HOW THE SSA EVALUATES PAIN
DOES THE SSA EVALUATE PAIN IN YOUR SSD CASE?
The SSA evaluates pain when it considers your claim for Social Security benefits. How the SSA evaluates pain is probably one of the most important issues in your SSD case. Social Security Regulations have evolved over time from using only objective medial evidence as proof of pain, to consideration of witness testimony along with medical evidence.
When medical signs or lab tests show a medical condition that could reasonably be expected to produce pain, then your testimony about how severe your symptoms are must be taken into account. This is especially true because the SSA is making a decision about your capacity for work.
In looking at your pain, Social Security considers all available evidence. This means the SSA, at the local office and at Disability Determination Services (DDS), should review your medical records and history. They will be looking at statements about pain from your medical sources, like your treating doctor.
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 limits with your ability to move. Also, your doctor will write about sensory loss and muscle loss. The SSA will be looking for pain statements from your doctor.
EVALUATING PAIN UNDER SSA’S GUIDELINES
Throughout the medical record, your statements about pain should be written down by your doctor. Your medical records are very important. If you see a nurse practitioner or PA, they can also document your pain statements. Obviously, your statements need to be supported by medical findings.
Using the example of back pain, you can complain about it, but eventually your doctor will need to perform an X-ray or MRI to figure out what is causing your pain. 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.
THE SSA EVALUATES PAIN BY LOOKING AT MANY FACTORS
Pain is subjective. Therefore, the SSA should consider all the evidence that you present to document your pain symptoms. 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. 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. They also look at what medical treatment you have tried to eliminate your pain. The SSA will even consider phantom pain, as in the case of an amputation.
The SSA will want to know, for example, if have you seen a doctor. They will also want to know if you have done everything she tells you to do to lower your pain level. Often, doctors will offer medications. Do your medications help your pain? Or, do your medications have bad 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 a “medically determinable impairment” in the list of SSA’s medical conditions. SSA will also develop evidence regarding the possibility of a mental condition when information suggests that one exists. They will also look to see if the medical findings show any physical condition 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 ALJ, at your Social Security 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 your “persistent attempts to find pain relief and your 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 symptoms).
SOCIAL SECURITY RULING 16-3P & HOW THE SSA EVALUATES PAIN
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 the issue of pain.
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 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.
It must also be consistent with 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, then you can’t work. No one can concentrate when pain distracts them from work tasks. Even getting through an eight hour day at work when you experience severe pain is intolerable. We understand what it is like to suffer chronic pain. At our law firm, it is our job to help the SSA evaluate your pain. Contact our office for a free review of your case and we will guide you through the five step SSA review process.
We can’t guarantee that it will be an easy or short process. Many people become upset while waiting for the SSA to make a decision or provide a hearing date. However, 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 your pain and medical symptoms. We are the legal team with the most experience in Utah and Nevada. Find out more information in your Utah SSD benefits. Find out more Nevada SSDI and SSI information. Contact us for a free review of your benefits today.
YOU DON’T PAY AN ATTORNEY FEE UNTIL WE WIN BENEFITS
Most importantly, we do not charge you an attorney fee until we win you benefits. If we do not win your case, then you do not pay an attorney fee. How much is the fee? It is 25% of your back benefit. Also, the fee is capped at $7200. You do not pay more than the cap in attorney fees. And, 25% is usually less than the $7200 cap.
If there are costs in your case, then you pay for those costs. But, the costs are usually less than $100. You must pay for a copy of your medical records. The cost of your medical records is whatever your doctor charges for them. You will owe costs whether we win or lose your case. To hire most lawyers, you have to pay a fee upfront. However, you can’t do that because you don’t have a job. We understand that. Which is why you only pay an attorney fee if we win your SSD benefits.
CANNON DISABILITY LAW IS THE BEST SSD FIRM
The attorneys and staff at our law firm have over 30 years of experience helping clients win SSD benefits. Learn about our lawyers on our About Us page. Our goal is to win your SSDI and SSI benefits. During our 30 year in business, we have won our clients over $100 million in past due disability benefits. We can help you too.
It is also our goal to make the process easier for you. Don’t go to court without excellent representation. Your future income, for yourself and your family is at stake. You need to hire a firm that is on your side. After all, you paid for disability benefits. They are not a handout. We want to win the Social Security benefits you deserve. If you have chronic pain, you need benefits. Contact us today. We can help.
If you want to learn more about our lawyers, then read our About Us page. For instance, Andria Summers is an amazing advocate. She can also help you with your Medicare plan. Additionally, she has won thousands of SSD cases. Dianna Cannon has been helping SSD and SSI clients for thirty years. Brett Bunkall also has years of experience helping people obtain their benefits. We are experts at helping the SSA evaluate your pain symptoms. You can trust us to help you win your SSD and SSI benefits. Contact our firm today. Put our experience to work for you.