Disability is one of the most challenging aspects of living with chronic pain. It is frustrating every day to be unable to do the things you used to do, and to miss out on social activities you used to enjoy.

For many people, having to stop working is even more difficult because it can lead to feelings of defeat and inadequacy. This is especially hard for "type A" people used to measuring their success and their value to society by their work.

Financial issues may necessitate your having to apply for disability benefits from an insurance plan or Social Security. This is often a long and complex process, which in part helps to discourage people who aren't truly disabled from cheating the system. But I think the main reason that applicants must jump through so many hoops is basic economics: The money has to come from somewhere, and there isn't enough to go around.

So how do you know when it's time to stop working and apply for disability benefits? 

Start by figuring out how much of your job you can accomplish within the limits of your pain. Can your responsibilities or hours be adjusted? Can other adjustments and accommodations be made to help you do your job with less pain?

Would telecommuting from home help? Continuing to work as much and as long as possible helps to maintain self-esteem and overall psychological health. And maintaining some type of employment may actually turn out to be a component of your pain-management plan.

However, sometimes the pain doesn't allow you to work at all due to physical limitations, medication side effects, or just the inability to think clearly. Sometimes the work itself worsens the underlying problem. In cases like these, it should be clear that applying for disability is the only logical option.

It may be hard for you at first to admit to yourself that you are disabled - but that may also be a reassuring sign that you're not "faking" it. I often have to convince patients that they must stop working to give their bodies a chance to heal and gain some control over their pain.

Eventually, some of them successfully return to part-time or less stressful work. But a period of rest and dedicated pain management usually needs to happen first.

Once you decide to apply for disability benefits, you'll need detailed medical records of your:

• diagnoses
• symptoms
• limitations and abilities
• treatments
• response to treatments

Work with your doctors and therapists to complete the necessary forms and letters. Don't exaggerate any symptoms, but don't minimize your problems either.

Consider having your physical therapist or rehabilitation medicine specialist perform a formal Functional Capacity Evaluation to document your abilities and limitations. This information will be very useful as the process unfolds. 

Don't be surprised if you are turned down the first time you apply for disability benefits. You may need to appeal the decision one or even several times, and you may have to hire a lawyer to help you navigate the process, which can be mentally, physically, and financially taxing.

But if you've made an honest effort to keep working and now find that you just can't continue anymore, patience and persistence should ultimately result in a fair resolution.