Tuesday, January 23, 2007

Social Security Disability SSI and Pain

In the past, I've posted on this blog about back pain and have even posted about my own back problems and the pain that ensues whenever I wind up in bed for several days at a stretch (usually caused by a seemingly innocent chain of events such as A. dropping an envelope, B. bending over too quickly to pick it up, and C. experiencing and perhaps even hearing a crunching phenomenon, and D. going to bed with muscle relaxants and pain killers).

Well, here we are again. Several days ago, I was wrapping up a several-day-long project regarding a website and had probably been sitting at the computer desk for four or five hours without taking a break. I turned my head to the left and heard "crunch". Well, as they say in various parts of the country "that was all she wrote". The rest of that day could be described as a precipitious decline in posture and mobility. By nightfall, I was moving about like Igor and wincing every time I turned to look at something. Flexeril, pain killers, none of it seemed to help much (though I wouldn't have taken a pass on any of them). I couldn't even get away from the pain in my sleep, as it kept me tossing and turning, and that's been the case for several days.

Of course, this situation is temporary. Eventually it will "work itself out" and everything will be back to normal. However, what if it didn't get back to normal? What if it simply went on and on, with no forseeable relief in sight? I have no doubt that it would become extremely depressing and anxiety provoking very quickly.

Now, what's the point of this. Here it is: as a social security disability examiner, I saw cases like this all the time. And I certainly don't mean situations like mine, which will resolve over just a few days of taking it easy. I'm talking about chronic pain cases involving degenerative disc problems, RSD, fibromyalgia (and a number of other conditions which I won't list) and simply chronic pain by itself. How much consideration does the social security administration give to "pain". Sadly , not much at all.

This is partly the fault of doctors (treating physicians) who fail to document the limiting effects of pain in their treatment notes (and, in general, doctors fail to note functional limitations in their records), and the fault of the social security administration in failing to address pain and the limitations caused by pain.

How could SSA address something which a disability claimant's own doctors may have done little to document? Sending a medical source statement--also known as an RFC, or residual functional capacity form--to a claimant's treating physicians at the initial claim or reconsideration level might be a good way to start.

Unfortunately, this is not something that SSA instructs disability examiners to do (Cost may be a factor since doctors are less likely to complete such forms without receiving compensation for their time. Likewise, SSA would probably be forced to pay on more claims if RFC forms were routinely sent out as a matter of case processing).

However, claimants can take an active role in this regard by requesting that their treating physician(s) complete on their behalf a detailed statement regarding their medical condition and functional limitations. And if severe and unrelenting pain is a factor in a claimant's inability to work, there's no reason why this cannot be addressed in the physician's statement. Claimants who make such requests of their doctor(s) should, of course, explain the need for providing detail in describing mental or physical functional limitations.

Return to the Social Security Disability SSI Benefits Blog

Other Posts

Checking the credentials of a Social Security Disability Lawyer
Disability Benefits for Mental Illness (bipolar disorder, schizophrenia, depression)
Overpayment owed to Social Security Administration


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