Chronic pain affects an estimated 116 million American adults - more than the total affected by heart disease, cancer, and diabetes combined, according to a recent Institute of Medicine report.
Allsup, a nationwide Social Security disability representation company, helps thousands of people with chronic pain obtain their SSDI benefits each year. To salute those who persevere, Allsup is distributing free posters for Pain Awareness Month in September and explaining how chronic pain is evaluated in the Social Security Disability Insurance (SSDI) claims process.
SSDI is a payroll tax-funded, federal insurance program established in 1954. It provides a monthly benefit for people who have worked in the past, paid Social Security taxes and are unable to work for a year or more because of their disability
"Pain is a major consideration in many claims," said Ed Swierczek, Allsup senior claimant representative. “In fact, there are court cases throughout the country that state the effect of pain on a person’s functioning must be considered in the evaluation of a disability claim.”
The Social Security Administration is required to consider pain and the limitations it causes when evaluating a disability claim. However, before pain may be considered, a medically determinable severe impairment must be established and the established impairment must reasonably be expected to produce the pain.
For example, individuals with lupus often experience pain in their joints or muscles, or in the form of migraines. Systemic lupus erythematosus is included in the SSA’s Listing of Impairments and is considered a medically determinable severe impairment. Another common example is lower back pain due to a condition that meets the SSA listing of disorders of the spine.
"Because pain is subjective, the presence of a medically determinable severe impairment lends credibility to the pain,” Swierczek said. “It is important for individuals to inform their treating physicians each time they experience pain, and to document the presence of the pain at each office visit, if the pain is present."
When evaluating a disability claim, the SSA must consider whether pain is severe enough to significantly limit a person’s ability to perform basic work activities. These activities include:
- Walking, standing, sitting, lifting, pushing, pulling, reaching, carrying or handling
- Seeing, hearing and speaking
- Understanding/carrying out and remembering simple instructions
- Responding appropriately to supervision, co-workers and usual work situations
- Dealing with changes in a routine work setting
The SSA also considers:
- The location, duration, frequency and intensity of the pain (or other symptoms).
- Factors that precipitate and aggravate the symptoms.
- The type, dosage, effectiveness and side effects of any medication the individual takes or has taken to alleviate pain (or other symptoms).
- Treatment, other than medication, the individual receives or has received for relief of pain (or other symptoms).
- Any measures, other than treatment, the individual uses or has used to relieve pain (or other symptoms—e.g., lying flat on his/her back, standing for 15 to 20 minutes every hour or sleeping on a board).
- Any other factors concerning the individual’s functional limitations and restrictions due to pain (or other symptoms).
"The most important thing to remember is always let your doctor know what your symptoms are, be it pain, shortness of breath, fatigue, etc.," Swierczek said. "This not only documents your claim, but gives your doctor important information that he/she needs to provide treatment."