Chronic pain is a reality for over 50 million Americans. This is more than just the occasional backache or headache, but serious discomfort that causes stress, reduces job performance, and leads to a range of mental and physical health issues. Living with this pain is bad enough, but then there’s figuring out how to pay for long term medical treatment and care. Understanding long term disability insurance and chronic pain can help you make the best decision for getting the care you need.

What is long term disability coverage?

Many companies provide a long term disability insurance option to employees. You may be able to receive benefits if you pay in between 1-3% of your annual salary.

In some respects, it’s quite similar to Social Security disability insurance and workers compensation benefits. This is because it is a form of financial assistance paid to an individual. Disability varies depending on the nature of the claim.

In some instances, it may be for physical therapy or medication. For others, some may be eligible for total long-term disability benefits. The benefit amount can change if you are unable to work. This includes changes to your chronic pain disability. 

Long Term Disability and Chronic Pain wheelchair in hallway

Essential first steps 

In ideal circumstances, you would already know whether your current insurance coverage includes either short-term disability insurance or long-term disability insurance. Even if you have yet to experience any significant complications, it’s a good idea to check on your insurance coverage and benefits if your doctor has diagnosed you with any disabling conditions such as a chronic pain syndrome. 

You may not require additional care right now, but you may need it down the road. In some cases, you may have to purchase additional coverage or examine other options. Fortunately, there are many options out there. The more you plan ahead, the better prepared you will be when filing for disability benefits for chronic pain. 

Submitting your disability application

Although medical professionals often recognize the severity of reported symptoms of a chronic pain disorder, it can be more difficult to get insurance companies to actually pay out in a disability case. In many cases- such as with fibromyalgia, arthritis, and diabetes, people often find their claims have been denied.

Long Term Disability and Chronic Pain patient talking to doctor about chronic pain

Chronic pain conditions are tricky. People often forget that insurance companies are businesses and are looking to reduce the number of monthly benefit claims they pay out. Unfortunately, that puts a lot of burden on the patient to prove the severity of the condition. As a result, only 37% of claims are approved on average.

How to successfully file a claim

There is a high burden of proof placed on patients by disability insurance companies. It comes down to you being able to overcome them with sufficient and compelling evidence.

This begins by getting a letter from your doctor and other medical professionals indicating the severity of your condition. Ask your doctor to conduct neuropsychological testing, x-rays and other pain journal standard examinations so you can paint a full picture of your illness.

You’ll also need to submit your complete medical history. In some cases, letters from employers can also be helpful because they establish both character and need.

patient medical history form

Do you need a law firm?

Most people suffering from chronic pain already have enough expenses to worry about. In addition, the point of battling your long term disability insurance company to recognize your chronic pain is to ease financial stress when you can’t return to work for a period of time, not to add more expenses.

Talk with your insurance company, file a claim and submit any documentation you might have. If this doesn’t work, you may want to strongly consider heading to a lawyer who is well versed in disability awareness. 

Many long term disability attorneys offer free consultations. They’ll be able to explain to you the most effective ways to go about getting your claim approved. They can also help you determine if you might qualify for Social Security disability and if there are exclusions and limitations on your insurance. It may be expensive initially, but they can save you immensely down the road in medical care bills.

Long Term Disability and Chronic Pain disability lawyer consulting with client

Also, you may be able to qualify for reduced fees, tax breaks or other government incentives that can make hiring a lawyer more affordable.  

What your disability claim means

Once you’ve successfully secured your disability claim, it may come along with certain stipulations. These are often things you will work out beforehand with your insurance company and disability attorney. It’s important to be aware of how they will impact your life.

For example, if you receive 6 months of disability leave, you need to discuss with your employers your long term options.

  • Will you still have a place to work after 6 months?
  • Are you allowed to work part-time?
  • What flexibility will you be offered?
  • Will your monthly income change?
  • What needs to be reviewed before you come to back to work?

Long Term Disability and Chronic Pain employee and employer talking

It’s very important you understand the full requirements of your claim, especially if there are pre-existing conditions. If you have any questions at all, be sure to ask your attorney and your employer. Plan ahead so you are ready for the next stages of the process.

The bottom line: long term disability insurance and chronic pain

Navigating disability insurance can be very difficult. You’re tasked with dealing with your own health problems as well as doctors, insurance companies, employers, lawyers and more.

However, if you create a clear plan and follow these steps, you have a good chance to get the benefits you need to affordably manage your chronic pain. 

Do you have an experience you’d like to share about long term disability insurance and chronic pain?

Share your story with us by emailing info@painresource.com.

What topics related to insurance and chronic pain would you like to see us explore?

Email us at info@painresource.com with your ideas or with your travel testimony.

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This post was updated in May 2019 with new information and resources. 

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