Your Disabling Condition

Chronic Pain Attorney Representation For Your Disability Insurance Claim

Living with chronic pain can feel overwhelming, especially when it affects your ability to work and perform daily tasks. It is not uncommon for a person to suffer with chronic pain, yet a medical provider cannot establish the cause of the pain. People suffering from chronic pain often cannot perform their jobs as they used to as it physically prevents workers from performing certain tasks, not to mention that the pain can be so distracting that they cannot complete jobs that require focus and care.

Understandably, insurance companies need to see some evidence that your pain is so severe that you cannot do your job. Since pain is subjective, disability companies require an extraordinary amount of evidence on the claimant’s part. Unfortunately, insurance companies will find any excuse they can to deny or limit your benefits. Many use in-house physicians to discredit your claims, even though they have never met you or physically diagnosed your symptoms and will often rely upon video surveillance or other insurance company investigations to challenge a claimant’s complaints of chronic, disabling pain.

Consulting with one of our attorneys early is crucial as errors in your application can delay benefits for months or years. We can provide essential information related to the law that can increase your chances of claim approval. Our disability insurance attorneys have fought for claimants suffering from chronic pain since 1979. We know this industry well, and we can give you your best shot of receiving legitimate benefits. Reach out to us if you’re applying for chronic pain disability insurance benefits, appealing a denial, or filing a lawsuit anywhere in the USA.

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How Insurers Assess Chronic Pain Claims

In disability insurance policies chronic pain is often seen as a complex symptom that can come from many medical health issues but may or may not have any objective evidence and cannot necessarily be linked to a specific disability. Because chronic pain doesn’t always show up on medical tests, proving it exists, and the resulting impairment can be tough for disability insurance claimants to prove.

Many medical conditions are associated with chronic pain:

  • Fibromyalgia: A condition with widespread musculoskeletal pain, often with fatigue, sleep, memory and mood issues.
  • Arthritis / Osteoarthritis / Rheumatoid Arthritis: Inflammation of one or more joints that causes pain, swelling, stiffness and limited range of motion.
  • Neuropathy: Damage to the nerves that cause pain, tingling or numbness, often seen in health issues like diabetes.
  • Chronic Back Pain: This can come from injuries, degenerative diseases or other underlying medical conditions. It often limits mobility and can make it hard to do physically demanding jobs.
  • Migraines: Debilitating headaches that cause severe pain and may also cause nausea and light/sound sensitivity making it hard to keep regular work schedules.
  • Neck Pain: Often caused by injuries, poor posture or degenerative disorders, neck pain limits mobility and functionality. Illnesses like cervical spondylosis and herniated discs cause ongoing pain that affects daily tasks and job performance.
  • Abdominal Pain: Irritable Bowel Syndrome and endometriosis can cause severe abdominal pain. Unpredictable pain affects physical and cognitive tasks and makes job duties harder.

These are just a few examples of how chronic pain can come from many medical conditions and complicate disability insurance claims.

Insurers Don’t Believe

Insurers don’t believe chronic pain claims for several reasons:

  • No Objective Evidence: Chronic pain doesn’t show up in standard medical tests like MRIs or X-rays so it’s hard for insurers to prove the claim. The lack of objective medical evidence makes the claim less believable.
  • Pain is Subjective: Pain is subjective and can vary greatly from one person to another. Insurers will argue that disability insurance claimants are exaggerating or making up the pain to get benefits.
  • Policy Exclusions: Many disability insurance policies have exclusions for self-reported afflictions or time limits for chronic pain claims making the process more complicated.
  • Built-in Bias: There’s an inherent bias against chronic pain claims as they are often misunderstood, and insurers will question the legitimacy of health issues that don’t have clear quantifiable symptoms.

In general, the combination of the subjective nature of chronic pain, the difficulty in linking it to a specific disability and the skepticism from insurers makes it tough for individuals to get disability benefits for chronic pain conditions.

Chronic pain challenges for disability insurance claims

Chronic Pain Disability Insurance Claims Challenges

Filing a valid disability claim for disability benefits can be tough. Many disability insurance claimants face various obstacles that can block their benefits and knowing these obstacles can help you navigate the disability insurance world better.

