Facts about Chronic Pain and Filing for Disability
These selected pages answer some of the most basic, but also some of the most important, questions for individuals who are considering filing a claim for disability benefits.
Facts about the condition
1. Chronic pain occurs over a long period of time and tends to be associated with an unknown cause.
2. Pain is different for each individual and each individual subjectively rates his or her pain from a mild to severe level.
3. Chronic pain is increasingly believed to be related to the way an individual's brain processing and interprets pain signals.
4. Those with chronic pain often worry that the pain is merely psychological, especially when there seems to be no medical cause. However, pain is believed to always be in your head; an experience without a proven existence but that we all feel during an injury.
5. It is also believed that individuals have different levels of pain sensitivity. Those with chronic pain often appear to have fewer painkilling endorphins.
6. Injuries or infection are believed to sometimes alter the pain signals sent between the affected tissues and the brain, and can amplify pain messages even after the body has finished healing.
7. The process of transmitting signals of trauma from parts of the body to the central nervous system is called nociception. The brain then interprets these signals as pain.
8. Studies have shown that those with chronic pain have impairment in their ability to pay attention and stay on task and in their working memory. Therefore, chronic pain, especially when it is severe, is distracting enough to cause difficulty with everyday tasks that require memory and attention.
9. Physicians approach chronic pain through attempting pain management, which involves a variety of tactics. These include medication, rehabilitation, interventional and behavioral therapy, and biofeedback.
10. While over-the-counter anti-inflammatory drugs and opioids are commonly known for pain treatment, it is less commonly known that some drugs used to treat depression and epilepsy can help with pain management. These drugs alter the central nervous system and brain signals and are sometimes effective in treating chronic pain.
Qualifying for disability benefits with this condition
Whether or not you qualify for disability and, as a result, are approved for disability benefits will depend entirely on the information obtained from your medical records.
This includes whatever statements and treatment notes that may have been obtained from your treating physician (a doctor who has a history of treating your condition and is, therefore, qualified to comment as to your condition and prognosis). It also includes discharge summaries from hospital stays, reports of imaging studies (such as xrays, MRIs, and CT scans) and lab panels (i.e. bloodwork) as well as reports from physical therapy.
In many disability claims, it may also include the results of a report issued by an independent physician who examines you at the request of the Social Security Administration.
Qualifying for SSD or SSI benefits will also depend on the information obtained from your vocational, or work, history if you are an adult, or academic records if you are a minor-age child.
In the case of adults, your work history information will allow a disability examiner (examiners make decisions at the initial claim and reconsideration appeal levels, but not at the hearing level where a judges decides the outcome of the case) to A) classify your past work, B) determine the physical and mental demands of your past work, C) decide if you can go back to a past job, and D) whether or not you have the ability to switch to some type of other work.
The important thing to keep in mind is that the social security administration does not award benefits based on simply having a condition, but, instead, will base an approval or denial on the extent to which a condition causes functional limitations. Functional limitations can be great enough to make work activity not possible (or, for a child, make it impossible to engage in age-appropriate activities).
Why are so many disability cases lost at the disability application and reconsideration appeal levels?
There are several reasons but here are just two:
1) Social Security does not try to get a statement from a claimant's doctor. By contrast, at the hearing level, a claimant's disability attorney or disability representative will generally obtain and present this type of statement to a judge.
Note: it is not enough for a doctor to simply state that their patient is disabled. To satisy Social Security's requirements, the physician must list in what ways and to what extent the individual is functionally limited.
For this reason, many representatives and attorneys request that the physician fill out and sign a specialized medical source statement that captures the correct information. Solid Supporting statements from physicians easily make the difference between winning a disability hearing or losing a disability case at the hearing level.
2) Prior to the hearing level, a claimant will not have the opportunity to explain how their condition limits them, nor will their attorney or representative have the opportunity to make a presentation based on the evidence of the case. This is because at the initial levels of the disability system, a disability examiner decides the case without meeting the claimant.
The examiner may contact the claimant to gather information on activities of daily living and with regard to medical treatment or past jobs, but usually nothing more. At the hearing level, however, presenting an argument for approval based on medical evidence that has been obtained and submitted is exactly what happens.
About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.
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