One of the key factors the Social Security Administration (SSA) looks at to determine disability is whether your self-reported symptoms are consistent with objective medical evidence. Because reports of chronic pain or mental distress are fundamentally subjective, the SSA needs to see that they're in line with evidence like lab tests and doctor's notes.
In the past, Social Security had to decide whether an applicant's statements of subjective symptoms were "credible," a term which implied that the agency was making a character judgment. But the vast majority of people who are denied disability benefits aren't exaggerating or making it up—they just don't have the right evidence to show they can't do any jobs.
Since releasing Social Security Ruling 16-3p, the SSA no longer formally assesses credibility when deciding disability claims, but it's still a factor in a broader sense. You'll need to have believably disabling functional limitations in order to win a Social Security disability case. Below are a few ways you can show the agency that your pain and other symptoms legitimately result in your inability to work.
When you first apply for disability benefits, you should be prepared to answer questions about your symptoms in Form SSA-3373, Adult Function Report (also referred to as the "activities of daily living" or "ADL" questionnaire). Depending on where you live, your state's Disability Determination Services might also have you fill out a pain questionnaire with questions tailored to specific activities that cause you to hurt.
You'll submit these forms along with your Adult Disability Report when you file your initial application, so it's important to make sure you don't rush through it or neglect important details. Here are some tips on how to fill out your disability function report in order to increase your chances of winning your claim.
Because it can take up to several years before you're able to see an administrative law judge—the appeal stage where applicants have the greatest chance of success—you'll likely have to describe your functioning several times to disability claims examiners along the way. While it can feel tiresome to rehash your limitations, the SSA needs to know whether your symptoms have gotten better, worse, or remained constant during the application process.
Once you get to the hearing level, you'll be able to describe your pain directly to an administrative law judge. The judge will likely have questions to ask you as well, so you should be ready to answer them with the same level of detail (if not more) as you did in your disability function report. Here's some ways you can make the most of your hearing time.
You'll probably have to sit for at least an hour at your disability hearing, so if extended sitting causes you discomfort, don't just grin and bear it. Tell the judge that you're in pain, and ask to stand up and walk around. Judges won't mind making it easier for you to finish the hearing, and your body language can show the ALJ what movements you have difficulty with.
Keep in mind that Social Security isn't allowed to award disability benefits based only on subjective symptoms. Even if you fully filled out your function report or answered all the judge's questions perfectly, you'll need to show that you have a documented mental health disorder or that your pain is caused by an underlying condition that shows up on medical diagnostic tests.
By their nature, pain and mental health symptoms are highly individualized. A diagnosis of moderate spinal stenosis can cause severe, debilitating pain in one person, while somebody else with the same diagnosis might not have any issues. The SSA acknowledges that symptoms can feel more intense than what's shown by objective evidence alone, but the agency only considers your limitations to the extent they're consistent with your medical records.
So no matter what step you are in the disability determination process, diligently documenting your treatment is key to winning your case. You should be ready to submit the following information to the SSA along with your function report or before you have a hearing with an administrative law judge.
Social Security won't award you benefits if your doctors haven't been able to identify a condition that can be reasonably expected to produce pain or other symptoms. Your medical records should include results of clinical exams (such as a tender-point exam for fibromyalgia or a straight leg raising test for back pain), X-rays, MRIs, and lab tests that your doctors used to diagnose your impairment or rule out other causes.
If you have a consistent record of employment throughout your adult life, don't hesitate to emphasize that fact. Because it's unlikely that somebody who's been working for many years would want to give up a steady income for relatively modest disability benefits, a strong work history can sway a claims examiner or judge who might be on the fence about your case.
A strong work history tends to show Social Security that you're not engaged in "benefit-seeking," or trying to take advantage of the system. The SSA has access to your earnings and employment history, but only for the last 15 years, so if you've worked longer, be sure to point it out. If you enjoyed working and wish that you could return to your previous jobs, you might mention that as well.
On the other hand, in some cases a sporadic work history can support a disability claim based on mental health. Somebody with schizophrenia may miss many days of work during a manic episode, for example, or somebody with obsessive-compulsive disorder might be fired for interfering with coworkers' duties. Here, an inconsistent employment record makes it more believable that you have trouble holding down a job due to a mental disability.
Having a letter from a third-party who has witnessed your limitations can help strengthen your disability case. "Third parties" include doctors, friends, relatives, and former employers. An old boss might indicate that you were let go because you weren't able to lift boxes at your job, took unscheduled breaks, or couldn't stay on your feet. If you couldn't complete basic job duties at your past work, the SSA is more likely to find that you couldn't do the same at another job.
Opinion letters from your regular physician or psychologist—known as "medical source statements"—are especially helpful. In the statement to Social Security, your treating doctor should address your exertional (strength-related) and non-exertional limitations, including your ability to lift, carry, stand, sit, walk, bend, and stoop. Your doctor should also address whether they've observed any signs of "malingering" (exaggerating the severity of your symptoms).
If you're obtaining a third-party statement from a former co-worker, boss, friend, or family member, make sure it describes only direct interactions they've had with you. For example, if you struggle with severe anxiety, your cousin or neighbor might mention that they do the grocery shopping for you because you can't leave your house. Such statements can help confirm your self-reported symptoms and make your limitations more believable.
Chronic pain is sometimes the only symptom of back problems, migraines, fibromyalgia, joint pain, carpal tunnel syndrome, and reflex sympathetic dystrophy. And if the SSA doesn't find your complaints entirely believable, your chances of winning your case decrease considerably.
Additionally, most disability applicants who are ultimately awarded benefits aren't approved until after a hearing with a judge. Nationally, around 50% of hearings result in a favorable decision, but this varies significantly by region and doesn't mean that each individual application has a 50% chance of success.
Having an experienced disability attorney help you with your application can make the difference between winning your case and receiving a denial. Your lawyer can gather crucial medical records needed to establish that your symptoms are disabling, handle all correspondence with the SSA, and represent you at a disability hearing.
Updated February 6, 2024