Can you Collect Social Security Disability Benefits for Chronic Pain?

It is extremely common for individuals applying for Social Security disability benefits to be experiencing problems with chronic pain, as one might imagine.  There are a panoply of medical conditions that could the cause of such symptoms, whether it’s from a degenerative disk disease in one’s back or neck, or, for example, from diabetic neuropathy that might cause excruciating, burning nerve pain in one’s feet.

The problem arises, however, where an individual is continuing to experience chronic pain and there is no easy offender at which to point the finger.   Chronic pain can arise from any one of a number of reasons and pointing to a diagnosed medical condition as the culprit may not be so easy.   It is important to understand that the inability to point to a medical condition as causing the impairment may end up proving somewhat problematic with a potential Social Security disability claim.

The Social Security Administration is required to undertake a five (5) step sequential evaluation process, which process is set forth by the Social Security regulations.  Step 1 requires that an individual is not gainfully employed.  Step 2 requires that a disability claimant is suffering from what is deemed to be a severe medically determinable impairment: an impairment is deemed to be “non-severe” if it does not significantly impact one’s ability to undertake basic physical or mental ability to do basic work-related functions.

A skilled Social Security disability lawyer will ensure that an individual has been diagnosed as suffering from a severe medical condition that meets the statutory and regulatory requirements right up front.   As set forth in the Social Security Act, “disability” is defined as an “inability to engage in any substantial gainful activity by reason of a medically determinable physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for a continuous period of not less than 12 months.”  The Social Security regulations additionally spell out at 20 C.F.R. §404.1529(b) that symptoms alone (such as pain, fatigue, shortness of breath) cannot be found to impact your ability to function unless and until  a medical impairment has been shown through acceptable medical signs and laboratory findings that are “established by medically acceptable clinical or laboratory diagnostic techniques” as the cause of such symptoms.  It must be shown that the symptoms from which one is suffering are indeed reasonably expected to result from the medical condition. 

Thus, an individual who is treating with their primary care provider who assumes that they are suffering from arthritis is not doing a service to their patient if they decide not to order x-rays to confirm the condition.  Moreover, if one has been referred to a rheumatologist for treatment of what is believed to be Fibromyalgia, that specialist will not be doing any favors to a potential Social Security disability claimant if they are not properly diagnosing the condition by first excluding other potential causes of one’s pain through lab work, is not obtaining a sufficient history of the symptomatology involved and, finally, is not undertaking trigger point examination to determine whether the condition meets the criteria set forth by the American College of Rheumatology.  The mere mention of a diagnosed medical condition is not sufficient: it needs to be backed up by appropriate examination and clinical testing.  The Social Security Administration has issued Social Security rulings to assist with determining whether chronic pain may be associated with diagnoses involving Fibromyalgia, Chronic Fatigue Syndrome and Interstitial Cystitis.   And yet, it remains a not uncommon practice that a claimant will come in having been treated for pain and fatigue issues without having in place a definitive diagnosis from a physician (or, what might be in this day and age,  nurse practitioner, naturopath  or physician assistant)  that results from appropriate examination and testing.

This type of issue is yet another example of the pitfalls that can befall a Social Security disability claimant.  It confirms the importance of consulting with an experienced Social Security lawyer as early as possible so that such issues can be identified and appropriately resolved early.  Contact the Law Offices of Russell J. Goldsmith at 1-800-773-8622 if you or someone you love is suffering from chronic medical conditions that are keeping them from working.