Chronic Pain

Definition

Chronic pain is a term generally accepted to describe pain that lasts greater than six months.  Another popular alternate definition is “pain that extends beyond the expected period of healing.” In contrast, acute pain is a term given to pain that begins suddenly, is usually sharp, and resolves when the underlying cause has been treated. Common conditions causing chronic pain are arthritis pain, headache, low back pain, cancer pain, psychogenic pain, and neurogenic pain.

General Information

Pain is an unpleasant response to some sort of stimulus to the body. The purpose of pain is to warn the body of potential damaging situations and to motivate avoidance or removal from that situation. Once the pain-inducing stimulus is gone and the body has healed, pain should stop; however it can sometimes persist without any identifiable cause.

Chronic pain can be classified as nociceptive, psychogenic, or neuropathic. Nociceptive pain is caused by stimulation of nerve fibers in response to either mechanical, thermal, or chemical stimuli whereas neuropathic pain is caused by disorder or damage affecting any part of the somatosensory system, the part of the nervous system that involves bodily feelings. Psychogenic pain is defined as pain that is either increased or directly caused by psychological factors.

In addition to the pain complaints, individuals who suffer from chronic pain often endorse cognitive impairments such as forgetfulness, difficulty sustaining attention, and difficulty completing tasks. Chronic pain is also associated with higher rates of depression and anxiety.

Evaluation of Chronic Pain by the Social Security Administration

Disability evaluation under the Social Security Administration requires that you have a medically determinable impairment (MDI) in order to be found disabled. Social Security Ruling 96-4p states that a symptom is not a medically determinable impairment, and that no symptom by itself can establish the existence of an impairment. Additionally, 20 CFR 404.1529 and 416.929 direct that an individual’s symptoms, such as pain, will not be found to affect their ability to do basic work activities unless medical signs and laboratory findings show there is a medically determinable impairment. In other words, medical evidence must exist to show that chronic pain symptoms are the result of an underlying medical condition. Although chronic pain is not itself a listed condition, the underlying cause of chronic pain can be the result of a condition found in Social Security’s Listing of Impairments. If the underlying cause of chronic pain is not severe enough to meet the medical listing, you may still be found disabled through an assessment of your residual function capacity , or RFC.

Your representative can help you determine whether your chronic pain syndrome is severe enough for you to qualify for disability benefits under the Social Security Administration.