How Does the SSA Evaluate Pain?
Pain, and, especially, the tolerance of pain, is a very subjective experience. Certain individuals can withstand a greater degree of pain than others. Consequently, injuries and disabilities will affect certain individuals differently than others. This variance will influence whether a particular individual is disabled enough to continue working and, whether it is possible to file for disability benefits, such as those offered by the Social Security Disability Insurance (SSDI) program. In order to have the best chance possible at obtaining SSDI benefits, it is crucial – and advisable – to retain the services of an experienced disability benefits attorney. Recently, the Social Security Administration (SSA) requested input which it will use to potentially revise its pain evaluation procedure. A discussion of the current procedure used to evaluate pain in SSDI applications, and how an applicant can prove his/her pain is debilitating, will follow below.
Evaluating Pain
The SSA maintains that, to receive SSDI benefits, an applicant must be disabled. Specifically, a disability is the inability to engage in any substantial gainful activity as a result of a medically-determinable impairment which is expected to last at least 12 months or result in death. The SSA uses a predetermined process to determine whether an SSDI applicant is disabled under the applicable law. At various steps in the process, the SSA will consider both the medical evidence of an impairment and the applicant’s descriptions of his/her symptoms, including any pain suffered by the applicant.
With specific reference to the evaluation of pain, the SSA currently uses a two-stage process. In the first stage, the SSA will determine whether there is objective medical evidence showing the existence of a medically-determinable impairment which could reasonably be expected to result in pain. If this evidence does not exist, the SSA will determine that the applicant is not suffering from pain. However, if the evidence does point to the applicant having a medically-determinable impairment which could reasonably be expected to result in pain, the SSA will then evaluate the intensity and persistence of an applicant’s degree of pain based on the evidence. The SSA typically considers several factors at this stage, including the following:
- The objective medical evidence;
- The applicant’s medical history, including any clinical and/or laboratory findings;
- Any statements or record about the pain’s effect on the applicant;
- The applicant’s ability to conduct activities on a daily basis;
- The location, duration, frequency, and intensity of the pain, as well as any aggravating factors contributing to the pain;
- The type, dosage, effectiveness, and side effects of any medication taken by the applicant;
- Any treatments, other than medication, the applicant is currently receiving or has received for relief of the pain;
- Any measures the applicant currently uses or has used to relieve pain (g., lying flat on the back, standing for 15 to 20 minutes every hour, sleeping on a board, etc.); and
- Any other factors concerning functional limitations and restrictions due to pain.
Proving Pain
The benefit analysis described above is that the SSA lays out exactly what an SSDI applicant needs to do to provide proof of his/her pain. Further, it is important to understand that, although the level of pain is subjective for each individual, the greater the amount of subjective proof submitted, the better. To increase chances of approval, it is extremely beneficial to ensure that the applicant’s medical history is as detailed and comprehensive as possible. An experienced disability benefits attorney will be able to sort through the available evidence to ensure that the most effective evidence is presented to the SSA in its pain evaluation.
Get Help
If you have filed, or are contemplating filing, an application for SSDI benefits, contact a disability benefits attorney as soon as possible. The legal team at Farrell Disability Law understand the rules that govern the SSDI disability benefits program, and can educate you on the process for receiving SSDI benefits, and how to increase your chances at receiving benefits. Upon a review of your situation, we will work to ensure that your application is as strong as possible. Contact our Jacksonville office today.
Resource:
regulations.gov/document?D=SSA-2018-0017-0001