Wednesday, March 16, 2011



Pain Medication and Your Social Security Disability Claim at the Application and Recon Levels

My wife and I recently had a discussion regarding pain medication and how it affects people. She, like me, is a former disability examiner for disability determination services.

For those who are unaware, claims that are filed in social security offices get sent to an agency that is known in most states as DDS, or disability determination services. At that agency, each social security disability claim and SSI claim is assigned to a disability examiner (if you filed under both programs, it becomes a single concurrent file for the examiner) who basically does all of the processing legwork on the case, eventually taking the claim to a decision point where the claim is either approved or denied.

So, what was the discussion about? Backdrop: she, like me, has an ongoing back condition (most likely, some level of degenerative disc disease) and her back had "gone out" recently. This put her in the position of having to use anti-inflammatories, muscle relaxants (flexeril), and prescription pain medication.The effect of all these meds, as it has been in the past, was to make her tired, less co-ordinated, and somewhat clouded in thought. This, of course, is exactly the kind of thing that is reported by individuals who file for disability benefits.

Obviously, since we've both been down this particular road before (back injury and pain medication), these collateral effects are not something new and unsurprising. However, the occasion did allow us to reflect back to the time that we handled disability claims for the social security administration.

How much consideration does social security actually give to the fact that a person who is applying for disability is having to take pain medications? At the disability application or reconsideration appeal levels, my recollection is that not a lot of consideration is given at all. Disability examiners will do their write-ups of cases (usually a notation of the more prominent bits of the medical evidence of record) and will present this information to the medical consultant in their case processing unit. But seldom ever (unless changes have changed significantly since I was an examiner) will there be significant discussion in writing, or during the consultation between the disability examiner and the medical consultant (the doctor who actually works at DDS), of the potential, or likely, impact of the pain medications on the claimant's ability to engage in normal daily activities.

This is unfortunate and poses an unfair disadvantage to claimants. And it does for many reasons. Pain medications have a definite impact on activities of daily living and on one's ability to persist in a work environment. The effects of pain medications are many, including nausea, gastrointestinal effects, fatigue, drowsiness, breathing impairment, mental fogginess, slowed reaction times, etc.

Most jobs are would be seriously impacted by side effects such as these. Yet, why is it then that when cases are evaluated by disability examiners very little consideration is given to the side effects and limitations posed by pain meds?

1. Most disability examiners are younger individuals who have very little to any experience with pain related conditions and age-related conditions that involve pain.

2. The Social security administration has a very long history of giving very little credence to the limiting effects of pain.

3. The doctors who serve as medical consultants at disability determination services (the agency that renders decisions on claims for SSA) have generally been out of practice and out of contact with patients for quite some time. A number of them spent very little time with patients before deciding to abandon field practice for the security and ease of working in an office as a medical consultant (think about it: What kind of "doctor" prefers reading files on people he has never met to actually using his or her medical degree to treat patients or perform research? Answer: not a very good one)




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