Pain is a Top Cause of Disability Claims, But It's Tough to Prove

June 21, 2013

When you are treated in a hospital emergency room, you will repeatedly be asked by staffers to describe your pain on a scale of 1 to 10. Your answer will be what they have to rely upon.
For all of the advances in medicinal technology over the last century, there is no way for health professionals - or anyone else, for that matter - to objectively or independently verify another person's pain level.

With depression or fatigue, you can't peer into someone's brain to see exactly how sad or tired a person is. Neither can you say how much pain a person is in, aside from what they tell you and the symptoms they display.

Los Angeles Social Security Disability Insurance Attorney Vincent Howard of HOWARD LAW knows this is what makes federal disability claims involving pain so difficult to prove to independent reviewers. Your pain may indeed be debilitating, but successfully securing disability benefits will rely on your ability to prove it. This is where having an experienced legal team working with you is an uncompromising must.

The Council for Disability Awareness recently released a report indicating that back pain, arthritis, sciatica and other musculoskeletal conditions one of the top disability claims made to the 19 top insurers, including Mutual of Omaha, MetLife, Prudential, Aetna and Sun Life. The same is reflected in terms of public disability benefits, available through the Social Security Administration.

Just in the private sector, the CDA learned that $9.4 billion in long-term disability claims was paid out to 664,000 workers by these private agencies. Of those, about one-third were for musculoskeletal conditions. That number has been inching upward over the past several years.

(The SSA, by contrast, paid nearly 9 million workers by the end of last year.)

With regard to SSDI awards, musculoskeletal conditions are the No. 1 source of disability claims, accounting for 34 percent of all new SSDI awards in 2011, compared to 8 percent in 1960. These conditions are followed in prevalence within the program by mental disorders, circulatory system disorders, cancers and tumors, nervous system and sense organs, respiratory conditions and injuries.

In many of these claims, pain is the main factor people cite for why they are unable to work. The types of pain vary depending on the condition.

Still, merely telling the administration that you have chronic pain won't be enough to qualify you for federal benefits. You will be expected to produce as much evidence as possible to bolster your case.

This could include x-rays, lab tests, physical exam results or a diagnosis that is synonymous with pain. It might also involve a doctor finding widespread pain in 11 out of 18 possible tender point sites. Or, it could mean a diagnosis of somatoform pain disorder, which is a pain condition traced to a psychological cause.

While chronic pain isn't listed in the Social Security Administration's disability blue book, a number of conditions associated with chronic pain are. Those include:

  • Back injury (listing 1.01);

  • Chronic renal disease (listing 6.02);

  • Inflammatory bowel disease (listing 5.06);

  • Inflammatory arthritis (listing 14.09);

  • Somatoform disorders (listing 12.07);

  • Neurological disorders (listing 11.00).

Your application approach will depend on a variety of different factors. Let us help guide you through the process.

Los Angeles Disability Benefits Attorney VINCENT HOWARD at HOWARD LAW can help. Call toll-free at 1-800-872-5925 or send us a message online.

Additional Resources:
Pain Remains Leading Cause of Disability, June 18, 2013, By Pat Anson, National Pain Report

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