If you have chronic, disabling pain that prevents you from doing your job, it’s something that should help you to qualify for long-term disability. In fact, a number of cases have reaffirmed this position and said that insurance companies and doctors can’t just ignore a person’s pain when deciding whether or not they are actually disabled and deserving of benefits. However, proving chronic pain can be a challenge.
For anyone out there suffering, this is good news. Unfortunately, it’s not quite as straightforward as saying, “my pain keeps coming back and I can’t work – give me the help I need!” What makes proving chronic pain so tricky?
The Disability Issues Inherent to Chronic Pain
Severe chronic pain is complicated in disability cases for a number of related reasons.
Unlike many other symptoms that can be easily pinpointed as the effects of specific disabilities, chronic pain is something that can occur due to a number of medical conditions: fibromyalgia, neuropathy, degenerative disc disease, and failed back surgeries are just a few. Because there’s no definitive way of telling what is causing the pain, it can be difficult to connect it to a disability (which means insurance companies often try to leave chronic pain out of a long term disability claim).
Related to the inability to proving chronic pain to a specific disability is the fact that it’s not something that shows up in any objective medical tests. Things like MRIs, x-rays, and CT scans may be able to prove that there’s a break or a tear, but they don’t quantify the actual pain that someone might be feeling, which is something that differs from person to person.
Put both of these things together and it allows insurance companies to argue that claimants are lying about – or at least exaggerating – the pain that they are feeling in order to get benefits. As insulting as this may be to someone dealing with debilitating pain, it’s a part of the process you’re likely to face if that’s the most significant symptom of your disability.
How Do I Make My LTD Case for Chronic Pain?
To prove chronic pain in a claim for long-term disability benefits, three components must be present: credibility, continuous treatment, and record keeping. Let’s examine these components in more detail:
- Credibility – You can demonstrate your credibility with consistent descriptions of your pain to different medical personnel and by acting in ways that show your limitations because of it. A disability claims examiner will be more likely to believe your reports of pain if that examiner sees the same information in medical records from different physicians. The examiner might also assign an investigator to your case. If they observe you moving or participating in activities that do not show pain-related limitations, your claim is more likely to be denied. You might think that you are better off pushing through your pain, but your efforts can short-circuit a Long-Term Disability claim.
- Continuous Treatment – A disability insurance company will likely reject your claim if you have only one or two medical appointments related to your disability or if you are not following a physician’s treatment plans to accommodate and treat it. If you experience chronic pain, make regular appointments with your doctor, take all medications that your doctor prescribes, and go to recommended physical therapy sessions. You can also try alternative treatments such as acupuncture or massage therapy. If you merely live with your pain rather than search for remedies, a Long-Term Disability insurer will probably conclude that your pain is not debilitating.
- Recording – Maintain a pain journal and write down your daily impressions of how your chronic pain is affecting your life and daily activities. A written record of your pain experiences can convince a claims examiner that your pain is legitimate and that you deserve the Long-Term Disability benefits that you are seeking. Start your journal with a description of when the pain began, including the accident or incident that gave rise to it, to what extent it got worse over time, and the medical and other treatments you have sought to alleviate it. Describe in detail the location and duration of your pain and whether it occurs when you move a specific way or try to do some activity.
When present, these components will improve your chances of winning a chronic pain LTD case.
Your Pain Can be Used to Your Advantage
The way around this issue is to do what you’re probably already doing anyway: try to make the pain go away. Claimants who can show that they have repeatedly sought out help to deal with their pain can use that fact to bolster their cases because they have a record to prove that something is going on.
After all, most reasonable people aren’t going to willingly submit themselves to doctors over and over – often racking up big medical bills – just so they can scam their insurance company. A record of seeking out help for your pain is proof that it’s real and it’s serious, and insurers have to pay attention to it.