Friday, September 10, 2010

Proving Disabling Pain

Disability adjudicators accept that applicants can become disabled if their pain is bad enough to reduce their ability to perform the physical demands of working. The problem for claimants is usually how to prove that their condition is severe enough that they can no longer work. The claimant’s task basically is trying to provide objective proof to support the subjective claim of pain.

I represent a 57 year old former airline passenger service agent whose radiating neck pain forced him to stop working. His disability benefits were approved today four months after his application was filed without requiring any type of appeal or hearing.

Among other things, the claimant had a cervical MRI that showed discs contacting the spinal cord. His pharmacy list of pain medications and patches, and operative reports of pain injections, were lengthy. As the default position of disability adjudicators is that a claimant’s pain is overstated, simply providing a supportive MRI would be deemed insufficient because while it confirms a diagnosis it fails to establish severe pain. Similarly, just providing pharmacy records would be deemed insufficient because it could be evidence of an addiction or overreaction to a condition. However, supplying both types of medical records provided objective evidence not only that the claimant had a medical condition that was capable of causing severe pain, but also that the condition was being treated as causing severe pain. That objective evidence rendered the pain management physician’s opinion, that the claimant’s condition prevented him from being able to work due to his pain, readily credible.

Some of my colleagues believe that I “gild the lily” by securing and submitting as much evidence as I do, which does make for extra work. However, the end result speaks for itself.

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