Your Credibility and Applying for Disability: How Social Security Assesses Your Complaints

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.

Factors Social Security Uses to Assess the Reasonability of Your Complaints

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.

Do You Have a Medically Determinable Impairment?

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."

• Lila filed for disability because of back pain. In her application, she alleged that she wasn't able to stand for longer than 30 minutes at a time because of numbness, tingling, weakness, and pain in both of her legs. However, Lila wasn't taking any medications, had a normal range of motion on her physical exam, and her MRIs and X-rays were all normal. Social Security didn't find that Lila had a medically determinable impairment.
• Abe filed for disability due to anxiety. Abe reported in his application that he was unable to work because he experienced panic attacks that kept him from leaving the house. Abe provided records of weekly counseling sessions with a therapist and a prescription for anxiety medications from a psychiatrist. Social Security concluded that Abe's anxiety is a medically determinable impairment.

What Do Others Have to Say About Your Condition?

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.

• Dottie filed for disability based on rheumatoid arthritis, which affected her hands. Because she could no longer type without pain, Dottie had to quit her job as a medical transcriber. Dottie's supervisor wrote a letter stating that he had witnessed Dottie struggle to keep up with her workload as her hands became more swollen with arthritis. Social Security found that the supervisor's letter supported Dottie's own statements about her symptoms.
• Peter filed for disability due to ongoing pain in his hands following a carpal tunnel release. Peter's doctor noted that his grip strength had improved after the surgery and that he was able to make a fist without difficulty. During a consultative examination, Peter was observed sending lengthy text messages and had no trouble completing multiple forms with a pen. Social Security found that these observations made Peter's statements about his pain less believable.

Have You Been Seeing a Doctor Regularly and Complying With Treatment?

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.

• Claudia applied for disability due to chronic migraines. Claudia's medical records contained a wellness visit where she complained about unbearable pain and nausea. Her doctor prescribed Claudia an anti-inflammatory medication and asked that she return in three months to see if she felt better, but Claudia didn't fill the prescription and didn't see her doctor until next year. Social Security didn't find Claudia's complaints of debilitating migraines believable.
• Javier filed for disability due to PTSD. In an effort to control his symptoms, Javier enrolled in an intensive outpatient program that he attended weekly. He was also compliant with his medication and met with his psychiatrist and therapist weekly. Social Security found Javier's consistent treatment to be supportive evidence of his mental limitations.

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.

• Gary applied for disability based on bipolar disorder. Gary had been successfully treated by a psychiatrist for many years until his employment ended. Gary couldn't afford the COBRA premiums needed to keep his insurance coverage, so he had to go without his medication for several months. Because Gary had a good reason why he wasn't following his treatment, Social Security didn't hold this period of noncompliance against him.

Are Your Statements Consistent?

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.

• Wendy applied for disability due to depression. In her application, Wendy reported that she was unable to get out of bed most days. Wendy's medical records included statements she made to her psychiatrist that she stopped attending her weekly book club, had her groceries delivered instead of going to the market, and no longer went on daily walks with her neighbor. Social Security found that Wendy's consistent statements supported the severity of her symptoms.
• Moe applied for disability based on diabetic neuropathy in his hands and feet. At his disability hearing, Moe testified that he couldn't stand for more than a few minutes or move small objects around. But when the judge asked if Moe had any hobbies, he said he enjoyed woodworking and playing pickleball, activities that require frequent fine manipulation and lower extremity movement. The judge didn't find that Moe's testimony was consistent with a finding of disability.

Factors That Help Strengthen Your Case

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.

Showing Symptoms at the Hearing

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.)

Having a Work History That Supports Your Claim for Disability

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.

Having Unsuccessful Work Attempts

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.

Applying for Disability as a Last Resort

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.

Getting the Help of a Disability Attorney

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:

• not having enough (or not having the right kind of) medical evidence
• not following treatment recommendations
• a history of drug or alcohol dependency, or
• difficulty accessing medical treatment.

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}