Chronic pain is defined as pain that lasts for three months or more, beyond the expected range of recovery for a specific illness or injury. A 2015 National Institutes of Health study reported that 11% percent of people in the U.S. (more than 25 million) experienced pain every day for the three prior months. Other estimates go as high as 100 million people who are suffering from chronic pain. These people don’t only suffer from pain. They suffer from a wide range of symptoms and limitations to their every day lives. It can have wide-ranging effects on a person’s ability to engage in daily activities and even work. Because of this, many people ask: “Is chronic pain a disability?” The answer: it depends.
Is chronic pain a disability?
When people ask about disability for chronic pain, they’re generally referring to Social Security disability claims or workplace accommodations under the Americans with Disabilities Act (or ADA). The short answer is that for Social Security benefits, chronic pain itself is not a defined category of disability. However, many conditions that lead to chronic pain are defined as disabilities, such as inflammatory arthritis, spinal disorders, peripheral neuropathy, and systemic lupus. Further, many chronic pain sufferers do qualify for benefits based on their functional limitations, as we’ll discuss in more detail below. The ADA does not contain a list of defined conditions that constitute a disability, but rather a definition of disability and impairments that a person must meet to qualify. Some people with chronic pain will meet these definitions, others won’t.
Disability claims are complicated, as we’ll discuss. Many times they rely on multiple visits with your doctor over a long period of time. It can be difficult to measure something as subjective and personal as pain and how it affects a person’s daily life. Because of this, it’s important that you gather as much information as possible before applying for benefits.
For example, a person with fibromyalgia may have troubles concentrating or remembering important information. Someone who suffers from arthritis may not be able to use a mouse and keyboard. A person with back pain may suffer from severe depression. Up to 50% of all chronic pain sufferers may battle depression, in fact. Again, chronic pain doesn’t only cause pain.
Who can help?
While applying for Social Security benefits, most people recommend working directly with a disability attorney to oversee your case. Since this is such a complicated area, an attorney can help you file the right forms and gather the right information for your case. They’ll also be able to guide you on the best way to frame your application.
For ADA accommodations, you’ll likely have to work closely with your company’s Human Resources team to create the best plan moving forward. Oftentimes, accommodations are arrived at that are a collaboration between employee and company.
Who qualifies for Social Security disability for chronic pain?
The Social Security Administration maintains a list of impairments that may qualify for disability benefits. You can see the full list of adult impairments here. Chronic pain as a singular condition is not listed within this criteria. However, other chronic pain related conditions are. These conditions include:
- Peripheral neuropathy
- Systemic lupus erythematosus
- Inflammatory arthritis
- Major dysfunction of a joint
- Disorders of the spine, such as spinal stenosis and degenerative disc disease
- Inflammatory bowel disease
In addition to physical conditions, mental health challenges are a major concern for chronic pain patients. Up to 50% of all chronic pain patients also suffer with depression. A large percentage struggle with anxiety. Mental health conditions can result in limitations that qualify for benefits. These defined benefits include:
- Depressive disorders
- Anxiety and obsessive-compulsive disorders
- Trauma- and stressor-related disorders
The SSA has a sequential evaluation process, which means that they go through a number of tests to determine eligibility. Your first evaluations should show that you:
- Have a diagnosis from a doctor that was established by direct medical evidence, such as lab tests, X-rays, objective symptom tests, or blood work
- Be suffering from an impairment that has lasted 12 months or more, or be expected to last that long
- Not be earning more than $1,170 a month as an employee (always check the Social Security website, as this number may change)
You do have other options if you suffer from another form of chronic pain, such as fibromyalgia. You may be able to qualify for benefits through a residual functional capacity, or RFC, assessment as we’ll discuss below.
How to qualify for disability benefits for chronic pain
Even if you are diagnosed with a defined condition, there are a number of factors you must be able to prove in order to qualify for disability benefits. One of these is the residual functional capacity assessment. If you suffer from another form of chronic pain, you can also undergo this assessment to show that you’re not able to work or must work in a limited capacity. These tests show your capacity or incapacity to do certain tasks for your job.
