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HOW THE SSA EVALUATES PAIN

The SSA evaluates pain when it considers your claim for disability benefits. How the SSA evaluates pain is probably one of the most important issues in a disability case. Social Security Regulations have evolved over time from using only objective medial evidence as proof of pain, to mandating consideration of subjective testimony along with objective medical evidence. When medical signs or laboratory findings show a medically determinable impairment that could reasonably be expected to produce pain, then the claimant’s testimony about the severity of these symptoms must be taken into consideration. This is especially true because the SSA is determining a claimant’s capacity for work.

EVALUATING PAIN UNDER SSA’S GUIDELINES

In evaluating pain, Social Security considers all available evidence. This means the SSA, at the local office and at Disability Determination Services, should review your medical records and history. They will be looking at statements about pain from your medical sources, like your treating physician. When you primary care doctor evaluates your physical problems, he or she will evaluate your pain. For example, if you have back pain, the doctor will write down if you have motion limitations or sensory loss. The SSA will be looking for pain statements.

Similarly, throughout the medical record, your statements about pain should be written down by your doctor. If you see a nurse practitioner or physician’s assistant, they can also document your pain statements. Obviously, your statements need to be supported by objective medical findings. Using the example of back pain, you can complain about it, but eventually your physician will need to perform an X-ray or MRI to document the problem. If the MRI or X-ray does not show a reason for your back pain, then the SSA will not accept your testimony as valid.

Another way to put this is to say the SSA requires objective medical testing. For example, if your arm is broken, you may know it is broken because of the pain. However, the SSA requires you to show the broken bone to them on an X-ray. An X-ray is objective medical evidence that you have a broken arm.

PAIN

THE SSA EVALUATES PAIN BY LOOKING AT MANY FACTORS

Pain is subjective and difficult to explain. Therefore, the SSA should consider all the evidence that you present to document the symptoms of your pain. This evidence includes your prior work record. If you have a strong work history, then that is evidence which shows you would continue to work if you could do so. A consistent number of years working at any single job, in other words, demonstrates your credibility.

One of the other factors the SSA evaluates is the location and frequency of your pain and what treatment you have sought to eliminate your pain. For example, have you seen a doctor and done everything she tells you to do to lower your pain level. Often, physicians will offer medications. Do your medications help your pain? Or, do your medications have debilitating side-effects?

One of the other questions that the SSA may ask is do you have “chronic pain?” Chronic pain is a symptom that must be part of another “medically determinable impairment” in the list of disabling conditions. SSA will also develop evidence regarding the possibility of a mental impairment when information suggests that such impairment exists and the medical signs and laboratory findings do not substantiate any physical impairment capable of producing the alleged pain or other symptoms.

HOW THE SSA EVALUATES PAIN IN THE TENTH CIRCUIT

The 10th Circuit Court states that the Administrative Law Judge, at your disability hearing, must consider: 

  • (1) whether the claimant established a pain-producing impairment by objective medical evidence;
  • (2) if so, whether the impairment is reasonably expected to produce some pain of the sort alleged (what we term a “loose nexus”); and
  • (3) if so, whether, considering all the evidence, both objective and subjective, the claimant’s pain was in fact disabling. Keyes-Zachary v. Astrue, 695 F.3d 1156, 1166-67 (10th Cir. 2012) (citing Luna v. Bowen, 834 F.2d at 163-64).

Within this analysis, the ALJ should consider factors such as “a claimant’s persistent attempts to find [pain relief] and [his] willingness to try any treatment prescribed, regular use of crutches or a cane, regular contact with a
doctor . . . and the claimant’s daily activities, and the dosage, effectiveness, and side effects of medication.” Id. at 1167 (internal quotation marks omitted); see also SSR 16-3P, 2016 WL 1119029, at *7 (Mar. 16, 2016) (listing similar factors to consider in evaluating intensity, persistence, and limiting effects of a claimant’s symptoms).

The ALJ need not consider these factors in a formalistic way, but the substance must be there. See Keyes-Zachary, 695 F.3d at 1167. What this means is that the judge cannot use boilerplate language in his decision to avoid discussing the issue of pain.

SOCIAL SECURITY RULING 16-3P

In Hardman v. Barnhart, 362 F.3d 676, 679-80 (10th Cir. 2004), for example, the Tenth Circuit rejected the ALJ’s pain analysis as boilerplate language. The Court said he made no attempt to link factors to evidence, in a case where the claimant persistently complained of pain and sought treatment.

The Court noted that their approach to the issue of how to evaluate pain was consistent with Social Security Ruling 16-3P. SSR 16-3P states the ALJ’s decision “must contain specific reasons for the weight given to the individual’s symptoms, be consistent with and supported by the evidence, and be clearly articulated so the individual and any subsequent reviewer can assess how the adjudicator evaluated the individual’s symptoms.” SSR 16-3P, 2016 WL 1119029, at *9. If the ALJ does not sufficiently articulate his reasoning, the reviewing court cannot conduct a meaningful review of the pain assessment.  

CANNON DISABILITY CAN HELP YOU WIN YOUR SSD CASE

If you have debilitating pain, you can’t work. No one can concentrate when pain is distracting them from work tasks. Even getting through an eight hour day at work when you experience severe pain is intolerable. At Cannon Disability, we understand what it is like to suffer chronic pain. Contact our office for a free consultation and we will guide you through the disability process.

We can’t guarantee that it will be an easy or short process. Many people become frustrated while waiting for the SSA to make a decision or provide a hearing date. There is very little we can do to make the process go any faster. However, we will do our best to prepare your case so that you are ready to present evidence of the disabling pain you experience. We are the disability legal team with the most experience in Utah, Nevada and Idaho. Contact us for a free consultation today.

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