My Symptoms are Severe: So Why was I Denied my Social Security Disability claim?

And so for years you’ve been struggling with a bad back or with stiff hands that have more and more difficult to function at work.  You’ve gotten to the point where your employer is  no longer able to accommodate your missed days missed from work, or the slow down in your production.   You may be one of those individuals that just hates going to the doctor.

Or, you may be one those individuals that’s been going to the neighborhood chiropractor for years: he treats you week after week, telling you that you have what he believes to be severe arthritis of your back or a case of degenerative disk disease and lumbar radiculopathy.  He or she suggests that  you  to go ahead and apply for Social Security disability benefits (and that they’ll be supportive of your claim).

Unfortunately, the denial comes back from the Social Security Administration (SSA) in short order and it is now time to call the lawyer to see what can be done.   This is all too familiar a scenario in our office.  Whether it’s because health insurance has been an issue, or simply because someone doesn’t believe in doctors and they can tough it out (or, perhaps, because it’s difficult to find a doctor to treat your condition in your area): too many times we’re hearing from claimants who are wondering why their severe symptoms are simply not being listened to by SSA.

By obtaining an experienced and local (Maine, Massachusetts or New Hampshire) Social Security lawyer,  this can help ensure you’re receiving the best treatment available to you in your area, and treatment that will be recognized and respected by those deciding your claim at SSA.  In evaluating your potential disability claim, we will first look to see if you can establish what is called a medically determinable impairment that can be reasonably expected to cause the symptoms about which you complain.  The Social Security rules and regulations spell out in detail  in what way they will consider an individual’s complaints of symptoms (whether it be pain, dizziness, fatigue or other such symptoms).  Understanding this approach and ensuring that you meet Social Security’s guidelines is important prior to presenting  a disability claim.

If, for example, the condition causing your symptoms has yet to be diagnosed objectively (that is, though clinical examination, laboratory testing or objective diagnostic testing), then SSA will not even begin to listen to your complaints.   And it is not sufficient for this documentation to come from simply any provider: the Social Security regulations require that the objective medical evidence come from an acceptable medical source.  Treatment providers such as physician assistants, chiropractors, family nurse practitioners are not considered acceptable medical sources and so their findings could not be considered so as to establish a medically determinable impairment.   While the regulations provide that SSA has an obligation to develop evidence regarding a potential medically determinable impairment, this typically means that they may seek out additional answers from you about the treatment you’ve undergone (to see if there is acceptable medical source evidence that can be obtained) or will contact your medical providers directly to see whether they can provide either the objective testing or clinical examination details that would help establish the necessary diagnosis of a medically determinable impairment. It is likewise quite common for SSA to send individuals to examinations with physicians (called consultative examiners) who are paid by the state to undertake a clinical examination and even undertake diagnostic testing that could potentially assist with the diagnosis of a condition (for example, ordering x-rays for an otherwise undiagnosed back ailment or pulmonary function testing for problems with breathing).  From our experience, however, relying on SSA to undertake such a referral for testing is much more than rare occurrence than the rule: in most cases, SSA will simply deny your claim without sufficient explanation as to what you can do.

Only once a medically determinable impairment has been established by way of an acceptable medical source through objective evidence can SSA begin evaluating an individual’s symptoms as part of step 2 of the evaluation process, which requires that SSA evaluate the “intensity and persistence of an individual’s symptoms such as pain” to determine the extent to which the symptoms then limit their ability to perform work-related activities.   SSA will look to see whether the statements one makes about their pain or other symptoms are reasonably consistent with the objective medical evidence provided.  It is important to note, however, that during the step 2 process of evaluating one’s symptoms that SSA will then look at not only the medical source notes (including the history presented, treatment provided, responses to treatment, among other factors), but can consider both the opinions and treatment records of other, non-acceptable medical sources in order to gather a sense of the severity of one’s symptoms and how this impacts their ability to function.

Before considering an application for Social Security disability benefits, give strong consideration to contacting a Social Security disability lawyer who can assist you by analyzing your individual circumstances to ensure you have your best foot going forward the the first time you present a disability claim to SSA.  Contact the Law Offices of Russell J. Goldsmith at 1-800-773-8622 now for a free assessment of your claim.