Chronic pain doesn’t show up clearly on imaging or lab tests the way a fracture does, so disputes in these cases usually come down to whether reported symptoms, functional limits, and treatment history hold together and are properly supported by the clinical findings. A chronic pain QME evaluation performed by a pain medicine specialist carries more weight precisely because that physician is trained to assess whether ongoing medication management, including opioid therapy, remains medically necessary, whether the pain is consistent with the original injury mechanism, and whether further treatment is reasonable — judgment calls that a general evaluator without pain medicine training is less equipped to make defensibly.