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Social Security Disability Insurance (SSDI) - Do You Qualify?

Part 2 of 2 - Qualifying for SSDI

By

Updated June 27, 2014

The Standard of "Pain"

In 1984, Congress passed the Social Security Disability Benefits Reform Act, which defined the standard of judgment on pain. It stated that:

"An individual's statement as to pain or other symptoms shall not alone be conclusive evidence of disability as defined in this section; there must be medical signs and findings established by medically acceptable clinical or laboratory diagnostic techniques which show the existence of a medical impairment that results from anatomical, physiological or psychological abnormalities which could reasonably be expected to produce the pain or other symptoms alleged".

Though this act had an expiration date of 1986, it became the standard of judgment. In 1988, Social Security ruled there need not be objective evidence of the degree of pain.

Factors Used in the Judgement of Pain

Several factors are used in the standard judgement of pain including:

  • the nature of the pain
  • locations
  • onset
  • duration
  • frequency
  • radiation
  • pain intensity

Other Factors

Other factors which must be considered in determining proof of pain include:

  • what causes the pain and makes it worse
  • name, dosage, effectiveness, and side effects of pain medications
  • treatment for pain relief other than medications
  • functional restrictions
  • daily activities

Other Symptoms and Health Problems

Many other health problems can directly interfere with an individuals ability to work. These effects are also given consideration in the disability determination process. Factors considered can include health problems such as:

Listing of Impairments

The specific list of severe impairments used by the Social Security Administration to decide disability cases from Social Security Disability Determination (The Blue Book).

Arthritis is considered under the Musculoskeletal Body System and has several specific medical listings or categories.

1.00 Musculoskeletal System

1.01 Category of Impairments, Musculoskeletal

1.02 Active rheumatoid arthritis and other inflammatory arthritis

1.03 Arthritis of a major weightbearing joint (due to any cause)

1.04 Arthritis of one major joint in each of the upper extremities (due to any cause)

1.05 Disorders of the spine

1.08 Osteomyelitis or septic arthritis (established by X-ray)

14.00 Immune System

14.01 Category of Impairments, Immune System

14.02 Systemic lupus erythrematosus

14.04 Systemic sclerosis and scleroderma

Problems to Overcome in Receiving Social Security Disability Benefits

More than one million people file for disability benefits with the Social Security Administration each year.

Do You Need Representation?

Though initially designed to make it easy for people to represent themselves, it did not take long for representatives to become involved in the disability process. Representation in a Social Security Disability case can be valuable since:

  • learning the details of the system can be difficult.
  • rules are increasingly complex.
  • experts know the details of the process.
  • experts may improve your odds of winning disability benefits.

Applying for Social Security Disability Benefits - 5 Part Self-Help Guide

This five-part guide is a practical approach to the Social Security disability application process for the disabled person who is thinking about applying and plans to do it without a representative.

There are steps you can take to give yourself the best chance for a favorable decision on your initial claim, thereby avoiding the lengthy appeals processes. This will involve some effort, and success is not guaranteed. You will help yourself by doing your part to present your case as strongly as possible.

Sources: SSA Publication No. 05-10029, 5/1996; How to Apply for and Win SSA Disability Benefits, 1997 3rd Edition, by Frederick A. Johnson

Back to Part 1 --- Social Security Disability Insurance: Do You Qualify? --->

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