Here are some of the common challenges for chronic pain claims:

No Clear or Objective Medical Proof

One of the biggest challenges in getting disability insurance benefits for chronic pain is the lack of concrete medical evidence. While physical exams and lab tests can diagnose injuries or illnesses, chronic pain can’t be detected on standard diagnostic tools like MRI or X-rays. The subjectivity in pain evaluation is a big challenge and insurance companies will question the validity of these claims.

Claims Denied for Lack of Documentation

Disability companies rely on detailed documentation to process claims. Inadequate medical records or lack of reports from healthcare providers can result to instant denial of a claim.

Many disability claimants underestimate the importance of documentation which includes pain management history, treatment plans, medication lists and therapy records. Well organized records that fully describe the individual’s condition is key to proving chronic persistent pain.

Insurers Don’t Understand Medical Records

Many insurance companies do not or choose to not understand chronic pain and therefore misunderstand medical records as the technical terms in medical documentation and various treatment methods can be confusing.

Insurers might misinterpret the lack of certain interventions as proof that the patient is not really disabled. This hurts their credibility and chances of approval.

Surveillance by Insurance Companies

Disability insurance companies use video surveillance to challenge chronic pain claims. This involves private investigators monitoring disability claimants to find evidence that contradicts their reported limitations. Insurers want to prove claimants are more capable than they claim and can result to claim denial.

This can be frustrating for those who are truly disabled and already going through a tough time.

Disability insurance claimants should prepare for surveillance and make sure their medical records and personal testimony are strong enough to support their claims.

State Specific Rules

Each state has its own rules for disability insurance benefits, and these can change depending on the insurance company. Knowing these specific rules can make a big difference to your claim for disability insurance.

Our chronic pain attorneys are familiar with your state’s laws and can make sure you comply with all the requirements needed for a successful claim. We can also advise you on the time limits to file claims or appeals so you won’t miss the deadlines.

Industry Specific Rules

Different industries have different rules for disability claims. For example, the requirements for a construction worker are different from an office worker. Our team can help you customize your application for disability insurance based on your job description and the demands of your job. This will increase your chances of approval. Consider the physical and mental demands of different jobs when applying for chronic pain disability benefits.

Customise Your Claim to Your Industry

Different jobs have different roles and responsibilities that affect how chronic pain can impact your ability to work. For example:

  • Construction Workers: This job involves heavy lifting and standing for long hours. A construction worker with chronic pain may struggle with tasks like carrying materials and operating machinery. Make sure to explain how chronic pain affects these activities and any related safety risks to support the claim.
  • Office Workers: On the other hand, office workers may have chronic pain that affects concentration, posture and repetitive tasks. Make sure to document how this pain impacts tasks like typing and attending meetings. Our lawyers emphasize the cognitive and emotional effects to increase chances of approval.
  • Healthcare Professionals: Nurses and physical therapists have different challenges with chronic pain. Their physically demanding job requires movement and emotional toughness, but pain can prevent them from lifting patients and using equipment. This increases injury risk and affects their work capacity and full-time employment.
Therapeutic and diagnostic chronic pain records in the hospital

The Importance of Documentation for Chronic Pain Disability Insurance Claims

You need comprehensive documentation from your healthcare providers to show why you cannot go back to work and how chronic pain affects your ability to do your job. This documentation should outline your job, daily tasks and physical and mental demands.

We recommend all our clients keep a daily pain journal to document their medical conditions. We also suggest you see pain management specialists like physiatrists or anesthesiologists. Get as much medical documentation as you can for short- or long-term disability.

