Chronic Pain, Failed Back Surgery, and Social Security Disability: Proving Your Case and Avoiding the Waddell Sign Trap

Welcome to Season 2, Episode 16 of Winning Isn't Easy: Navigating Your Social Security Disability Claim. In this episode, we'll dive into Chronic Pain, Failed Back Surgery, and Social Security Disability: Proving Your Case and Avoiding the Waddell Sign Trap.

Chronic back pain can be debilitating, but under Social Security rules, pain alone is not enough to qualify for disability benefits. Many claimants assume that describing severe, persistent pain will be sufficient to win a case, only to discover that the Social Security Administration requires objective medical evidence tying those symptoms to a medically determinable impairment. MRIs, CT scans, nerve studies, and documented clinical findings often become the foundation of a successful claim, while incomplete records or misunderstood examination findings can quickly lead to a denial. In this episode of Winning Isn’t Easy, we explain how Social Security evaluates chronic pain claims, why back pain cases are especially difficult, and how certain medical findings can shape the outcome of a disability application. We also examine the role of Waddell signs, why they are frequently misunderstood, and how insurers, judges, and the SSA sometimes interpret them in ways that can unfairly damage a claimant’s credibility. If you’re pursuing Social Security Disability benefits for chronic pain, this episode breaks down what the SSA is really looking for, and the mistakes that can undermine an otherwise legitimate claim.

In this episode, we'll cover the following topics:

One - Chronic Pain and Your Rights to Social Security Disability Benefits

Two - Understanding Chronic Pain and Chronic Back Pain

Three - Why a Positive Waddell Sign on Examination Can Be Used by a Social Security Judge to Deny Your Social Security Disability Claim for Back Problems

Whether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.


Listen to Our Sister Podcast:

We have a sister podcast - Winning Isn't Easy: Long-Term Disability ERISA Claims. Give it a listen: https://wiedisabilitypodcast.buzzsprout.com


Resources Mentioned In This Episode:

LINK TO YOUR RIGHTS TO SOCIAL SECURITY DISABILITY: https://mailchi.mp/caveylaw/your-rights-to-social-security-disability-benefits

FREE CONSULT LINK: https://caveylaw.com/contact-us/


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Need help with your Social Security Disability claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.

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Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals.

Transcript

Nancy Cavey [00:00:15]:
 If you think chronic back pain alone will qualify you for your Social Security disability benefits, I want you to think again. Without objective medical evidence and without avoiding certain pitfalls in your medical records, your claim very well could be denied. Welcome back to Winning Isn't Easy. Social Security Disability Benefits this is a podcast where we break down everything you need to know about navigating the Social Security claims process. I'm your host, Nancy Kavey. Now, before we get started, I've got to give you that legal disclaimer. This podcast is not legal advice. The Florida Bar association says I've got to tell you that.
 
 Nancy Cavey [00:00:54]:
 But now that I've said it, I want to assure you that nothing will prevent me from giving you an easy to understand overview of the Social Security disability claims process, the games that are played, and what you need to know to get the disability benefits you deserve. So off we go. Now, if you think telling the Social Security Administration that you suffer from chronic pain is going to be enough to win your claim, I want you to think again. I know that chronic pain can be real, persistent, and even disabling. But under the Social Security law and regulations, pain alone is not considered to be a disability. To qualify for your Social Security disability benefits, your pain has to be linked to what Social Security calls our medically determinable impairments. That means that your symptoms have to be supported by objective medical evidence like MRIs, CT scans, nerve studies, or documented physical exam findings. Without this foundation, the Social Security Administration can deny your claim even if your pain prevents you from working.
 
 Nancy Cavey [00:01:57]:
 Now, I know that back pain claims can be challenging. I've had back surgery myself, and I know the post residual pain and problems that you can have from surgery, for example. Now, you may have tried injections, taken medications, even undergone surgery, and you still live with pain every day. But the Social Security Administration is going to look for that objective testing and clinical findings to verify not only the source of your pain, but the severity of your pain. And when the medical records are incomplete or when the examination findings are misunderstood or not complete, the claims can be denied. So one thing that I want you to pay attention to is something called the Waddell Signs. It's a set of physical exam findings that were originally developed to help physicians determine whether a patient might benefit from psychological support along with treatment for back pain. Unfortunately, these findings are sometimes misinterpreted by Social Security administration by judges and disability insurance carriers, for example, as evidence that you're malingering or exaggerating your symptoms.
 
