An important part of your Social Security disability claim is being able to show that your medical complaints (such as pain from a physical condition or hallucinations from a mental impairment) are supported by substantial evidence. Because such complaints are subjective by nature, Social Security needs to see that the intensity and persistence of your symptoms can reasonably be expected given your medical history.
Until 2016, Social Security referred to these symptom evaluations as "assessing the credibility" of a claimant's (applicant's) statements. However, the word "credibility" made it sound like Social Security was making a character judgment, so the agency stopped using the term. But even though Social Security no longer officially evaluates your credibility, you'll still need to make sure that complaints about your symptoms are accurate, truthful, and proportionate to the medical care you've received.
Under Social Security Ruling SSR 16-3p, the agency considers all of your self-reported symptoms and complaints to the extent that they're reasonably consistent with the evidence in your medical record. Consistency is determined by a number of factors. Here's a look at some of the main factors that Social Security considers, along with examples of how those factors are applied.
Social Security isn't allowed to approve a disability claim based on self-reported complaints alone. The agency needs to see that you have medical records (like blood tests, MRIs, or mental status evaluations) that show that you have a condition that could cause your symptoms. In Social Security lingo, this is called "having a medically determinable impairment."
Once Social Security determines that you have a medical condition that can be expected to cause your symptoms, the agency will next look at statements and observations made by your friends and family, your medical providers, and your employers in order to better understand how your symptoms limit your activities of daily living.
Because most people don't go to the doctor unless something's wrong, receiving ongoing care alerts Social Security that your condition is severe enough to require medical attention. And if you're still experiencing symptoms despite following "doctor's orders," that signals to the agency that your complaints should be taken seriously—even though you made the effort, your symptoms didn't respond to treatment.
Not every instance of inconsistent compliance with treatment is necessarily damaging to your case, however. Social Security is aware that medical treatment can be prohibitively expensive, and doesn't expect you to pay for a treatment that you can't afford.
Social Security wants to see that you're generally telling the same things to different people. That doesn't mean that you can't have "good" days and "bad" days, but broadly inconsistent statements are a red flag that an applicant isn't telling the whole truth—which can be very harmful to a disability claim.
While the above factors focus mainly on your medical record, other non-medical factors can help sway a disability judge or claims examiner who is on the fence about your case.
Judges pay close attention to claimants' body language during a hearing. Hearings tend to last between 30 and 60 minutes, which can be difficult for claimants who can't sit for that long. If the judge notices that you're frequently shifting in your chair or if you ask to get up and stretch your legs, the judge may be more likely to believe that you're in too much pain to do a desk job.
The same goes for claimants with mental impairments who struggle to answer basic questions, beyond the normal nervous chatter or clam-up. Bursting into tears when the judge asks you when your birthday is may demonstrate that you'd be unable to respond to even gentle criticism from a manager at work.
Keep in mind that if you don't show any signs of distress during the hearing, the judge isn't allowed to hold it against you, because that could encourage claimants to exaggerate their symptoms. (This is called the "sit and squirm" principle.)
Social Security considers your work history as part of your disability claim. Broadly speaking, claimants with a long, consistent history of employment are given the benefit of the doubt. Because SSDI and SSI don't pay very much (the average monthly SSDI benefit in 2023 is $1,483, while SSI caps out at $914), the agency assumes that most claimants who are used to earning more than that amount would rather return to work if they could.
But for some mental impairments, the opposite is true—having a consistent work history can show that you're reliable enough to maintain regular employment despite your mental health disorder. If you can't hold down a job for longer than a month or you've been fired from many jobs due to conflicts with coworkers, that may (in some cases) strengthen the argument that your symptoms prevent you from working full-time.
Say you were a delivery truck loader for many years but had to quit because of your back pain. As bills start piling up and your pain doesn't improve, you start looking for easier jobs. You work for three months as a driver and two months as a dispatcher before filing your claim for disability benefits. Social Security will consider your time as a driver and dispatcher to be "unsuccessful work attempts."
Unsuccessful work attempts can strengthen your case because they show that you tried to return to work, but couldn't. They can be particularly helpful if the jobs you tried were less stressful or less physically demanding than the type of work you're used to, since Social Security usually needs to see that you can't do other work before the agency can award you benefits.
Social Security is more likely to take your complaints at face value if you've exhausted all other options before applying for benefits. The agency is aware of negative stereotypes about the disability program, and showing that you didn't file for benefits at the drop of a hat is a good way to establish that you're serious about being unable to work.
One example is filing multiple initial applications for disability benefits. While many claimants do file more than one application—usually because they got discouraged after an initial denial or missed the appeal deadline—having three or more applications on the same record can give a negative impression that you're more interested in getting disability than finding work.
Applying for disability can seem like an uphill battle, especially if you have symptoms that are hard to document with objective medical evidence. Consider hiring an experienced disability attorney to review your case and help you address any weak spots in your application, such as:
Your lawyer will work with you by handling all communications with Social Security, keeping on top of appeal deadlines, and preparing you for a disability hearing.
Updated October 2, 2023