Daily Pain Journal

Keeping a daily pain journal is key to showing the extent and impact of chronic pain on your daily life – and another way to build your claim. Here are the key things to include:

  1. Pain Levels: Rate your pain on a scale of 1 to 10 throughout the day. This will help show pain fluctuations and acute pain episodes.
  2. Activities and Limitations: Document daily activities, work tasks, family responsibilities and social engagements. Note any obstacles you faced because of your pain and how it prevented you from doing these activities.
  3. Symptoms and Triggers: Record any other symptoms that come with your pain and triggers. This could be movements, weather changes, stress levels. This will give your doctors and attorneys insight into your impairments.
  4. Treatment and Response: Document any treatments you receive, medications, therapies, specialist visits. Keep track of what works, what doesn’t and any side effects. This will help your case.
  5. Emotional Impact: Chronic pain can affect mental health. Keep notes on how your pain affects your mood, relationships and overall well-being. Mental health issues often come with chronic pain, so documenting feelings of anxiety, depression or frustration will further show the severity of your disability.
  6. Communications with Healthcare Providers: Keep track of all communications with your medical team. Note dates of appointments, diagnoses, advice given and outcome of visits. Written records of conversations about your condition will support your claims.
  7. Support System Involvement: If you have a support system (family, friends or caregiver) document how they help you. This might be physical help with daily tasks, emotional support or participating in therapy sessions. This will show your limitations and how chronic pain affects not just you but also your loved ones.
  8. Financial Impact: Record how chronic pain affects your finances, missed workdays, reduced hours or increased medical expenses. Financial strain because you can’t work or pay for necessary treatments should be included to show the bigger picture of your condition.

By documenting these things, you can build a strong narrative of the severity and daily struggles of living with chronic pain.

See Pain Management Specialists

Working with pain management specialists is key to building your case for chronic pain long term disability claim. Specialists like rheumatologists, neurologists and pain management physicians can provide targeted treatment and objective assessments.

Specialist medical documentation is key to a claimant’s case, providing specialized knowledge and evidence to show the severity and effects of chronic pain.

Working with these professionals shows the claimant is committed to managing their condition and the legitimacy of their medical need for disability insurance benefits.

Collect Medical Documentation

Getting medical documentation is critical to a successful chronic pain disability claim. To support your claim, you need to get detailed and organized medical records that show how your condition affects your work.

Get diagnostic tests like MRIs and nerve conduction studies which serves as objective evidence of your condition. These tests will be key to substantiating your claim by showing the physical basis of your chronic pain.

Make sure you have detailed treatment records of all medications, therapies and procedures you’ve had. This includes physical therapy sessions, medication regimens and any surgeries or invasive procedures. These records will show the extent of your condition and the ongoing management of it.

Also get statements from your doctor that link your chronic pain to work limitations. These should describe how your condition affects your ability to do specific job tasks and any workplace accommodations.

Here’s a checklist to follow:

  • Diagnostic Test Results (e.g. MRIs, Nerve Conduction Studies): This will be objective data of the physical issues causing your chronic pain.
  • Detailed Treatment Records (Medications, Therapies): Include notes on all treatments and how they’ve affected your daily life.
  • Doctor Statements on Work Limitations: These should explain how your chronic pain affects your job, and what functional limitations you have.
  • Prescriptions and Medication Management Plans: Show evidence of ongoing treatment and adherence to medication regimens, how serious your condition is.
  • Physical or Occupational Therapy Notes: Document any therapies you’ve had and the outcomes, especially how they relate to your ability to work.
  • Employability Assessments or Vocational Expert Evaluations: If applicable, these will explain what kind of work you can do with your condition.
  • Functional Capacity Evaluation: If you have one, this will be a detailed assessment of your physical abilities and limitations for various tasks to show the severity of your chronic pain.

Get all these documents together and you’ll have clear medical evidence to match the definition of disability in your disability insurance policy.

Chronic pain attorneys

How We Can Help

Our law firm has years of experience helping chronic pain disability insurance claimants through the entire claims process. We have the financial means, skill and tenacity to take on the multi-billion-dollar disability companies we face every day. We aim to provide personalized, compassionate representation and deliver top notch legal work and client service.

