Disability insurance companies don’t always make it easy for policyholders who have chronic pain and pain syndromes to get the disability benefits they deserve.
Be prepared for a fight, because disability carriers hate these types of claims. Pain is subjective; there is no way to prove your claim of pain.
The Common Reasons Disability Carriers Deny Chronic Pain and Pain Syndrome Disability Claims
Many chronic pain and pain syndrome claims are denied because the disability insurance company says:
(1) There is no objective basis of the chronic pain or pain syndrome,
(2) There is no objective basis for the restrictions and limitations assigned by your physician,
(3) There is no causal relationship between your chronic pain or pain syndrome and/or your restrictions and limitations, and your inability to do your own or any occupation.
(4) There is no reason you can’t work in a sedentary capacity.
Nancy Cavey, who has 35 years experience handling disability cases, has successfully represented many policyholders with chronic pain and pain syndrome. She overcomes a claims denial by working closely with you and your physician.
If you are ready to file a disability application and want to improve your chances of getting disability benefits, or if your claim for chronic pain and pain syndrome disability benefits has been denied, it is time to call Nancy Cavey.
She offers a free initial consultation and welcomes the opportunity to speak with you about your disability claim.
What Is Chronic Pain and Pain Syndromes?
There is no gold standard test for chronic pain and pain syndromes. You can be in constant pain or have intermittent pain. The intensity and duration of your pain may change or increase as a result of physical activity. Chronic pain is thought to be caused by a dysfunction of the central or peripheral nervous system. That can lead to abnormal impulses from your nerves that affect your blood vessels and skin.
Common chronic pain syndromes include:
- Chronic spinal pain
Chronic spinal pain can result from aging or trauma and can be unrelieved by pain medication, injections and even surgery.
- Chronic fatigue syndrome
Chronic fatigue syndrome (CFS) causes extreme fatigue and muscle pain.
- Complex regional pain syndrome or reflex sympathetic dystrophy syndrome (RSD)
RSD causes severe pain in your hand, arm, foot or leg and typically develops after an injury. It can spread to other parts of the body.
Fibromyalgia causes widespread musculoskeletal pain with fatigue, memory loss, poor sleep, bowel problems, and depression.
- Headaches or Migraines
Chronic headaches or migraines can cause nausea, vomiting, dizziness, and can result in depression.
- Irritable bowel syndrome
Irritable bowel syndrome (IBS) causes cramping, abdominal pain, bloating, gas, diarrhea and constipation.
- Interstitial Cystitis
Interstitial cystitis, also called painful bladder syndrome, causes bladder pressure, bladder pain and pelvic pain.
- Temporomandibular Joint Dysfunction
Temporomandibular joint dysfunction (TMJ) causes pain in the jaw, face or neck, headaches, and locking, popping and clicking of the jaw.
Many disability carriers have position papers on chronic pain and pain syndromes that dispute the existence of these conditions, discount pain as being “in your head” and reject any notion of disability.
Because pain is subjective, disability carriers want overwhelming proof of the underlying medical condition that causes your pain, and they want overwhelming proof of disability.
That is why it is crucial that you have an attorney who understands chronic pain and pain syndromes and knows how to gather the medical and vocational evidence required to approve a claim.
Many carriers ultimately acknowledge your pain but contend it is not disabling. A Functional Capacity Evaluation (FCE) may provide objective evidence, from both a physical and cognitive basis, of how pain affects your ability to work.
How Do I Get The Disability Insurance Benefits I Deserve?
Chronic pain and pain syndromes can make it difficult, if not impossible, to do things around your home and work. If you no longer can work or your doctor has told you to apply for disability, before you apply for benefits, you should:
- Obtain a copy of your disability policy. See how it defines “disability,” “occupation” and “self-reported conditions.” You’ll need to understand what you have to prove to get your benefits because of chronic pain and pain syndrome.
Your policy can include a self-reported limitation. It limits how long you can get benefits that result from self-reported symptoms, including problems with pain, memory loss or fatigue. You’ll want to know what’s in your policy before you apply for benefits.
- Also look for how your disability policy defines a mental/nervous condition. It is not uncommon for disability carriers to characterize your chronic pain or pain syndrome as a mental condition. The carrier will try to limit your benefits to two years.
- Obtain a copy of your medical records. Review them to see if there is an objective basis for your diagnosis, what your records say about your report of symptoms and your restrictions and limitations. It is crucial you have neuropsychological testing to document the reason for any memory complaints caused by your pain.
- Get treatment from a pain specialist, who will follow established criteria for diagnosing your chronic pain. Don’t forget to have neuropsychological testing to provide objective evidence of your cognitive problems.
- Obtain a copy of your personnel file to see whether your chronic pain or pain syndrome has affected your work performance.
- Obtain a copy of your job description. Create your description of your physical and cognitive duties, with an explanation of how your symptoms impact your ability to do your occupation.
- Provide your doctor with the occupational description. Ask your doctor to prepare a report that explains the objective basis for your diagnosis, the objective basis of your restrictions and limitations, and the objective reasons you can’t perform some or all of the material and substantial duties of your occupation.
- Prepare a diary that explains your symptoms and the side effects of the medication you are taking. Be sure to give examples of how your symptoms interfere with your ability to do things on a daily basis.
- Prepare your statement and explain how pain has affected your life. Make sure any statement is consistent with your medical records and the Functional Capacity Evaluation.
- Prepare the statement of your family members, friends and co-workers who support your complaints of pain and how it has impacted your ability to function at home and at work.
- Hire Nancy Cavey to help you file your initial application. The application process is confusing and designed so you and your physician make mistakes that can result in a delay or even a denial of your benefits. Ms. Cavey knows how to prepare and file a winning shock and awe disability application that leaves the carrier little reason to question your claim.
- Hire Nancy Cavey to help you appeal a wrongful denial or termination of your disability benefits. Disability carriers are in the business of collecting premiums and not paying disability benefits for chronic pain or pain syndromes. They’ll use any reason to deny your claim. The odds of getting your benefits on appeal are greater when you are represented by an experienced ERISA/private ID policy disability attorney.
Contact Disability Attorney Nancy L. Cavey, Who Can Help You Regardless of Where You Live
Chronic pain and pain syndromes can make it difficult, if not impossible, to work. You owe it to yourself and your family to get help today! Nancy Cavey can review your policy and your medical records, and explain to you what your policy says and how to get your disability benefits. Call today for a free consultation at 727-894-3188.