People with somatic symptom disorder (also called somatoform disorder—this article uses both terms interchangeably) experience physical pain for which no cause can be identified. While establishing a diagnosis of somatoform disorder can be challenging, if you have well-documented symptoms that keep you from working full-time, you may qualify for disability benefits.
Somatoform disorder is characterized by physical symptoms that aren't intentionally produced and can't be fully explained. The exact cause of somatoform disorder is unknown, but doctors think that genetics and environmental factors play a role.
People with somatoform disorder may have the following symptoms, which typically get worse with stress and anxiety:
According to the National Institute of Health, people with somatoform disorders may experience and process pain differently than those without the disorder. Many people with the disorder are preoccupied with having a serious medical condition that hasn't been diagnosed yet.
Yes, when the disorder is severe enough to keep you from working full-time for at least one year. The Social Security Administration (SSA) can award you benefits in one of two ways—by finding that you meet the Blue Book listing for somatic symptom disorder, or by determining that your symptoms prevent you from doing any jobs.
Social Security's "Blue Book" contains a list of impairments that the agency considers especially severe. If you have medical documentation of specific criteria stated in the listing, the SSA will award you benefits without having to decide whether you can work.
Somatic symptom disorder is a listed impairment. The criteria that the agency uses to evaluate somatoform disorder can be found under listing 12.07. You can meet the listing with evidence of one of the following:
In addition to the above diagnostic criteria, the SSA also needs to see that your somatic symptom disorder causes an "extreme" limitation in one, or a "marked" limitation in two, of the following functional areas:
Having an "extreme" limitation is worse than having a "marked" limitation. Whether your limitation is extreme or marked generally depends on how well you can perform the activity independently. Consider asking your doctor to write a letter to the SSA that describes the degree in which you're limited in the above areas.
Even if your somatic symptom disorder doesn't meet the requirements of listing 12.07, you can still win your case. You'll need to show that no jobs exist that you can do despite your somatic symptom disorder—in Social Security terms, you have a residual functional capacity (RFC) that rules out all work.
Your RFC is a set of restrictions on what you can and can't do in a work environment. Social Security looks at your medical records, doctors' opinions, and self-reported daily activities to determine what limitations should be included in your RFC. The agency then compares your RFC with the demands of your past work to see whether you could still do that job today and, if not, whether you could do any other jobs.
It's important to make sure that your RFC accurately reflects all the restrictions you have, physical and mental, on your ability to work. (Remember that if the agency thinks you can still do your old job, or any other less demanding job, your disability claim will be denied.) The more limitations you have in your RFC, the more likely it is that no jobs exist that you can do.
Because the symptoms of somatoform disorder are mostly subjective—meaning they don't show up on medical imaging or lab results—people with the condition may face an uphill battle getting the SSA to agree that they have a medically determinable impairment. So it's especially important to have a solid medical foundation when applying for disability benefits due to somatic symptom disorder.
You'll increase your odds of winning if you provide extensive documentation of your struggles with, and treatment for, somatoform disorder. Make sure the SSA has the following information:
You may want to ask your friends, family, or even former employers to write a letter to the SSA explaining how your somatic symptom disorder affects your life. Helpful witness statements may convince a claims examiner or disability judge who is on the fence about your claim to award you benefits.
"Malingering" is the medical term for faking or exaggerating symptoms, often for some material benefit. People with somatic symptom disorder can run the risk of being labeled as a "malingerer," due to the lack of objective evidence supporting their symptoms.
Fortunately, doctors can usually tell the difference between malingering and somatic symptoms, but not always. Typically, if a doctor thinks you're malingering, they will mention it in your clinical notes. If you don't have a mention of malingering in your record, you can breathe easier—but it's still a good idea to get your doctor to say in writing that you're definitely not malingering.
"Doctor shopping" involves going to multiple physicians looking for medications or trying to get a diagnosis that will help win a disability claim. The SSA frowns at doctor shopping, and if you've seen many doctors in a short period of time, the agency can view it in a negative light.
However, it's not unusual for people with somatoform disorders to see multiple physicians over several years in an effort to get a correct diagnosis or proper treatment for their symptoms. While this shouldn't be considered doctor shopping, the SSA may wrongly interpret it that way. You can avoid accusations of doctor shopping by making sure that you try and stay with one doctor as much as you can. Consistent treatment and a strong doctor-patient relationship are important factors in winning your claim.
Social Security has several methods you can use to start your application for disability benefits:
With a somatic symptom disorder, you'll likely be denied benefits initially and need to appeal to an administrative law judge. Winning a disability hearing with somatic symptom disorder isn't easy, but it can be done. Consider speaking with an experienced disability attorney before you attend your hearing—our survey results show that your odds of winning increase considerably with representation.
Updated February 29, 2024