Proving your pain and other symptoms to the Social Security Administration
As a Tennessee Social Security lawyer, I know that your credibility can be the key to convincing Social Security Administration decision makers that your symptoms are disabling. Your symptoms, such as pain, shortness of breath, dizziness and so forth are your own description of your physical or mental impairments.
When your medical evidence alone does not establish you are disabled, the Social Security decision maker must carefully consider your statements about your symptoms because they may suggest a more severe impairment than the objective medical evidence shows.
Social Security decision makers are expected to recognize that individuals may experience their symptoms differently. One person may be more limited by symptoms than another person who has the same medical impairments and the same medical examination and test results.
The extent to which the Social Security Administration will rely on your statements about your symptoms depends on how credible or believable they are.
The threshold requirement for proving pain and symptoms
Before the Social Security Administration will even consider the effect of your symptoms on your ability to work, your medical evidence must show that you have a medically determinable impairment that could reasonably be expected to produce your symptoms. Once you pass this threshold, Social Security decision makers will next look at the intensity and persistence of your pain or other symptoms and determine the effect they have on your ability to work.
Credibility of your statements about pain and symptoms
If your objective medical records (medical examination and test results) alone are not enough to substantiate your pain or other symptoms, the decision maker must consider all of the evidence in the case record, including any statements by you and other persons concerning your symptoms. The decision maker must then decide how credible or believable your statements about your symptoms are.
Factors Social Security uses to evaluate your credibility
The evidence that the decision maker will consider in assessing the credibility of your statements about your pain or other symptoms and their effect on your ability to function includes:
- The results of your medical examinations and laboratory tests.
- The diagnosis and medical opinions provided by doctors, psychologists, and other health care professionals who have treated or examined you.
- Statements and reports from you and from your treating or examining doctors or psychologists and other persons (such as co-workers, employers, teachers, friends and family) about—
- your medical history,
- your treatment and response,
- your prior work record and efforts to work,
- your daily activities, and
- other information concerning your symptoms and how they affect your ability to work.
- Any observations about you recorded by Social Security Administration employees during interviews, whether in person or by telephone.
- The decision maker’s own recorded observations of you.
Consistency of your statements about pain and symptoms
One strong indication of the credibility of your statements is their consistency with each other and with other information in your case record. The decision maker must consider such factors as:
- The degree to which your statements are consistent with the results of your medical examinations and laboratory tests and other information provided by medical professionals, including information about your medical history and treatment.
- The consistency of your own statements. The decision maker will compare statements you made in connection with your claim for disability benefits with statements you made under other circumstances, if that information is in your case record. Especially important are statements made to treating or examining doctors and to other health care providers. The decision maker will also look at statements you made to the Social Security Administration at each prior step of the process. Likewise, the case record may contain statements you made in connection with claims for other types of disability benefits, such as workers’ compensation, veterans’ benefits, or private insurance benefits. The lack of consistency in your statements does not necessarily mean that they are not credible. But you should have a good explanation. For example, symptoms may vary, or may worsen or improve with time, and this may explain why you have not always alleged the same intensity, persistence, or functional effects of your symptoms.
- The consistency of your statements with other information in the case record, including reports and observations by other persons concerning your daily activities, behavior, and efforts to work. This includes any observations recorded by Social Security Administration employees in interviews and observations recorded by the decision maker in administrative proceedings.
Role of medical evidence in proving pain and symptoms
Symptoms cannot be measured; but their effects can often be observed. For example, pain can lead to reduced joint motion, muscle spasms, sensory deficits, and movement disruption. These findings in your medical records lend credibility to your allegations about pain.
Important information about your symptoms recorded by your doctors and health care professionals and reported in your medical evidence may include:
- Onset, description of the character and location of the symptoms, precipitating and aggravating factors, frequency and duration, course over time (e.g., whether worsening, improving, or static), and effect on your daily activities. Very often, your doctor will have obtained this information directly from you. The decision maker may compare this information with your other statements in the case record.
- A record over time of any treatment and its success or failure, including any side effects of medication.
- Indications of other impairments, such as potential mental impairments, that could account for your symptoms.
How your treatment history proves your pain and symptoms
In general, a medical record over time demonstrating your attempts to seek medical treatment for pain or other symptoms and to follow that treatment once it is prescribed lends support to your allegations of intense and persistent pain or other symptoms. Persistent attempts to obtain relief of pain or other symptoms, such as by increasing medications, trials of a variety of treatments in an attempt to find one that works or that does not have side effects, referrals to specialists, or changing treating doctors may be a strong indication that the symptoms are a source of distress to you and generally lend support to your allegations of intense and persistent symptoms.
On the other hand, your statements may be less credible if the level or frequency of treatment is inconsistent with the level of complaints, or if the medical reports or records show that you are not following the treatment as prescribed and there are no good reasons for this failure, such as inability to afford treatment or ineffectiveness of treatment.
Help from a Tennessee Social Security attorney
If your pain or other symptoms are preventing you from working and you are not already represented by a Tennessee Social Security attorney and want our evaluation, give us a brief description of your claim using the form on the left.
Chattanooga Social Security disability attorney
