrome
CRPS causes extreme pain in an extremity. Often developing out of an injury, the condition affects the nervous system. it is caused by the damage or dysfunction of peripheral sensory nerves. This damage then causes secondary effects on the brain and spinal cord. Because the nervous system is all connected, CRPS can cause pain in other areas of the body as part of these secondary effects. In over 90% of cases, nerve trauma or injury to the thinnest nerve fibers is what causes CRPS.
Degenerative Disc Disease
While not a true “disease,” DDD is a chronic condition that can progressively worsen. It develops as the disc joints between your vertebrae shrink over the years. This often happens because of dehydration, damage, and the general effects of aging. The discs do not receive as much blood flow as most other body tissues, which causes them to self-repair at a much slower rate than others. Normally, the discs act as cushions between vertebrae. But as they shrink or deteriorate, the bones can begin to scrape against each other. Over time, it can get more and more painful.
Fibromyalgia is a chronic condition known for causing widespread pain throughout the body. The condition affects the musculoskeletal system of the body. Additional symptoms include fatigue, sleep issues, memory loss, and secondary emotional issues. Often, the painful nature of this condition can have lasting cognitive deficits that can affect one’s ability to work.
Also known as Painful Bladder Syndrome, this chronic condition is associated with bladder pressure, pelvic pains, and bladder issues. The pain from this condition can be severe.
Irritable Bowel Syndrome
IBS is a bowel condition that affects the colon and gastrointestinal tract. Cramping, bloating, constipation, diarrhea, and abdominal pain are all common symptoms. IBS can also cause distressing and uncomfortable symptom flare-ups.
Temporomandibular Joint Dysfunction
TMJ is a painful condition that causes the locking of the jaw, face, and/or neck. It is often accompanied by a painful popping or clicking of the affected joints. It can also affect how your teeth fit together in a resting position.
Proving Disability for Chronic Pain Symptoms
While pain can often be one of the most debilitating symptoms, it is often easy for insurers to deny claims for chronic pain. Because pain is a “self-reported” and subjective symptom, they try to play down its role in your disability. In some cases, they may try to claim that the condition is a mental or nervous condition. This allows them to classify under Mental Illness Limitations. They do this to terminate your benefits after just 2 years. Because of this, you and your disability attorney will have to provide credibility to your pain symptoms. Below, we will discuss some important aspects of your claim that can help support your chronic pain symptoms.
Generally, insurance companies rely on objective medical evidence to prove your condition. But, there are no lab reports or imaging tests that can prove that you are in pain. While tests can rule out or show that you have a condition, they can’t quantify your pain. Laboratory testing and imaging tests could, at the very least, legitimize the cause of your pain. When combined with other evidence, you may have a higher chance of approval.
Treatment Notes From Your Doctor
Your doctor’s treatment notes can be helpful in corroborating your painful symptoms. This can be especially important if your doctor has a record of you describing your pain on a scale during your visits. Providing a history of your pain symptoms can be helpful in bolstering your claim.
Attending Physician’s Statement
An Attending Physician’s Statement is a written report of your doctor’s findings of your condition. More formal than treatment notes, these statements can go a long way in providing data on how your pain could limit your capacity for work. The statement can also provide further info on your symptoms, diagnosis, and treatment for your condition.
A personal statement from you, close family members, or coworkers can help provide more evidence for your claim. While these are often not as relevant, they can still provide an extra layer of coverage for your claim. Your disability attorney can help you write or evaluate statements to ensure that they have a positive impact on your long-term disability insurance claim.
Chronic Pain and Functional Capacity Evaluations
A Functional Capacity Evaluation (FCE) is a series of tests that measure your physical limitations. Generally, the test determines how much your injuries can limit your ability to perform work tasks. Your pain may limit your ability to move in certain ways or to stay in a position (such as at your desk) for prolonged periods. As such, the FCE can provide objective evidence of these limitations. A 2-day FCE can also show the effect fatigue has on your capacity for work. A Functional Capacity Evaluation is run by a trained medical professional, usually an occupational therapist or a rehabilitation physician. An FCE can provide strong evidence of your limitations for work, as the results are quantifiable.