  1. Claim Assessment: The process starts with a thorough review of your claim. Our initial review includes a detailed analysis of your disability policy and medical records. By identifying the strengths and weaknesses of your case early on we can develop a strategy specific to your situation.
  2. Filing Claims: Filing a disability insurance claim requires a solid foundation of medical documentation and evidence. Our team will guide you through this process by working with medical experts and advising you on what documentation is required. We help you navigate the common pitfalls during the filing process, so you have a strong case for appeals if needed. Our disability insurance lawyers will tell you what the insurers are looking for, so you have the best chance of approval on the first submission.
  3. Appeals and Denials: A denied or terminated claim can be disheartening but our chronic pain disability attorneys will overturn unfavorable decisions. We work with medical experts to build a strong case for appeals so you have the best possible outcome.
  4. Ongoing Communication: We will keep you informed throughout the claims process. From the initial consultation to resolution, we will keep you updated and explain each development in your case so you are always in the know. Our team will negotiate with insurance adjusters on your behalf. They are experts at minimizing payouts and will challenge the legitimacy of your claim. We know the tricks insurance companies use to deny or undervalue claims and we will fight for the benefits you are entitled to.
  5. Litigation Support: If negotiation and appeals don’t get the results you want then litigation may be necessary. Our disability insurance law firm will represent you in lawsuits against the insurance companies using our years of experience and resources to fight for you. We will take your case to court if necessary to get you long term disability insurance benefits.
  6. One-Time Lump Sum Buyout Settlements: If you prefer to resolve your disability insurance claim with a one-time lump sum settlement agreement, we can help you negotiate a fair buyout. This option provides financial stability by offering a single payment, freeing you from ongoing interactions with your insurer. Our attorneys have extensive experience in negotiating these agreements and will work to ensure you receive the maximum possible value for your claim.

Why Choose Us?

For over 40 years, we’ve successfully helped clients with chronic pain disability insurance claims secure the benefits they deserve. We know how insurers operate using biased physicians, surveillance, and legal loopholes to deny claims and we counter these tactics with umatched litigation experience, strong evidence, and a deep understanding of disability insurance law.

We provide compassionate, personalised representation tailored to your unique circumstances. Living with chronic pain is hard enough; you deserve an advocate who understands your struggles and fights tirelessly on your behalf. Plus, with no upfront fees, you only pay if we win your case. Contact us today to start building your path to the benefits you’re entitled to.

Chronic Pain Disability Insurance Claim Success Stories

We’ve helped thousands of clients get disability insurance benefits, even after being denied, sometimes multiple times. Chronic pain claims are difficult as insurance companies love to deny or undervalue them. Through evidence, appeals and litigation experience we’ve overturned denials and gotten benefits for people from all walks of life. Here are just a few examples:

Speak With One of Our Lawyers Now

If you are having trouble navigating a chronic pain disability insurance claim, please be assured we can help. We always offer a free initial consultation to discuss your case and determine how we can assist you in securing the benefits you deserve. You can meet with us in person, over the phone, or via video if that is more convenient for you. Our disability insurance attorneys can provide you with personalized guidance and support. Contact us today to schedule your free consultation.

Additional Resources

We understand how confusing and overwhelming the disability claims process can be, especially for chronic pain cases. To support you, we’ve answered common questions about chronic pain disability insurance claims. These resources provide valuable insights and tips to help you better understand your rights and what to expect throughout the process.

You’re also invited to visit and subscribe to our YouTube channel where we have over 900 videos and provide weekly tips to help protect your disability insurance benefits. Reach out if you have any questions.

Answers to Frequently Asked Questions

Will I have to file a disability benefit lawsuit to get my benefits?

Probably not. In fact, most chronic pain disability claims are resolved at the application and appeal stages and do not require a lawsuit. If your claim is wrongfully denied or the insurance company is not negotiating in good faith, then litigation may be necessary. Our lawyers will prepare your claim for litigation if it gets to that point. We will do everything possible to make sure that you are in the best position to receive your monthly disability benefit payments.

Will pre-existing conditions hurt my chronic pain claim?

Yes, pre-existing conditions can be a problem for chronic pain disability claims. Many disability insurance policies have exclusions for health issues that you were diagnosed with before purchasing the insurance or have a waiting period for pre-existing conditions. The insurance company will argue that your chronic pain is a continuation of the pre-existing condition and not a new disability. Our lawyers need updated medical records from your primary care physician, specialist opinions and evidence that links your chronic pain to functional limitations and not your pre-existing condition.

