Yes, it is possible to qualify for Social Security Disability Insurance (SSDI) when you have chronic pain. However, this is hardly a foregone conclusion. It depends on the underlying condition, its severity, and your limitations. Chronic pain can feel debilitating, but the Social Security Administration may conclude you can have a sedentary job. The skilled Boston disability attorneys at Keefe Disability Law can improve the chances the SSA will approve your claim.
Chronic Pain Conditions That May Qualify
Self-reported levels of chronic pain are not enough to qualify for disability benefits. The subjective experience of chronic pain cannot be objectively measured. So, the symptom of pain must be connected with a medical condition.
While a confirmed diagnosis on its own won’t qualify you for SSDI either, applicants with the following conditions associated with chronic pain may be eligible for benefits:
- Carpal tunnel syndrome
- Certain types of arthritis
- Chronic regional pain syndrome
- Ilioinguinal neuralgia
- Peripheral neuropathy
- Reflex sympathetic dystrophy (RSD)
- Somatoform pain disorder
By no means is this list exhaustive. People with a wide array of conditions may suffer from chronic pain. The SSA looks for medical records pointing toward a severe medically determinable impairment (MDI). Discuss the matter further with the Social Security disability lawyers at Keefe Disability Law. We can assess your case and offer insight into your SSDI eligibility prospects.
Meeting Blue Book Listing Requirements
The Social Security Administration (SSA) maintains a Blue Book that outlines qualifying disabilities. For each condition, it provides specific criteria to meet that listing’s requirements. Applicants who meet one of these Blue Book listings may qualify for disability benefits.
For example, Blue Book Section 14.09 describes inflammatory arthritis. This falls under a larger category of adult immune system disorders. Among the ways to meet the listing requirements for inflammatory arthritis, the applicant must have:
- Persistent inflammation or deformity of one or more major peripheral joints in a lower extremity
- A documented medical need for a walker, bilateral canes, or bilateral crutches
- Persistent inflammation or deformity of one or more major peripheral joints in each upper extremity
- Medical documentation of an inability to use both upper extremities to independently initiate, sustain, or complete work-related activities involving fine and gross movements
The section also provides other ways to meet the listing requirements. Notably, “chronic pain” is not one of the criteria. It is only a symptom that may point toward a related condition or disability. Other examples include section 11.00 for neurological disorders and section 12.07 for somatoform disorders.
Equaling Criteria With an RFC Assessment
Along with meeting the criteria in a specific Blue Book listing, applicants can equal a qualifying condition too. Some SSDI applicants may suffer from multiple medical conditions. They may not meet the listing criteria for any one condition. But, their combined effect can be adequately disabling to qualify for disability benefits.
When the SSA evaluates a claim, it often requires a residual functional capacity (RFC) assessment. This looks at physical and mental limitations that could prevent someone from being able to work. The results of an RFC assessment may point toward “less than sedentary” levels of ability. If this is the case, you may qualify for SSDI with chronic pain even if you had a sedentary job before your disability.
How the SSA Defines Sedentary Work
A major hurdle you may face is, despite your chronic pain, the SSA may believe you are still capable of sedentary work. This is a greater challenge for younger applicants than older SSDI applicants. The SSA assumes younger applicants can more easily receive additional training or education. They can also pivot more easily to other careers than older people.
Notably, the SSA does not restrict sedentary work only to jobs where you are seated for the entirety of a standard eight-hour workday. Rather, while sedentary jobs are mostly seated, they may require some physical activity and ability. The Social Security Code of Federal Regulations § 404.1567 describes these physical exertion requirements:
- Standing or walking up to two hours per day
- Lifting up to 10 pounds at a time
- Carrying light objects like folders and small tools on occasion
If you are unable to do any of these things, you may be eligible to receive SSDI benefits.
Proving the Limitations of Your Condition
Because chronic pain, in and of itself, will not qualify for SSDI benefits, you must prove that your medical condition prevents you from being able to work. This includes showing that you can’t even do sedentary work, including your past job. The way to prove you are disabled is through compelling medical evidence.
The SSA denies many SSDI claims due to lack of medical evidence. A skilled Massachusetts disability attorney can help you gather this evidence and present a compelling case to the SSA. You must show that your disability is expected to last for at least 12 months or result in death. The limitations on your ability to work must persist through your eligibility period.
For instance, you may be unable to lift 10-pound objects due to debilitating arthritis. In addition to chronic pain, you may lack the strength or dexterity in your hands to do this task. Similarly, you may only be able to walk short distances while suffering excruciating pain and using a cane. It would be unreasonable to think you could do this for up to two hours daily. Being unable to sit for six out of eight hours is another example.
Getting Your SSDI Application Approved
The harsh reality is that the SSA denies most SSDI claims initially. To improve the chances they approve your claim, work with a disability attorney who can help you complete your application. This is especially important if you have an invisible disability. They can be harder to prove, and building a compelling body of medical evidence is crucial. Your lawyer can recommend what medical records and supporting documents you may need.
Should the SSA deny your claim, your attorney can help you appeal the SSDI appeal process. They can help you prepare for court hearings with the administrative law judge (ALJ). That way, you can improve the chances the ALJ renders a favorable outcome.