Assessment of Pain
By the Social Security
Administration
Many denial letters
from the Social Security Administration and its State Agencies improperly apply
(or completely ignore) the requirements of Social Security Administration
Ruling SSR 96-7p.�
This ruling sets
forth criteria for assessing the credibility of a claimant's statements about
symptoms and their effects. Specifically, it requires the Social Security
Administration to consider
(1) the individual's
daily activities;
(2) the location,
duration, frequency, and intensity of the individual's pain or other symptoms;
(3) factors that
precipitate or aggravate the symptoms;
(4) the type, dosage,
effectiveness, and side effects of medication;
(5) treatment other
than medication the person receives for pain or other symptoms;
(6) any measures
other than treatment the person has used to relieve pain; and
(7) any other factors
concerning the person's functional limitations and restrictions due to pain or
other symptoms.
An unfavorable
decision must contain a credibility determination whether the Social Security
Administration thinks the claimant is or is not credible.� Thus, the Ruling states that in setting forth
a decision it is not enough for the Social Security Administration to make a
conclusory statement such as "the allegations have been considered,"
or "the allegations are (or are not) credible."� Neither is it sufficient to simply set forth
the factors described in the regulations.�
Rather, the decision must set forth the "specific reasons for the
finding on credibility, supported by evidence in the case record, and must be
sufficiently specific to make clear to the individual and to any subsequent
reviewers the weight the adjudicator gave to the individual's statements and
the reasons for that weight." The ruling essentially restates the
requirement that decision makers build an accurate and logical bridge from the
evidence to the conclusion, and that they state which of a claimant's
complaints are being rejected and why such complaints were unsupported by the record.
Recent publications by the Social Security
Administration (when changing the Musculoskeletal Listings) make this point
clear: objective evidence of severity of pain is not required.
. . . Our intention is
to make sure that no one has the erroneous impression that there must be
objective medical findings that directly support the severity of a person's
pain.� 66 FR 58013
The new language, . . .
clarifies that there need only be medical signs or laboratory findings that
show the existence of a medically determinable impairment which could
reasonably be expected to cause pain or other symptoms for these symptoms to be
found to affect an individual's ability to perform basic work activities.� 66 FR 58013
Considering pain as a
factor in an individual's loss of function is consistent with � � 404.1529 and
416.929 on evaluation of symptoms, including pain. Because the language in
these final regulations is consistent with the current regulatory language
regarding pain and other symptoms, it should not affect documentation
requirements or practices, nor do we see any need for further clarification of
the pain standard.� 66 FR 58028
We do not see lack of
objectivity as an issue. A claimant's own statements about his or her
functioning have always been factored into a decision, because symptoms are the
claimant's statements about how impairment affects the individual. We base
disability determinations and decisions on all of the evidence in file,
objective and subjective, and we consider whether there are any conflicts
between the objective evidence and the claimant's own statements. 66 FR 58028