Disabling pain?

Pain is a subjective symptom and there is virtually no way to objectively or clinically confirm the complaints of pain by a person claiming disability. This makes it very difficult for an Administrative Law Judge and the Social Security Administration to determine who is disabled when considering limitations restrictions based on complaints of pain.

The Administration’s policy on pain, and other symptoms, requires a finding of credibility of an individual’s statements, in connection with the records as a whole. Pain can evidence a more severe impairment than the objective medical evidence alone and the individual’s subjective reports must be considered in determining disability. The ALJ cannot disregard the individual’s reports of pain simply because they are not substantiated by objective medical evidence. This rule is consistent with the courts decisions regarding long-term disability cases as well.

When an individual complains of limitations and restrictions based on pain, the ALJ is bound to evaluate and investigate (if necessary) the complaints and consider them in association with the record as a whole. This analysis is two fold. First, the ALJ must determine if there is an underlying condition (physical or mental) that can be established with medically acceptable techniques that could reasonably be expected to cause the symptoms.

If there is no objectively determinable impairment or the symptoms could not reasonably be caused by the impairment, the symptoms cannot be found to prevent the individual from working. If however, there is an impairment and the symptoms are reasonable based on that impairment, the ALJ must them consider the severity, duration and effect of the symptoms in order to determine whether the symptoms limit the ability to work.

Generally speaking, the severity and duration of the symptoms cannot be confirmed with any clinical test and therefore the ALJ must make a finding on the credibility of the individual. The ALJ should consider not only the subjective statements from the claimant, but also statements from family members, observations by medical practitioners, vocational examiners, and other SSA employees. The combination of these observations, including the observations of the ALJ, should be weighed together to determine if the individual is credible and the reports some consistency in type of complaint or limitation.

The above observations generally include testimony regarding the claimant’s daily activities; frequency, duration and location of pain; precipitating or aggravating factors; dosage, effectiveness and side effects of medication; any other attempts to alleviate the symptoms; and any other factors resulting in functional limitations and restrictions.

Finally, the ALJ cannot discredit the complainant’s subjective reports simply because of a lack of continuous medical treatment. If treatment is interrupted or the complainant is not following medical instructions, the ALJ must make efforts to determine the reason for the lapse in treatment or cessation of medication, etc. For instance, if a person is unable to afford treatment or stops medication because the side effects are worse than the actual condition, those factors must be taken into consideration.

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