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Defining ‘pain’ is a real pain for SSD claimants

By September 18, 2018September 24th, 2018Social Security Disability

One of the biggest factors in proving you are no longer able to work at any job in the economy  and deserve to receive Social Security Disability (SSD) benefits is: How much pain do you suffer?  And one of the most difficult factors to prove is: How much pain do you suffer?

Pain is a subjective thing.  We all experience pain in our lives at one time or another, but we all experience it differently. Today’s stand-by measure for pain is a scale of one to 10, but many doctors and nurses say that rating doesn’t work for most patients.  In fact, often patients minimize their pain. For example, Alan, who had a bone disorder, was in severe pain but he was uncomfortable rating his pain too high. What should he compare the pain to, he wondered? Was it as high as it would be if he were missing a limb? How can the average person judge that?

Clients who are applying for SSD should report their pain according to how it affects their daily living.  John Markman, a neurologist with the University of Rochester says patients should focus on how their pain interferes with particular activities.  The one to 10 numbers scale, he says, has led to a “sort of paint-by-numbers” approach to treatment. In a study Markman did, patients who rated their pain as four to seven on the scale (which is considered high enough to require an increase in pain meds), and yet described their pain as “tolerable,” were less likely to receive the needed higher dose of medication.

Additionally, due to the opioid crisis, many doctors are reluctant to prescribe higher doses and more effective pain medications, so when patients play down their pain level, they are even less likely to get the relief they need.

We encourage our clients to be very descriptive when they talk about their pain, particularly when they reach the hearing stage of the application process.  Is the pain aching or burning? Does it focus on one part of your body or does it move? What does your pain prevent you from doing? The better you can describe the pain you endure and how it affects you, the better the Social Security representative or Administrative Law Judge can understand your inability to work.

The shift from trying to rate the intensity of pain to looking at what it prevents an individual from doing can make a big difference in your treatment and in providing the right evidence to support your claim for SSD benefits.