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How the SSA Evaluates Chronic Pain Conditions in Social Security Disability Claims

Chronic pain conditions are among the most challenging claims to pursue under Social Security Disability (SSD) law. Unlike a broken bone or advanced cancer diagnosis, chronic pain often lacks clear, objective findings that fully explain the severity of a person’s limitations. Yet for many individuals, conditions such as fibromyalgia, chronic migraines, degenerative disc disease, and chronic fatigue syndrome can be completely disabling.

Understanding how the Social Security Administration (SSA) evaluates chronic pain conditions is essential for building a strong disability claim.

Step 1: Establishing a Medically Determinable Impairment

The SSA does not award benefits based on pain alone. The first step in any SSD claim is proving that you have a medically determinable impairment (MDI). This means there must be objective medical evidence—such as clinical examinations, imaging studies, or laboratory findings—from an acceptable medical source supporting the existence of a condition that could reasonably cause your pain.

For example, MRIs showing disc herniation, documented tender points consistent with fibromyalgia, or neurological evaluations confirming migraine disorders can help satisfy this requirement. Without this foundation, the claim will not move forward, regardless of how severe the pain may be.

Step 2: Evaluating the Intensity and Persistence of Pain

Once an impairment is established, the SSA evaluates the intensity, persistence, and limiting effects of the pain. Because chronic pain is often subjective, the SSA reviews:

  • Consistency of medical treatment
  • Frequency of doctor visits
  • Types of medications prescribed
  • Side effects of treatment
  • Efforts to obtain relief (physical therapy, injections, surgery, etc.)

The SSA also considers whether your statements about pain are consistent with your medical records and daily activities. If medical documentation reflects ongoing complaints, treatment adjustments, and physician observations supporting functional limitations, your credibility is strengthened.

Step 3: Assessing Residual Functional Capacity (RFC)

A key component in chronic pain cases is the Residual Functional Capacity (RFC) assessment. The RFC determines what you can still do despite your condition. Even if you do not meet a listed impairment in the SSA’s Blue Book, you may still qualify for benefits if your pain prevents you from performing full-time work.

In evaluating RFC, the SSA looks at your ability to:

  • Sit, stand, and walk for extended periods
  • Lift and carry weight
  • Maintain concentration and pace
  • Attend work consistently
  • Perform repetitive movements

Chronic pain often affects stamina, focus, and reliability—factors that can eliminate the ability to sustain competitive employment. Detailed medical opinions from treating physicians explaining these limitations are extremely valuable.

Step 4: Considering Vocational Factors

If you cannot return to your past work, the SSA considers your age, education, and transferable job skills. For individuals over 50, special medical-vocational rules may apply that make approval more likely if chronic pain significantly limits physical capacity.

Vocational expert testimony may also play a role at a disability hearing, particularly when determining whether jobs exist in significant numbers that accommodate your limitations.

Common Reasons Chronic Pain Claims Are Denied

Many chronic pain claims are denied due to:

  • Insufficient objective medical evidence
  • Gaps in treatment
  • Inconsistent statements about limitations
  • Lack of detailed functional assessments

Because these cases often hinge on documentation and legal strategy, professional guidance can make a substantial difference.

How Legal Representation Can Strengthen Your Claim

Chronic pain claims require careful development of medical records, persuasive legal argument, and strategic presentation of functional limitations. An experienced Social Security Disability attorney understands how the SSA analyzes pain-based impairments and can help ensure that your claim clearly demonstrates not just a diagnosis, but the real-world impact of your condition on your ability to work.

If chronic pain has made it impossible for you to maintain steady employment, you do not have to navigate the disability process alone. The attorneys at Regas & Haag have extensive experience representing individuals in Social Security Disability claims and appeals throughout Ohio. Contact us today for a consultation and let us help you pursue the benefits you deserve.