Chronic Pain Syndrome and Qualifying for SS Disability Benefits
Can I qualify for disability benefits if I am suffering from the effects of Chronic Pain Syndrome?
Author: Lonnie Roach
Most pain subsides as an injury heals, but pain that persists when there is no obvious cause is known as chronic pain syndrome.
The National Center for Complimentary and Integrative Health estimates that 25 million Americans are afflicted with chronic pain.
It may appear in a specific area of the body or manifest as general muscle or nerve pain. It may be diagnosed as a pain disorder such as chronic regional pain syndrome or a disorder that causes chronic pain, such as peripheral neuropathy, tendinitis, carpal tunnel syndrome, fibromyalgia, or arthritis.
A combination of pain and secondary complications defines chronic pain syndrome.
Chronic pain initiates an aggressive cycle where pain leads to secondary complications such as insomnia and stress; in turn, insomnia and stress exacerbate the pain. Usually, chronic pain syndrome begins with an acute injury or illness and lasts longer than six months.
Some examples of chronic pain are:
- Joint pain (arthritis, bursitis, tendinitis)
- Back pain (slipped discs, spinal stenosis, fractures)
- Nerve pain (sciatica, peripheral neuropathy, carpel tunnel syndrome, postherpetic neuralgia – the pain caused by shingles, trigeminal neuralgia- affecting certain nerves in the face
- Chronic headaches (tension headaches, migraines and cluster headaches)
Symptoms of chronic pain syndrome vary; the pain can be constant or there may be flare-ups of intense pain exacerbated by stress or increased activity. The most common symptoms include:
- Joint and muscle pain
- Burning pain
- Fatigue and difficulty sleeping
- Loss of stamina and flexibility
- Depression, irritability and anxiety
Sometimes there is no apparent cause for chronic pain.
Researchers believe that pain that continues after a condition improves can be attributed to a miscommunication between the brain and the nervous system. Chronic pain changes the way nerve cells in the brain transmit sensory input resulting in a hypersensitivity to pain.
Contact a Social Security disability attorney at 512-454-4000 for a free consultation and see if you can get disability benefits while suffering from Chronic Pain Syndrome. If you have been denied disability don’t give up!
If you are experiencing some form of chronic pain, your doctor will attempt to diagnose its cause through a review of your medical history. Your doctor will want to know:
- When the pain started
- What the pain feels like
- Where the pain is located
- What makes the pain better and what makes the pain worse
A series of tests such as x-rays or an MRI will most likely be ordered to determine the cause of your pain and an appropriate treatment plan.
Although the Social Security Administration acknowledges that chronic pain is a disabling condition, the Blue Book does not contain a separate listing for chronic pain syndrome. Instead, chronic pain is linked to specific impairments.
In order to be eligible for Social Security disability benefits with chronic pain syndrome:
- You must have the condition for one year or it must be expected to last for one year; and
- You must have medical evidence, including imaging and documentation, to support the diagnosis.
Meeting these requirements will still not be enough to obtain approval for SSDI.
Social Security will want to review your residual functional capacity or “RFC” to evaluate how your symptoms affect your daily activities and ability to perform basic work activities.
Among the factors Social Security will consider are:
- The intensity, location, duration and frequency of your pain
- Any factors that trigger your pain or make it worse
- Any medication you take to relieve pain
- Any other treatments employed to alleviate pain such as acupuncture or physical therapy
- Any other practices you use to manage pain such as applying ice or lying down
Your best chance for obtaining SSDI for chronic pain syndrome is applying for disability for multiple medical impairments or providing evidence that your chronic pain stems from another medical condition or conditions.
It is probable you will be denied benefits initially and be required to attend a hearing before an administrative law judge. In complex cases like chronic pain syndrome, it is advisable to retain a qualified disability attorney who can help avoid missteps in filing for disability and assist you in obtaining the benefits you deserve.
LTD Chronic Pain Claims
Our client, from Euless, had long term disability insurance with Lincoln Financial. He was diagnosed with Severe Legg-Perthes disease and chronic pain. He could not sit for more than 15 minutes before experiencing severe pain and could not walk for more than five minutes before his pain increased. He had exhausted all surgical options and was on long-term pain management. He was denied benefits by Lincoln Financial, but we were able to reach a settlement agreement for him.
We represented a client for her short and long term disability claims.
She suffered from failed back surgery syndrome, lumbar radiculitis, fibromyalgia, severe sleep dysfunction, moderate to severe depression and, quite probably, rheumatoid arthritis. She had been instructed by her primary care physician to “discontinue the workforce” for at least the next several years, but also advised that her condition was unlikely to change. This diagnosis was supported by another physician. She had multiple surgeries as well as diagnostic tests objectively verifying the pathology responsible for her chronic pain. She was awarded benefits from the Social Security Administration, but eventually denied by AT&T’s LTD plan administrator. We were able to get her benefits reinstated.
Disability benefits are an important source of income for those who are unable to work. If you not able to work due to accident or illness, you may be eligible for Social Security Disability or Long Term Disability benefits. If you have applied for benefits and been denied, contact the attorneys at Bemis, Roach and Reed for a free consultation. Call 512-454-4000 and get help NOW.
Author: Attorney Lonnie Roach has been practicing law for over 29 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion rated by Martindale Hubbell. Through his extensive litigation Mr. Roach obtained board certifications from the Texas Board of Legal Specialization. Lonnie is admitted to practice in the United States District Court - all Texas Districts and the U.S. Court of Appeals, Fifth Circuit. Highly experienced in Long Term Disability denials and appeals governed by the “ERISA” Mr. Roach is a member of the Texas Trial Lawyers Association, Austin Bar Association, and is a past the director of the Capital Area Trial Lawyers Association (Director 1999-2005) Mr. Roach and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.
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