Objective Evidence of Pain

Thousands of disability claims of all types are denied for lack of “objective” evidence, even though the case law consistently states that a claim should be denied solely because of a purported lack of objective evidence. Many people can no longer work because of pain, which is by definition subjective. Even when objective proof of a condition that causes the pain is presented, it is common for the claim to be denied.

A great way to “objectify” the pain is treatment by a pain management specialist. I had a claimant who was diagnosed with fibromyalgia and reflex sympathy dystrophy (“RSD) by a rheumatologist. The diagnoses were not disputed and were confirmed by objective clinical findings. Even though the rheumatologist supported the claim, the claim was denied on the grounds that there was no support that the claimant’s pain was severe enough to prevent her from working. The claimant asked me to handle the appeal.

On appeal, I submitted a medical report from the claimant’s pain management specialist, who was also a board certified neurologist. The neurologist had not been contacted, nor had his records been obtained. It seemed arbitrary to deny that the claimant’s pain was disabling without considering any evidence from the pain management specialist.

The neurologist diagnosed the claimant with fibromyalgia, complex regional pain syndrome, and chronic pain syndrome. Just like the rheumatologist, the neurologist identified the positive clinical findings that supported the diagnoses, and he also provided similar restrictions and limitations. The only real difference in the reports was that the neurologist detailed the nature, location, frequency, severity and precipitating factors of the claimant’s pain. As a pain management specialist, there was no basis for discounting his opinion regarding the severity of the claimant’s pain, and the claim was approved today.

I advise my clients to treat with pain specialists, even if the medications and treatments offered are similar to what other treating physicians are providing. It seems difficult to reject an opinion regarding a claimant’s pain from a physician who specializes in pain management.