Pension for chronic pain syndrome

If the patient, even with extensive therapy, is no longer able to work because of chronic pain, the following types of pension can be claimed. On the one hand, a reduced earning capacity pension can be one possibility. This is called “full” if the patient can only work three hours or less a day and is classified as “partial” if working three to six hours is possible.

The reduced earning capacity pension is only limited to certain periods of time and must be extended again when it expires. If an application is made for a reduced earning capacity pension, some medical assessments must be carried out and it must be certified that the pain has not been improved by rehabilitation measures. On the other hand, if a severe disability exists due to chronic pain, an application can be made for an old-age pension for severely disabled persons. This means that the normal old-age pension can be applied for earlier. However, in order to do so, a severe disability must first be certified.

Degree of disability (GdB) in chronic pain syndrome

The GdB (degree of disability) is a standardized measure for quantifying a degree of disability in physically or mentally ill people. The GdB is measured on a scale from 0 to 100, with no or hardly any restrictions at 0 and a severe disability at 100. In general, a severely disabled person is defined as a person with a value of 50 or higher.

The GdB usually depends on the underlying illness and the resulting functional restrictions. With regard to the chronic pain syndrome, there are many different types of disability. If the symptoms of the underlying disease are not particularly severe and the resulting pain hardly leads to restrictions in daily life, patients do not reach a value higher than 20. If, on the other hand, the underlying disease is severe, for example cancer, and the patient is no longer able to care for himself/herself, he/she is often classified as severely disabled. The GdB therefore plays an important role in the allocation of social benefits and represents a non-binding benchmark for the severity of an illness.

Therapy

The aim of the therapy should be to combat the cause of chronic pain. Since this is often difficult, the therapy should lead to an increase in the patient’s quality of life and not be fixed solely on reducing the intensity of pain. In addition, it is the task of the treating physician to recognise and treat psychological changes such as depressive moods or sleep disorders at an early stage.

The choice of pain medication depends on whether the pain is classified as nociceptive, i.e. starting from the tissue, or neuropathic, i.e. starting from the nerves. If the pain is nociceptive, painkillers such as ibuprofen can be given and, if necessary, opioids.

Neuropathic pain can be treated with anticonvulsants such as gabapentin or pregabalin (lyrica). If psychosomatic factors play a role in the chronic pain syndrome, drug therapy alone is not sufficient to treat the pain optimally. Here, psychosocial therapy in the form of behavioural therapy or attention-directed therapy to support the medication is suitable.

In general, the treatment of chronic pain syndrome should, if possible, always consist of a combination of drug and non-drug measures. Accidents are an important triggering factor for chronic pain syndrome. Prolonged pain due to injuries or incorrect processing of the pain can lead to changes in the body that are not yet fully understood and with the consequences of chronic pain syndrome.

Therefore, it is important after a traumatic accident not only to treat the physical damage, but to give the patient the opportunity to process what he has experienced. If this does not happen, accidents are also associated with post-traumatic stress disorders. This can lead to a disturbed processing of the pain and trauma and the pain remains even after all physical injuries have healed. Typical of post-traumatic stress disorder are deep feelings of loss of control, despair and helplessness.