Chronic Pain and Disability Insurance: A Claimant’s Guide
Chronic pain is a frustrating and widely misunderstood condition that disables roughly 100 million Americans. A variety of circumstances can cause it — including trauma, surgery, cancer, and nerve damage. Unfortunately, this pain can persist even after the underlying condition resolves.
If you’re struggling with chronic pain, you may be eligible for long-term disability benefits — but don’t be surprised if the insurance company puts up a fight and denies your claim.
In this article, the disability insurance lawyers at Bryant Legal Group explain the essentials of a chronic pain syndrome claim.
What Causes Chronic Pain?
If you’ve suffered from consistent pain for at least three months, you might have chronic pain. Our bodies send pain responses to notify us about injuries and health issues. We have specialized nerve fibers called nociceptors that identify potential injuries. For example, when you cut yourself, your nociceptors respond to the stimulus and send messages through your spinal cord to the brain. Your brain translates these messages into feelings of physical pain.
However, pain sometimes continues even after your wounds have healed and your condition resolves. Doctors believe this type of chronic pain occurs when your nerves are damaged or become overactive, causing them to send false pain messages to the brain.
Physicians define chronic pain as pain that lasts for at least 12 weeks, and it can occur in any part of your body. Common forms of chronic pain include:
- Arthritic pain related to degenerative joint disease
- Back pain due to degenerative disc disease and other conditions
- Cancer-related pain
- Headache and migraine
- Nerve pain due to neuropathy and other issues
- Postsurgical pain
- Post-traumatic pain, such as after a catastrophic car accident
- Psychogenic pain linked to mental trauma or psychological conditions
Sometimes, there is a clear cause for your chronic pain; other times, it is multifactorial or idiopathic (without an identifiable cause).
Your doctors’ treatment recommendations will depend on the severity of your pain, your other diagnoses, and how well you respond to conservative treatment. They may prescribe medications and order physical therapy, mental health treatment, nerve block procedures, acupuncture, and even surgery.
Many pain management medications and treatment options carry significant side effects, which can limit your ability to work. Even worse, some people develop intractable pain that is resistant to treatment and medications.
- Related Article: 5 FAQs About Private Disability Insurance Claims
Why Do Disability Insurance Companies Struggle With Chronic Pain Issues?
When you file a long-term disability claim for chronic pain, you may encounter significant skepticism. Disability insurance companies tend to approve cases where there is a clear diagnosis that is substantiated by diagnostic studies like MRIs, CT scans, and nerve conduction studies. However, almost every pain-related claim involves a level of subjectivity, and your pain might persist even after your underlying conditions have stabilized or resolved.
For these reasons, insurance adjusters regularly deny chronic pain — alleging that there is insufficient evidence, that your symptoms are inconsistent with objective data, or that you do not meet the policy’s definition of disability.
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3 Ways You Can Strengthen Your Chronic Pain Disability Claim
To combat the challenges associated with a chronic pain syndrome claim, you’ll need a well-prepared application for benefits, compelling evidence, and an aggressive legal strategy.
1. Seek Treatment With the Right Doctors and Specialists
When you’re dealing with a complicated diagnosis like chronic pain, it’s best to treat with respected pain management specialists and other highly trained practitioners. Both insurance adjusters and judges give more weight to medical opinions from doctors who specialize in chronic pain than to primary care providers and general practitioners.
For example, if you’re dealing with chronic back pain, your medical team may include orthopedic doctors, neurosurgeons, neurologists, and certified pain management specialists.
2. Don’t Overuse Your Pain Medications
Your credibility is essential in a chronic pain disability claim, since tests and scans may not explain all of your symptoms. If you have a pattern of overusing your medications, going to the emergency department for early refills, or exaggerating your symptoms to get additional medications, you’re more likely to run into problems in your LTD claim.
Furthermore, some long-term disability plans exclude or limit claims that are related to substance use.
Consult With a Disability Insurance Lawyer
When chronic pain is your primary disabling condition, you’ll need to have a well-built claim for long-term disability benefits. Depending on your unique circumstances, this may include statements and opinions from your physicians, evaluations by vocational experts, and a comprehensive review of your medical records.
When you’re dealing with chronic pain, it can be difficult to handle all of these tasks on your own — especially if your pain levels and medications impact your ability to concentrate or finish tasks. Rather than struggling through the process alone, consider hiring a qualified disability insurance lawyer.
Bryant Legal Group: We Fight for People With Chronic Pain
Are you juggling chronic pain and a long-term disability claim? At Bryant Legal Group, we assist individuals in Chicago and throughout the country with their complex disability claims. We have extensive experience handling matters involving chronic and intractable pain and are ready to put that experience to work for you.
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Contact Bryant Legal Group
Get the answers and insight you deserve. Our experienced disability insurance lawyers can evaluate your claim and help you understand all your legal options.