How will your law firm handle the insurance company?

We handle all communication with the insurance company. Our lawyers are meticulous in making sure that everything is done correctly, consistently and in accordance with the policy provisions. We file claims, respond to questions, submit appeals and handle additional documentation requests. We make sure that the insurance company is treating you fairly and we keep you informed of everything that is happening with your claim.

What should I bring to my free consultation with your law firm?

To get the most out of your free consultation we recommend that you bring the following:

  • A copy of your disability insurance policy.
  • Your medical records, including test results and doctor’s notes.
  • Any correspondence from the insurance company, such as denial letters and requests for additional information.
  • A list of any treatments, medications and therapies that you are receiving.
  • Any personal documentation, such as a pain journal and activities that you are unable to do.
What qualifies as chronic pain for disability insurance claims?

Chronic pain is defined as pain that has lasted for more than three months that interferes with your ability to work, perform daily activities or enjoy a normal lifestyle. Conditions such as fibromyalgia, arthritis, neuropathy, migraines and chronic back and neck pain are just a few examples of health issues that can be considered chronic pain. To collect disability insurance benefits, our chronic pain disability lawyers need to show that your chronic pain disability prevents you from performing your job or working on a regular basis.

How do I prove my chronic pain to the insurance company?

We prove chronic pain with the following evidence:

  • Your records of medical issues, diagnosis and treatment; and medical history;
  • Pain journals that document your symptoms and limitations.
  • Specialist opinions, such as rheumatologist or neurologist.
  • Functional capacity evaluations that measure your ability to perform work-related activities.
Why are chronic pain disability claims denied so often?

Chronic pain disability claims are denied often because pain is not an objective symptom that shows up on MRI’s and X-rays. The insurance company will usually rely on a medical review that is biased against you or argue that your symptoms are not as severe as you claim. Many disability insurance policies have exclusions for self-reported conditions or have limited benefit periods for chronic pain claims. Chronic pain disability claims require a lot of evidence to support your claim and make it more likely that you will be able to collect monthly disability benefits.

What evidence is most important to support my chronic pain claim?

Objective evidence that is most important is:

  • Diagnostic tests, such as MRI’s or nerve conduction studies (if applicable).
  • Treatment records that show you are following your doctor’s recommended treatment and taking your pain medications as prescribed.
  • A letter from your treating physician that explains how your chronic pain disability limits your ability to perform your job.
  • A pain journal that documents your symptoms and limitations daily.
Do I need to be diagnosed to file a chronic pain claim?

No, you do not need to be diagnosed to file a valid disability claim. A chronic pain disability claim is more focused on your symptoms and how they limit your ability to work. If you do not have a diagnosis, our chronic pain disability lawyers need medical records that show you are seeking treatment, evidence that you are following your doctor’s recommended treatment and therapy, and functional evidence, such as a functional capacity evaluation, that measures your ability to perform daily activities and work.

Will I need to see certain doctors to support my claim?

We do not require you to see certain doctors, but certain specialists can help support your claim. Pain management doctors, rheumatologists and neurologists are doctors that treat chronic pain and have the knowledge and experience to diagnose and document chronic pain conditions. Their opinions and evidence of your limitations are much more important than your primary care physician.

What are my chances of winning with attorney representation?

Your chances of winning are much higher with chronic pain lawyer representation. An attorney will make sure that your claim is supported with the necessary evidence and filed in accordance with your policy provisions. Chronic pain disability insurance attorneys handle appeals, negotiate with the insurance company and prepare your claim for litigation if necessary. Our team has the experience and knowledge to increase your chances of winning.

Can I file a claim for chronic pain if I’m still working part-time?

Yes, many disability insurance policies have residual disability provisions that allow you to claim if your chronic pain limits you to work part-time. To qualify, you must show a significant reduction in your work hours or income due to your condition. Medical documentation and evidence linking your limitations to your chronic pain is key in these cases.