Work closely with your doctor during this process. Tell them you are planning to apply for disability benefits, and ask them to fill out an RFC assessment. This tests a number of job-related activities, including your ability to:
- Lift or carry weight, and how often you’re able to do so
- Stand, walk, or sit during a normal eight-hour work day, and how long you’re able to do so
- Climb stairs, kneel, crouch, or crawl
- Use fine motor skills (such as typing or using a computer mouse)
- Reach for objects, especially those overhead
- See, hear, and speak clearly
- Withstand environmental conditions, such as extreme cold or heat, smells, and noise
While the Social Security office will use this assessment to evaluate your claim, they’ll also look at other factors. NOLO talks about these in more detail, but they can include:
- How pain affects your daily activities, going so far as to interview close family members and friends
- What activities precipitate or aggravate your pain
- The treatments you’re undertaking to manage symptoms, including medication, lifestyle treatments, complementary therapies, and other interventional procedures
- Any emotional or mental effects of living with pain
- Your age
- Your ability to perform your past work or any type of gainful work activity
Because of this, ask that your doctor thoroughly document:
- All treatments you’ve tried
- Your known pain triggers
- How pain affects you during the day
- What helps to relieve your pain (such as rest, stretching, or applying hot packs)
- Any therapy or psychological evaluations you’ve undergone for mental health concerns
Make sure to review all the documents your doctor has written to see if they support your application. Be honest and forthright during this process, and make sure to note all areas of how chronic pain has affected your life. Your new normal with chronic pain may be far different from your old normal. If you take frequent breaks, have memory issues, or often ask for physical help from coworkers, make sure to include this in your application.
How to get chronic pain benefits
So, is chronic pain a disability? As we hope you’ve learned, it can absolutely be considered a disability for Social Security benefits.
The process, however, is complex and it can be long. Typically, you must have had your condition for at least a year (or expect it to last at least another 12 months). Then, even after you qualify, benefits cannot begin for five months after the established onset of the disability. This is why it’s important to get a diagnosis as soon as possible.
Many professionals recommend working directly with a disability attorney to guide them through the process. This post should not be taken as legal advice, because it only scratches the surface of what you should know when it comes to benefit amounts, work status, and more. A lawyer can also work closely with your doctor to make sure they get all of the information they need for your claim. And, typically, your initial application will be denied unless you suffer from a number of diagnosable impairments. Instead, you’ll have to go to a hearing in front of a judge to support your case. A lawyer can help prep you for this. Many lawyers may also offer to represent your case on a contingency basis–that is, they only get paid if you win your case.
Is chronic pain a disability under the ADA?
Another common question for disability and chronic pain is about accommodations under the ADA. As noted, the ADA does not list covered disabilities. Instead, it defines a disability as a:
“(A) a physical or mental impairment that substantially limits one or more major life activities of such individual; (B) a record of such an impairment; or (C) being regarded as having such an impairment.”
“(1) Any physiological disorder or condition, cosmetic disfigurement, or anatomical loss affecting one or more body systems, such as neurological, musculoskeletal, special sense organs, respiratory (including speech organs), cardiovascular, reproductive, digestive, genitourinary, immune, circulatory, hemic, lymphatic, skin, and endocrine; or (2) Any mental or psychological disorder, such as an intellectual disability, organic brain syndrome, emotional or mental illness, and specific learning disabilities.”
How to get chronic pain accommodations
Similar to a Social Security application, you’ll want to bring a full explanation of your current diagnosis, symptoms, treatments, and functional limitations to your Human Resources department for review. Accommodations are not a one-size fits all solution. Rather, your HR team decides the best option on an individualized, case-by-case basis. Some people with chronic pain will have multiple accommodations, others will have just a few.
To determine this, your HR team will look at:
- Your current limitations
- Exactly how these limitations affect your job performance
- Available accommodations that could help
The Job Accommodation Network (or JAN) discusses possible accommodations in more detail. Some of the more common ones include:
- Allowing someone to bring in a service animal
- Moving the workstation closer to the restroom
- Allowing for longer rest breaks or naps
- Providing access to a refrigerator for snacks or medicine
- Allowing telephone calls during work hours to doctors or other mental health professionals
- Providing appropriate time off for treatment
- Reducing any physical requirements of the job
- Allowing for a flexible work schedule, hours, and location
- Bringing in ergonomic or assistive devices (such as adjustable work stations or lifting aids)
These accommodations can allow you to continue working with chronic pain in a sustainable and pain-relieving manner.
This article can only begin to cover the basics of what you need to know about applying for disability benefits with chronic pain. Is chronic pain a disability? Yes. But how you work and live and earn a sustainable income will depend on your exact symptoms, treatment history, and a host of other factors.
A diagnosis is almost always your first step. Working with a pain specialist who is experienced at helping with disability claims can be one of the best ways to get the information you need, when you need it. You can find a pain doctor in your area by clicking the button below or looking for one in your area by using the tips here: https://paindoctor.com/pain-management-doctors/.