 Nancy Cavey [00:03:08]:
 So in this episode, I want to talk about how Social Security evaluates chronic pain claims, why objective medical evidence is so important, and how issues like weddell signs can have a negative impact on your Social Security disability and even your ERISA disability insurance claim. So let's get started. I'm going to talk about three things today. One chronic pain in your rights to Social Security disability benefits 2 understanding chronic pain and chronic back pain and 3 why a positive Weddell sign on examination can be used by the Social Security Administration or or a Social Security judge to deny your Social Security disability claim for back problems. Let's take a break and we'll be back covering all these exciting topics.
 
 Speaker B [00:03:51]:
 Are you considering filing for Social Security disability or has your claim been denied already? Either way, you require a copy of your rights to Social Security disability benefits, which will cover everything you need to know about the Social Security disability claims process. Request your free copy of the book@kvlaw.com today.
 
 Nancy Cavey [00:04:31]:
 Chronic Pain and your rights to Social Security Disability Benefits now you may be entitled to Social Security disability benefits as a result of chronic pain, either before surgery or even after surgery, or whether in situations where your pain and dysfunction is expected to last at least one year and prevent you from returning to the work that you did in the five years before you became disabled or other work in the national economy in view of your age, education, work skills and restrictions and limitations. That's a lot of ifs, if you will. Okay, but I want to first talk about how Social Security will consider a chronic pain. They don't necessarily consider that chronic pain in and of itself is to be is a disability. They will consider the reports of your pain. But what they're really looking for is medical evidence of a physical or mental impairment. In other words, your pain has to be caused by something called a medically determinable impairment. There are pain disorders that Social Security recognizes, such as chronic regional pain syndrome, somatoform pain disorder, reflex sympathetic dystrophy.
 
 Nancy Cavey [00:05:40]:
 But alternatively, you could have a medical problem that causes pain that lasts a long time and is hard to treat and that pain interferes with your ability to do your past work or other work in the mythical hypothetical, not real world national economy. So what are those types of problems that you can have? Well, you can have pain from an arthritic condition. You can have failed back or neck surgery. You can have fibromyalgia, ibs, migraines, peripheral neuropathy. There are many conditions that will cause pain, but again, it has to be connected to that medical condition based on objective physical findings and diagnostic studies. Let's talk about warning signs of chronic pain after a surgery because I think this is important for you to understand because ultimately impacts how Social Security looks at claims. There was a recent study published in the British Journal of Anesthesia by a Dutch German research team that examined warning signs of chronification, if you will, of pain after surgery. And this was a report that was issued in June of 2022.
 
 Nancy Cavey [00:06:52]:
 What the study found was that the most important risk factors for developing chronic pain after surgery were preoperative opioid use, skeletal surgery, pain that lasted two weeks after surgery, your perception that cold stimuli was painful, and those are the kinds of things that doctors are looking at in chronic pain situations. Now. I know certainly it's been my experience that surgical pain will disappear after a few days. But you can have chronic pain that becomes so debilitating that you might become eligible for Social Security disability benefits, particularly if you've had a failed back surgery. And I will tell you that many of the Social Security claims that I am involved with in fact involve failed back surgery. They've often been prescribed opioids both before and after surgery. They've had limited pain relief and it's a bit of a predictor, if you will, ultimately with a failed back syndrome type claim. But what Social Security is going to want to see are medical records like CT scans, MRI studies, X rays of the lumbar spine, operative reports, post operative testing, post operative physical exam findings, postoperative treatments such as injections, and the use of multiple medications in an attempt to control your chronic pain.
 
