Social Security Disability Benefits and Pain
Pain is a poorly treated factor in social security disability and SSI claims. This is because, no matter how real and intense and debilitating pain is, it is still subjective and unlike other patient-claimant data, such as strength, reflexes, and range of motion, the medical record documentation (medical records are everything for social security disability) of pain relies completely on the statements that are issued by a patient and recorded by a doctor. Most doctors, of course, much to the later chagrin of disability claimants, do a fairly poor job of documenting a claimant's observable physical functional limitations and a terrible job when it comes to referencing pain in their records.
So, despite the fact that pain can be functionally limiting to the extent that pain is disabling--the cornerstone of disability approvals is residual functional capacity--the entire issue is problematic for A) individuals pursuing disability claims and B) for those attempting to engage in substantial and gainful work activity.
Pain physically limits the effective use of muscular strength and range of motion, and the duration and degree to which a person may engage in normal daily activities, including work activity. Pain also has a negative effect on an individual's mental ability to maintain concentration, persistence, and pace, which can immediately and dramatically reduce their level of functional capacity.
This obviously puts claimants who have decided to file for disability on the basis of a physical impairment, with no mention of a mental impairment on a disability application, at a disadvantage.
And the question becomes--will their pain, as a factor in reducing their ability to work, be given proper consideration? The unfortunate answer, from my perspective as a former disability examiner, is usually not.
Why? Again, it goes back to documentation. Disability examiners and the medical consultants they work with (the doctors who are assigned to their disability case processing units) rely exclusively on medical records to determine the outcome of a case. In other words, if its not in the records, it isn't considered. Sadly, very few doctors make an attempt to document pain or its effect on residual functional capacity.
For this reason, it may be good advice for individuals who are limited by pain and who are filing for disability to actually seek treatment from a pain specialist, simply to achieve proper documentation of their condition and limitations.
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