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Effective Pain Testimony

   Although pain is subjective, meaning that each person experiences pain differently, Social Security does recognize that chronic pain can create significant job limitations.  As you pursue your disability claim, keep the following points in mind about how Social Security adjudicators and judges use pain limitations when evaluating disability claims.

  • you must describe your pain with accuracy and with specificity.  Avoid comments like “I hurt all over and a I am in constant pain.”  Instead, describe each part of your body that hurts and what the pain feels like.
     
    • For example: “I have extreme pain in my left knee which I think is the result of years of working on a concrete floor in combination with a bad fall off a 7 foot ladder.  On a scale of 1 to 10, my left knee is always at a level 5, but if I walk or stand for more than 30 minutes, the pain jumps up to an 8 or 9 and it stays there until I take a Percocet, which knocks me out.  I have some arthritis in my right knee, but the pain there is nothing like what is on the left.”
       
  • the main issue in pain allegations is credibility.  You do not want to come across as a whiner and complainer.  You need to think of pain as a problem that you want to solve, rather than an excuse for you not to work
     
  • chronic pain often results in a level of depression.  If you suffer with chronic pain, Social Security judges will expect that you will seek mental health counseling and/or pain management.  If there is no evidence of counseling or pain management in the record, many judges will conclude that your pain really is not all that bad
     
  • many people use allegations of chronic pain to convince their doctors to prescribe powerful narcotic pain medications.  Judges are very sensitive to this problem.  A red flag for judges is an individual who receives pain medication from two or more doctors who are not aware of one another.  Remember that every communication you have with your doctor will be written down and made part of your record.  If a medical record contains too many references to phone calls made by a patient to request refills, that can be a problem.
     
    • If you have been prescribed narcotic pain medication, make sure to discuss with your doctor your concerns about dependence and addiction and raise the issue of whether you can begin to taper off the medications.  Powerful pain medications can help you live with pain, but they are not intended to serve as a permanent solution
       
  • your pain level should be consistent with your medical condition.  If your doctor suggests to you that your pain level is out of proportion to your physical injury or condition, you may be suffering from an undiagnosed physical or mental health problem
     
  • your doctor’s attitude, as reflected in his office notes, can help you win your case or insure that you lose.  Doctors are human beings and some physicians can grow cynical and burned out over the years.  If you sense that your doctor does not believe in you, do not hesitate to seek out a second opinion.
     
  • not every doctor is right for every medical condition.  Some doctors approach their patient’s care with pre-conceived notions.  For example, patients suffering from fibromyalgia or reflex sympathetic dystrophy (RSD) may find that some doctors simply do not believe that their condition exists or that their complaints are far too subjective to be believeable.
     
  • Social Security judges expect that chronic pain claimants will seek second, third, fourth, even tenth opinions.  Do not be passive about seeking relief.  A determined chronic pain claimant who seeks help from five specialists is sending a message to both her doctors and to the judge that she wants to get better.
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