How does my insurance policy define “disability” for chronic pain?

Disability is defined as:

  • Own-Occupation: You can’t do the duties of your current job.
  • Any-Occupation: You can’t do any job for which you’re qualified based on your education, skills and experience.

Pay attention to the disability policy language to see how your insurer defines “disability” and to tailor your claim.

What role do insurance adjusters play in chronic pain claims?

Insurance adjusters review your claim by looking at medical records, requesting more information and sometimes commissioning independent medical exams or surveillance. Their job is to find ways to pay out as little as possible by looking for inconsistencies or weaknesses in your claim for disability benefits. Having a lawyer handle communications ensures adjusters follow policy and don’t exploit gaps in your evidence.

Why is chronic pain disability so hard to prove?

Chronic pain claims for benefits are tough because pain is subjective and often lacks objective medical evidence like imaging or lab results. Symptoms can also vary making it harder to show consistent limitations. Insurers use this to deny claims, so you need detailed documentation, functional assessments and expert opinions to support your condition.

How do I claim chronic pain as a disability?
  • Submit medical records showing consistent treatment and diagnosis.
  • Provide functional capacity evaluations that measure physical and cognitive limitations.
  • Keep a pain journal to document daily symptoms and how they impact your life.
  • Get statements from treating doctors explaining why your condition prevents you from working.
What are the disability issues inherent to chronic pain?

Disability problems in chronic pain claims are:

  • No objective tests: Pain doesn’t show up on MRIs or X-rays.
  • Fluctuating symptoms: Variability in pain levels can kill your claim.
  • Insurer bias: Chronic pain is seen as exaggerated or self-reported so is scrutinized more.

Detailed and consistent evidence will help overcome this.

How does chronic pain affect your ability to work?

Chronic pain can affect:

  • Physical tasks: Trouble standing, lifting or repetitive movements.
  • Mental focus: Fatigue and pain reduce concentration and productivity.
  • Attendance: Frequent absences due to pain flares or medical appointments. These limitations mean reduced work capacity or unable to work.
What is an example of chronic pain disability?

A nurse with fibromyalgia has constant pain, fatigue and cognitive difficulties (“fibro fog”) so can’t safely lift patients, work long shifts or focus on critical tasks. These limitations mean she can’t perform the essential duties of her job.

How do I not let chronic pain control my life?

Managing chronic pain is a combination of:

  • Follow medical advice: Stick to prescribed treatments like meds or physical therapy.
  • Get emotional support: Connect with support groups, therapy or loved ones to reduce stress.
  • Prioritise self care: Focus on low impact exercises, healthy eating and activities that improve mental well being.
  • Set realistic goals: Break tasks into smaller steps to fit your pain levels and feel accomplished.
How would you explain chronic pain to a judge?

Chronic pain is a long term condition that persists beyond normal healing time, often for months or years. It severely impairs daily activities including work and its intensity can vary unpredictably. It may not have objective tests but its effects are measurable through functional assessments, consistent treatment history and expert medical opinions.

When is chronic pain an impairment?

Chronic pain is an impairment when:

  1. It lasts three months or more.
  2. It severely restricts major life activities like walking, working or daily tasks.
  3. It requires ongoing medical treatment and limits your ability to function independently.
How is chronic pain diagnosed?

Chronic pain is diagnosed by:

  • Clinical evaluation: A doctor assesses symptoms, medical history and duration of pain.
  • Exclusion testing: Imaging or lab tests to rule out underlying health issues.
  • Pain scales and questionnaires: These measure the severity and impact of the pain.

Diagnosis is based on patient reported symptoms and specialist’s expertise.

What are the common types of chronic pain disorders?

Common types are:

  • Fibromyalgia: Widespread muscle pain and fatigue.
  • Neuropathy: Nerve pain causing burning or numbness.
  • Chronic back pain: From injuries or degenerative diseases.
  • Arthritis: Stiffness and joint pain.
  • Migraines: Severe headaches with sensory sensitivities.

Each type requires specific treatment and evidence for disability claims.

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