Chronic Pain Syndrome

[Fat]

Service connected for Achilles Tendinosis (tears in Achilles Tendon).

I have been suffering with foot pain for 36-40 months.

I want to file a claim for Chronic Pain (in foot) secondary to service connected Achilles.

Has anyone filed a claim for chronic pain?

All information is appreciated.

[vetquest]

I have never filed a claim for chronic pain but I would be interested to see what comes up for you.  I have been dealing with chronic pain for the past twelve years.

[JKWilliamsSr]

The claim for this is Somatic Symptom Disorder.   This is what chronic pain is rated under.  I have seen posts (facebook) where many have been rated for this. 

[Richard1954]

I do see anything in somatic symptompton disorder that would address  chronic pain issues, the  description for somatic symptom disorder  is more like a hypochondriac  Just my opinion but I don't think this addresses the OP issue.

 

Code 9421: Somatic symptom disorder is a condition where the person regularly sees many different doctors complaining of pain, sexual problems, stomach problems, or nerve problems. These symptoms do actually exist in the patient, but there are no physical causes. The most common explanation, although not proven, is that the physical symptoms are the brain’s way of dealing with stress.

 

But this might fit:

Code 9422: Other somatic symptoms or similar disorders that are clearly defined, like pain disorder, are rated under this code.

 

 

Edited July 19, 2019 by Richard1954

[NoZZZ's]

Chronic pain (i.e. somatic symptom disorder 9422) is a mental health claim. You are being rated on the symptoms the pain is causing.  For example, you have pain daily arising from "lumbosacral strain." This pain causes you to feel depressed and you have difficulty concentrating at work, thus decreasing your quality of life, and your earning potential. The severity of the depression and concentration symptoms, and their impact on your life, will determine your rating, in accordance to the rating schedule for mental health claims.

Otherwise, pain is taken into consideration in musculoskeletal disorders in how it impacts range of motion, and therefore, functional loss of the effected body part. If pain is present, but does not effect ROM, then the lowest compensable rating is awarded. 

In either case, the pain is resulting in a condition which leads to a functional loss, either physically or mentally, which is why it can be compensated for.

[Buck52]

Chronic Pain Syndrome & Your VA Disability ClaimPain is considered to be chronic when it is present for six months or longer. Chronic pain usually begins with an injury or illness and can end up causing complications. Unfortunately, these complications can, in turn, make the chronic pain even worse. The combination of chronic pain and the resulting complications is known as chronic pain syndrome. A veteran with chronic pain frequently develops problems beyond the physical pain they endure. Chronic pain can cause symptoms such as the following:

• Reduced activity
• Impaired sleep
• Depression
• Suicidal ideation
• Social withdrawal
• Irritability
• Memory and cognitive impairment
• Relationship problems
• Helplessness
• Hopelessness
• Substance abuse
• Anxiety

As the above list of symptoms shows, veterans with chronic pain suffer from more than physical pain. This is backed up by multiple medical studies proving that chronic pain has a direct effect on the brain. These studies have looked at how the persistent perception of pain interferes with the natural balance of activity in someone’s brain. Chronic pain can result in anxiety, mood disorders, and cognitive impairments such as difficulty concentrating, difficulty focusing, and difficulty making decisions. The physical pain and resulting secondary problems associated with chronic pain significantly diminish a person’s quality of life.

VA Ratings for Chronic Pain

The VA does not have a specific diagnostic code for chronic pain. In order to receive VA disability compensation for chronic pain, the symptoms caused by the chronic pain disorder must be ratable. For example, oftentimes a veteran’s chronic pain will cause depression. In that case, the veteran’s chronic pain would be rated according to the rating criteria for general mental health disorders.

Keep in mind that, in order for symptoms of chronic pain syndrome to be ratable, the source of the chronic pain must be a service-connected condition. For example, a veteran with a service-connected back condition suffers from chronic pain. The chronic pain causes the veteran to become severely depressed. Because the chronic pain developed out of a service-connected condition, the veteran can receive VA benefits for the depression caused by his chronic pain. In other words, the depression is secondary to the veteran’s service-connected condition.

Evidence for Your Claim

One of the most helpful things a veteran can do for their claim is to get a private doctor to write a medical opinion. VA disability claims involving chronic pain often benefit from getting a medical opinion from a private doctor due to the complexity of the condition. The doctor should discuss the medical research regarding the effect chronic pain has on the brain. Make sure the doctor specifically relates any symptoms of chronic pain to a service-connected condition. For example, if a veteran has a back condition that is service connected, and a shoulder condition that is not service connected, the doctor needs specifically relate any symptoms associated with chronic pain to the veteran’s service-connected back condition. This does not mean that a doctor has to state a veteran’s service-connected condition is the ONLY cause of any symptoms of chronic pain. Taking the example further, if the veteran with a service-connected back condition and non-service connected shoulder condition has depression as a result of the chronic pain he is in, it’s likely that the depression is somewhat attributable to both conditions. In situations like this, the veteran’s depressive symptoms are likely “inextricably intertwined” with the back and shoulder condition. In other words, it’s impossible to tell which condition is the true cause of the depression secondary to the veteran’s chronic pain. As long as a doctor thoroughly explains this, the veteran can still receive service-connected for his depression secondary to chronic pain.

Lastly, don’t forget applying for individual unemployability. Veterans with chronic pain not only have physical impairments that affect their ability to work, they also have mental impairments associated with chronic pain that further impact their ability to work. As mentioned above, medical opinions are extremely important. An opinion from a private doctor can help show the specific limitations a veteran has due to their chronic pain and due to any secondary problems that are present as a result of the chronic pain. For example, a veteran with an orthopedic condition will likely have limitations impairing their ability to sit, stand, lift, walk, etc. All of these factors affect their ability to secure and maintain a job. However, that same veteran may have chronic pain as a result of their orthopedic condition and develop depression. In that case, the veteran may also have mental limitations such as difficulty concentrating, anger problems, inability to get along with co-workers, etc. It is important to show how both the physical and mental limitations affect the veteran’s ability to work.

 

 * Source : Hill & Ponton Disability Attorney's

[john999]

Since the VA considers chronic pain as a mental health condition I don't think you will get a separate rating for something like PTSD and Chronic Pain.  They will rate it together under one rating.  Now if you have a SC related physical condition and you have depression due to the chronic pain associated with the SC injury you can file a secondary claim for depression.  You might get a better rating for the depression than for the original injury.  I would advise any vet with a physical injury that limits his abilities to work or play to file a depression claim.  Not many vets who are crippled up due to injury that do not feel with depression.