 Nancy Cavey [00:08:20]:
 It's really crucial that your medical records are documenting the nature and frequency, location, duration and intensity of your symptoms before surgery, but that it is also following that same formula, if you will, post surgery. Where is the location of your post surgical pain? Is it accompanied by tingling, numbness, spasm? How often do you have it? Are there activities that will increase your pain like sitting more than 20 or 30 minutes or lifting more than £5 or walking more than a couple blocks in Publix, if you will, that pain, those pain complaints, symptoms, duration and location, intensity have to be cooperated, coordinated with, if you will, by those post surgical physical exam findings, the diagnostic studies and your response to treatment. You can see and hear that it's going to take a lot of great documentation to establish that you have a failed back syndrome that would qualify for Social Security disability benefits. So now I've set the stage. Let's take a break. Welcome back to Winning Isn't Easy. Let's talk about understanding chronic pain and chronic back Pain. Now, chronic pain is defined as pain that lasts longer than three months or or persist beyond the expected period of healing after an injury or surgery.
 
 Nancy Cavey [00:10:04]:
 Unlike acute pain that serves as a warning or a signal of an injury, chronic pain can continue even after the underlying medical condition has improved. And one of those is chronic back pain. It's the most common form of chronic pain and is frequently a basis of a Social Security disability claim. Now, the common causes of chronic back pain can include degenerative disc disease, herniated or bulging discs, spinal stenosis, arthritis of the spine, nerve compression or nerve damage, and the failed back surgery. You might also have other medical conditions on top of that. Chronic back pain associated with surgery. You might have neuropathy rather because of diabetes. You might have fibromyalgia superimposed, or you might have autoimmune disorders superimposed.
 
 Nancy Cavey [00:10:59]:
 You might have migraines. But what's important here is that we are documenting the underlying basis of your pain. What's the source? Is it a back condition? Is it fibromyalgia? Is it migraines? Is it a combination of things? And then we want to kind of parse, if you will, the location of the symptoms, the duration, the frequency of those sensations or problems, and how they impact your ability to function. So in terms of symptoms, you might have persistent aching and burning pain, stabbing or shooting sensations, numbness or tingling, muscle weakness, reduced range of motion, difficulty standing, walking or sitting. But the issue becomes, first, what are those symptoms? Every one of those symptoms, be it fibromyalgia imposed on the back or the back, or migraines or whatever, what are the symptoms? How often do those symptoms occur? Again, the duration of those symptoms? Do those symptoms become worse with certain types of activity like sitting, standing, or walking? And the key here is to connect all of that with the impact of chronic pain on your daily functioning, including what you do around the house, sitting, standing, walking, doing the dishes, going grocery shopping, vacuuming, doing the laundry, any of the pain conditions that I discussed can significantly interfere with your ability to do not only those activities of daily living, but maintain full time employment. So it's really important here that your medical records begin with a clear diagnosis, with objective testing and treatment and functional limitations. The objective testing is going to play a role in documenting, for example, the chronic back pain or any underlying medical condition. So they're going to expect to see MRIs, CT scans, X rays, nerve conduction study tests, EMG.
 
 Nancy Cavey [00:13:01]:
 The reason that's important is that these tests can help quantify and qualify, if you will, the Medical conditions that may be causing your problems. Now, doctors are also going to perform physical exam findings. They're going to evaluate your strength, your reflexes, your range of motion. They're going to be looking for signs of nerve irritation, spasm, and other objective findings on physical examinations. So your doctors are going to perform a variety of clinical testing to determine both the physical and functional impact of your medical condition, including that back condition. Some of these exam findings are going to be important in a Social Security disability claim. And one of the most controversial signs or symptoms, if you will, or test results are the waddell signs. I don't see doctors using that much anymore, but there are some doctors that do.
 
 Nancy Cavey [00:13:54]:
 And if the Social Security administration or the judge sees the waddell signs, their little spidey sense are going to start tingling. Now, weddell signs, in my opinion, are misunderstood and misused in disability evaluations, and that is that a positive weddell sign is interpreted as being the evidence of exaggerating or even malingering. That's important because ultimately, in a Social Security case, judges will make a credibility determination. They'll look at your medical records, your report of symptoms and functionality, and they'll try to determine whether what you have to say is believable. It's credible. And one of the very important things that can impact or even destroy your credibility is if a doctor is documenting this positive weddell signs. As I said, the spidey sense goes on. It's important if there are positive waddell findings in your medical records that somebody, some doctor is addressing them.
 
