Evaluating Symptoms in Social Security Disability and SSI Claims

In determining whether a Social Security Disability or SSI claimant is disabled, the Social Security Administration evaluates symptoms, including pain, and the extent to which the symptoms can be accepted as consistent with the objective medical evidence. 20 CFR 404.1529; 20 CFR 416.929. Routinely, the cases are won and lost on the determination of the validity, extent, and effect of a claimant’s symptoms, such as pain and fatigue though a case cannot be without verifiable conditions that reasonably could cause such complaints.

The adjudicator follows a two-step process for evaluating symptoms, such as pain, fatigue, shortness of breath, weakness, or nervousness. First, the adjudicator must consider whether an underlying medically physical or mental impairment could reasonably be expected to produce the claimant’s symptoms. Without such a finding, the symptoms cannot be found to affect the claimant’s ability to work.

Second, the adjudicator evaluates the intensity, persistence, and limiting effects of the claimant’s symptoms to determine the extent to which the symptoms limit the claimant’s ability to do basic work activities. If the claimant’s complaints are not substantiated by objective medical evidence, then the adjudicator must make a finding on the credibility of the claimant’s statements based on the entire record. The regulations provide that a claimant’s symptoms, including pain, will diminish a capacity to work to the extent the limitations can reasonably be accepted as consistent with the objective medical evidence and the record as a whole. When assessing the credibility of a claimant’s statements, the adjudicator should consider:

  1. The claimant’s daily activities;
  2. The location, duration, frequency, and intensity of the individual’s pain or other symptoms;
  3. Factors that precipitate and aggravate the symptoms;
  4. The type, dosage, effectiveness, and side effect of any medication the individual takes or has taken to alleviate pain or other symptoms;
  5. Treatment, other than medication, the individual receives or has received for relief of pain or other symptoms;
  6. Any measures other than treatment the claimant uses or has used to relieve pain or other symptoms; and
  7. Any other factors concerning the claimant’s functional limitations and restrictions due to pain or other symptoms.

In evaluating credibility, the SSA looks at observations of the claimant records by SSA employees, consistency of complaints, medical evidence like medical treatment history, and other sources of information such as public and private agencies, other practitioners, and nonmedical sources like family and friends.

If you need more information about a personal injury matter (car wreck, boating accident, slip and fall, etc.), Social Security Disability or SSI matter, EEOICPA claim, or a workers compensation matter, please contact the Law Offices of Tony Farmer and John Dreiser for a free case evaluation. We can be reached at (865) 584-1211 or (800) 806-4611, or through our website. Our office handles claims throughout East Tennessee, including Knoxville, Chattanooga, Kingsport, Bristol, Johnson City, Morristown, Maryville, Rogersville, Dandridge, Tazewell, New Tazewell, Jefferson City, Strawberry Plains, Sevierville, Gatlinburg, Loudon, Kingston, Halls, Maynardville, Crossville, Cookeville, Jamestown, Sweetwater, Lenoir City, Athens, Oak Ridge, Clinton, LaFollette, Lake City, Jacksboro, Bean Station, Cosby, Newport, White Pine, Mosheim, Wartburg, Sunbright, Pigeon Forge, and Deer Lodge.

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