How Social Security Evaluates Subjective Symptoms in Van Nuys Disability CasesBy Kenton Koszdin on April 10, 2023 | In Disease SSDI Claim
If your Social Security disability benefits have been denied because the SSA believes that your claim of chronic pain is fraudulent or exaggerated, it can have a serious impact on your life. You may be ready to fill out an application to receive benefits but are unsure how to define subjective symptoms’ functionally limiting effects.
A Social Security disability lawyer in Los Angeles can help you present a persuasive case to obtain the payments you deserve. The SSR 16-3p application process for disability benefits can feel daunting, especially when you’re unsure how SSA evaluates subjective symptoms. Don’t go it alone. Call a Los Angeles disability lawyer today.
What Is Credibility, and How Does It Apply to My Los Angeles Disability Claim?
Your SSA claims examiner evaluates your credibility as an applicant by looking at your entire case record. The more consistent your record, the more credible your claim is. However, the claims examiner must provide specific reasons for their decision under the 2016 SSA Credibility Ruling.
This ruling guides claims examiners in evaluating subjective symptoms. They must look at medical signs that are reasonably accepted as consistent with objective medical evidence to decide whether you have a medically determinable impairment.
The SSA’s Two-Step Process for Evaluating Your Medical Symptoms
The evaluation of symptoms in disability claims for benefits requires more than your self-reported symptoms. The Social Security Administration uses objective medical evidence to determine whether you have a qualifying disability.
Step 1: Legal Background
The first step is an evaluation by a Social Security Administration claims examiner. They determine whether objective medical evidence shows that you have a medically determinable impairment caused by a specific disability. They also assess how your symptoms affect your ability to work and whether your condition limits what could reasonably be expected for you to hold a job.
The claims examiner will use a basis of objective medical evidence — evidence that can be documented and verified. You can provide this evidence in your medical records, including laboratory findings, X-rays and other scans, and medical testing.
Evidence is only qualified for use if it comes from an acceptable medical source, which the SSA defines as:
- A licensed medical doctor;
- A licensed psychologist;
- A licensed osteopathic doctor.
In some cases, the source could be another medically acceptable clinical professional. You may have to see a specialist physician for additional confirmation, such as a doctor who focuses solely on your condition, or have additional lab work done to support your initial diagnosis.
Conditions with so-called invisible symptoms and chronic pain may be more difficult to objectively demonstrate, so you may need to seek treatment from multiple doctors to provide objective medical evidence.
Step 2: Current Analysis
Suppose that the SSA claims examiner determines that your symptoms exist based on the medical and other evidence, like laboratory findings, you present in your record. They then move on to the next step. The examiner evaluates the nature of your medical signs and the severity of your symptoms to determine the true impact of your condition on your daily life and ability to earn a living.
The SSA evaluation is based on the persistence and intensity of your symptoms and whether there is a functionally limiting effect of the symptoms on your ability to work. All the evidence in your case is evaluated, including the consistency of your claims about the extent of your disability or mental impairment.
The examiner considers all the evidence in your case, including the medical evidence you submitted from your treatment team and other acceptable medical sources, like a psychologist or chiropractor. Sometimes, medical opinions are included, too, like expert witness testimony or medical opinion testimony. All of this evidence comes together to prove the severity of your condition and the disabling impact that your pain and other symptoms have on your life.
Factors that Help Establish Credibility
Once the SSA claims examiner determines you have a legitimate impairment, they then look at how your alleged symptoms and pain interfere with your activities of daily living and your ability to perform work. They may consider the following when evaluating the limiting effects of your claim:
- The location, frequency, and duration of your pain;
- The pain’s effect on daily activities, including communication, sitting or standing, and walking;
- The type of medication used to alleviate your symptoms and any side effects;
- Other signs and laboratory findings.
The SSA focuses on objective medical findings using accepted laboratory diagnostic techniques.
How Can I Enhance My Credibility?
When it comes to establishing your credibility to Social Security, your greatest enemy is yourself. Do not make the common mistakes that often lead to denial. Instead, keep the following “best practices” in mind and stick to them if you want to maximize your credibility with the SSA:
- When asked by the administrative law judge to rate your pain, answer honestly. Do not exaggerate, but do not undercut your claim by providing a low number either. If you’re in enough pain to seek disability benefits, chances are your pain is somewhere in the 6-8 region, and you should answer accordingly.
- If your pain symptoms tend to come and go, let Social Security know. Otherwise, they may become suspicious about the inconsistency between your reported activities and your claims of disabling pain.
- Get medical treatment. It’s only logical that a person with chronic pain should be getting medical treatment. Seek help from the appropriate specialists and keep the receipts for any services provided. This way, your claim will have a lot more validity.
- Emphasize your strong work history. It is your job to convince the SSA that you’re not a lazy individual who just wants income without having to work. A consistent record of employment can work wonders in improving your credibility, as well as positive statements from former bosses and co-workers.
Consistency in medical records is key to establishing credibility for your SSDI claim. If your records contain noticeable inconsistencies, whether regarding the nature and duration of your symptoms or their impact on your daily life, then the SSA may view you as less credible. Inconsistencies in your lab records and other medical exams may also call your claim into question.
Even if each medical exam is completed by a licensed physician, if the findings contradict each other, then your entire record may be deemed not credible.
It is highly advised that you consult with a Los Angeles Social Security attorney who has experience in these matters. The right one can help you paint your situation in the most favorable light and get your application for benefits approved.
Contact a Los Angeles Social Security Attorney
The legal advice of a skilled Social Security attorney can help you navigate the SSA benefits claims process. We will review your medical records and advise you of any potential red flags the claims examiner may note. Whether you are just starting the benefits application process or you’ve had your benefits denied and need help with an appeal, Kenton Koszdin Law Office can help. Contact us today for a free SSA disability consultation about your claim.