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Qualifying Conditions

Getting Long-Term Disability (LTD) for Chronic Pain

Applying for long-term disability (LTD) benefits due to chronic pain can be a challenging claim to make due to the subjective nature of the condition.  At CCK, we know how to handle and develop claims for chronic pain and other subjective, symptom-based claims.

Understanding Chronic Pain

Chronic pain is persistent pain that lasts for weeks, months, or years and can result from a variety of sources.  Some medical conditions that cause chronic pain include arthritis, fibromyalgia, and Lyme disease.  Additionally, sometimes after an injury (e.g.) a bone fracture) heals, the pain persists for a prolonged period of time and is greater than would be expected from the causal injury.  This is known as complex regional pain syndrome (CRPS) or reflex sympathetic dystrophy (RSD).  The treatment of certain conditions like cancer can also result in persistent pain.  Occasionally, even mental health conditions such as depression can manifest as chronic pain.

Studies have suggested that chronic pain can be linked to certain glands and how they interact with your nervous system.  Abnormalities in these interactions can cause some people to react to pain differently.  Further, additional studies have shown that those suffering from persistent pain have a low level of endorphins in their spinal fluid.  Endorphins help our bodies naturally control pain, thus a low level of endorphins can result in chronic pain that persists after the injury has healed or the illness been treated.

Treating Chronic Pain

Most long-term disability policies require you to be in consistent treatment with a specialist as is appropriate for your disability.  Consistent treatment with an appropriate provider can be even more important in claims involving largely subjective symptoms, such as chronic pain.  Appropriate treatment, depending on the cause of your chronic pain, can include (among others): cognitive behavioral therapy; psychotherapy; occupational therapy; or physical therapy.  Doctors will often prescribe medications to treat persistent pain as well.  Common medications for pain include NSAIDs such as ibuprofen, Acetaminophen such as Tylenol, Cox-2 inhibitors such as Celebrex, antidepressants such as tricyclic antidepressants or Cymbalta, Gabapentin, or even opioids which are usually a last resort for pain management.  The medication that is right for you may vary based on the origin of your pain.

Additionally, you should make sure that you continue to report your pain to your doctor to ensure it is consistently documented in your medical record. Even if your provider does not feel there is a solution to your pain, it is still important to schedule follow-up visits so that you can maintain accurate documentation of your chronic pain and how it impacts your function day-to-day.

How Can Chronic Pain Impact Your Ability to Work?

Chronic pain can be very restricting in any work setting.  It may impede your ability to lift objects and walk around if you have a physical job; and even if you have a sedentary job, chronic pain can limit your ability to sit at a desk for a prolonged period of time.  Further, persistent pain can be distracting and reduce your ability to focus on your work throughout an 8-hour workday, which could cause you to be unproductive for a substantial portion of the day.

Additionally, chronic pain is often extremely fatiguing and can disrupt your sleep; this could cause you to need to take naps throughout the day. Typically, you would not be able to work reliably and consistently if you had extended periods of time in which you were unable to remain energized or perform any work activities or duties.  Your chronic pain might also require you to take frequent breaks while performing activities, which are typically unacceptable in most jobs.  Depending on the location and nature of your chronic pain, any job could become impossible.  You should consider contacting an attorney if you are not sure if your chronic pain would qualify you for long-term disability benefits.

Are Disability Benefits for Chronic Pain Covered Under My Long-Term Disability Policy?

Some long-term disability policies contain provisions that entirely restrict subjectively reported symptoms from qualifying for long-term disability benefits or limit the amount of time you can receive benefits for such conditions. Subjective symptom limitations often include conditions such as chronic pain.  Many claimants with chronic pain have difficulties proving their disability objectively because there are often no medical exams or tests that can prove the existence of chronic pain.

It is crucial to read your policy carefully and, in its entirety, if you are suffering from persistent pain and can no longer work.  You may also want to consider contacting an attorney if your policy contains provisions restricting you from or limiting the amount of time you can receive long-term disability benefits due to chronic pain.

How Can I Prove That My Pain is Real and Debilitating?

Whether or not your policy limits or restricts long-term disability benefits for disabilities based on subjective symptoms, the insurance company will likely challenge your claim if your symptomology is entirely subjective, even if you have supporting documents or evidence of treatment from your healthcare providers.  However, there are ways to help demonstrate the existence of your chronic pain.  The team at CCK knows how to prove that your chronic pain is disabling and can help you build the strongest long-term disability claim possible.

For example, functional capacity evaluations (FCE) can measure your ability to complete physical tasks. These evaluations often contain validity tests which will indicate whether you are being sincere in your effort to complete certain tasks based on the results of the test.  The physical therapists or specialists completing the evaluation will not tell you when you are working on a validity test, so it is important to give your best and honest effort during every exercise or task.  An FCE with valid results can serve as evidence of the existence of your pain and demonstrate your inability to engage in work tasks as a result.  These evaluations can be expensive and providing proper documentation indicating your medical history and background is important when arranging an FCE.  You should consider seeking the assistance of an attorney if you believe an FCE may be useful in proving your claim.

If your chronic pain is the result of joint or nerve damage, you may be able to prove its existence through CT scans, MRI scans, or x-rays.  These scans may also reveal muscle or bone damage from previous injuries that could continue to cause you pain.

Reports from your doctors or your family, friends, or coworkers who have witnessed the ways in which your pain affects you can also help demonstrate your chronic pain exists and is disabling.  Your doctor may be able to opine that based on their observations during your treatment, your pain is credible and totally disabling, thus preventing you from working.  Your friends and family may be able to confirm how your pain affects your ability to conduct and enjoy your activities of daily living.  Your coworkers may be able to note their observations regarding how your pain affects your ability to do your job.  All these reports can help bolster your claim and provide additional support to your reports of chronic pain.

Contact Chisholm Chisholm & Kilpatrick LTD

At Chisholm Chisholm & Kilpatrick LTD, our team of attorneys and professionals has the experience required to assist you with your long-term disability claim for chronic pain.  We have gathered various kinds of evidence, including arranging expert opinions, to help demonstrate chronic pain and how it disables you.  Contact us now at (401) 237-6412 for a FREE consultation to see if we can assist you in getting the benefits to which you are entitled.