 Nancy Cavey [00:14:56]:
 Are they valid? Are they significant? Are they really consistent with the physical exam findings? Because if that isn't addressed, that is something that the Social Security administration or a judge can seize on in denying a claim. Got it? Let's take a break.
 
 Speaker B [00:15:14]:
 Struggling with your Social Security disability case. The right attorney can make all the difference. Get our booklet the key to hiring a great attorney for your Social Security disability case. Discover how to find an experienced attorney who will fight for your rights and navigate the process with ease. Don't leave your future to chance. Request your free copy@kvlaw.com today and ensure you have the expert support you deserve.
 
 Nancy Cavey [00:15:52]:
 Foreign. Welcome back to Winning isn't easy. Why a positive weddell sign on examination can be used by a Social Security judge to deny your claim. Now, doctors will perform many tests during a physical exam. Findings. If you've got back problems, they're going to test your reflexes, do sensory testing. They'll palpitate your spine for muscle spasmodic but then there's, I think, a sneaky test, and that's the Weddell sign test. Now, originally, the Weddell Signs test was designed for doctors to determine whether a psychological consult should be recommended in a person who had back problems.
 
 Nancy Cavey [00:16:40]:
 It wasn't designed to single out a person for malingering or secondary gain, but it's become misused. Now, let's talk about Waddell Signs. The issue is not whether you're waddling or not, but rather on physical examination, you have superficial tenderness, non anatomic tenderness, regional weakness, regional sensory changes, an overreaction during the physical exam findings. Because if you've got a back problem, normally those back problems will file specific dermatomal track, if you will. For example, if you have an L5S1 disc, you're going to present with certain findings in your ankles with weakness, sensory changes. And so if you say, I've got weakness of my entire leg and you've got an L5S1 disc, that sort of is a little trigger that says, hmm, well, I wonder if this person is telling me the truth or they're exaggerating. Now, I understand that if you've had pain and you're beginning to feel better or you've had surgery and you might be feeling better, you might be reluctant to participate fully in a physical exam, particularly if you're afraid that you're going to be re injured. And so as a result you overreact.
 
 Nancy Cavey [00:18:02]:
 It also might be that you are having difficulty dealing with the pain from a psychological standpoint and that in both instances, fear of re injury or the difficulty coping can impact the results of this Weddell signs testing and generally testing of a physical nature. And I find that the test results can be misinterpreted and misused, and they're, by the way, misused in workers comp cases, disability insurance claims and Social Security disability claims is across the board, I think, and people will take the position that if there are three or more signs that are positive, you are malingering, you're not believable, and you're exaggerating your symptoms. Now, as I said, this test has been developed by doctors to help determine whether patients with back problems could benefit from an evaluation by a psychologist. But Dr. Waddell never intended this test to be used in determining malingering, exaggeration or lying. If your medical records are documenting that positive Weddell sign, as I've said, your attorney should be asking for clarification from your physician regarding the significance of those findings and how those findings have impacted your treatment, the treatment recommendations they've made to you, and your response to that treatment. Now, hopefully your doctor will be willing to answer these questions and make it clear that a positive weddell sign test is not consistent with the objective findings on testing or on your physical examination. Otherwise, again, the Social Security Administration and a judge can deny your claim on the basis of malingering, lack of credibility or exaggeration, and the judge has the discretion to make that decision.
 
 Nancy Cavey [00:19:42]:
 I will tell you that it is very hard to get a Social Security appellate court to overturn a credibility decision by the judge. So this is something potentially you've got to get fixed before a hearing. So don't let a positive weddell sign destroy your Social Security claim. That's it for today's episode of Winning Isn't Easy. If you found this episode helpful, please take a moment to like our page, leave a review, share it with your family and friends, and subscribe to this podcast. I look forward to joining you next week for another insightful episode of Winning Isn't Easy. Thanks for listening, Sam.