Chronic Pain

Chronic pain itself is typically handled as a physical claim — but the depression, anxiety, and exhaustion that build up alongside ongoing pain are a separate, real, and OWCP-recognized psychological injury. This page covers that mental health side: what it looks like, and how it gets evaluated and treated alongside your physical claim.

How common this actually is

This isn't a rare overlap — it's closer to the norm. A meta-analysis covering 376 studies and over 347,000 people with chronic pain found that roughly 39% had clinically significant depression and about 40% had clinically significant anxiety. Separately, a large U.S. survey found that unremitted anxiety or depression symptoms show up in nearly 24% of adults with chronic pain, compared with under 5% of adults without it — a roughly five-fold difference. One study put the number even higher: about 67% of people with chronic pain had some comorbid psychiatric diagnosis, and PTSD specifically was about three times more common in people with chronic pain than in the general population.

What tends to lead to it

• An injury from a work vehicle accident, fall, or repetitive strain that never fully resolved
• Being unable to return to your full route or duties because of ongoing pain
• The frustration of a slow or stalled physical recovery
• Sleep disruption caused directly by pain, which compounds mood and concentration problems

How it shows up day to day

• Depression or a flattened mood that tracks alongside your pain levels
• Anxiety about re-injury, especially when returning to physical duties
• Irritability or short temper driven by constant discomfort
• Sleep that's broken up by pain, leaving you exhausted the next day
• A sense of loss — of capability, identity, or the job you used to be able to do without thinking about it

Getting it recognized as an OWCP-accepted condition

This is typically evaluated as a consequential psychiatric condition tied to your existing physical injury claim. Our evaluation documents how your pain has affected your mental health specifically — separate from, and in addition to, whatever treatment you're already receiving for the physical injury itself.

Treatment through our practice

Telehealth counseling focuses on coping with the psychological weight of chronic pain — grief over lost capability, managing pain-related anxiety, and rebuilding a sense of control — and is billed directly through OWCP once accepted. We also coordinate, where useful, with whatever physical treatment you're already receiving.

Sources

Prevalence of Depression and Anxiety Among Adults With Chronic Pain: A Systematic Review and Meta-Analysis (JAMA Network); Co-occurrence of chronic pain and anxiety/depression symptoms in U.S. adults, PAIN journal; Healthesystems, "Pain Points: Chronic Pain and the Injured Worker."