Your Credibility and Disability: How Inconsistent Statements and Medical Treatment Hurt Your Claim

(Page 2 of 2 "Your Credibility and Applying for Disability")

How Inconsistent Statements Can Hurt Your Claim

One of the most important factors when Social Security assesses credibility is whether the disability claimant’s statements are consistent. The SSA will look at the consistency of statements that the claimant made to the SSA, doctors, or to any one else from whom the SSA may get information (for example, if the claimant applied for veteran’s benefits as well, the SSA can get information from the VA).

Inconsistent statements are a red flag to the SSA that a claimant is being untruthful about his or her condition. Here are some examples of inconsistent statements that indicate a claimant is exaggerating symptoms.

Example 1

The claimant claimed she couldn't work due to back pain and said that she could not sit or stand for more than a few minutes at a time. However, during her disability hearing, she testified that she routinely used public transportation to shop, run errands, and attend doctor’s appointments.

Example 2

The claimant filed for disability based on arthritis in both knees and hands. On the claimant’s application, he stated that he was unable to walk without the assistance of a cane and that he needed help buttoning clothes and tying shoes. The claimant’s treating physician, however, noted that shortly before his hearing, the claimant made statements to the doctor that indicated he had undergone improvement since beginning treatment and that he was now able to get dressed without assistance and only occasionally required his cane. This casts doubt on whether the claimant's difficulties are still disabling.

Example 3

In another case, a claimant alleged that her anxiety was so intense that she rarely left her house. However, the claimant’s psychiatric records included statements made to her psychiatrist that she was able to attend church every week, do her own grocery shopping, and occasionally take walks with her neighbor.

Example 4

The claimant filed for disability based on diabetic neuropathy in her legs and feet. She testified that she was unable to work because sitting for more than a few minutes at a time aggravated her symptoms and increased her pain. However, when the ALJ asked what types of activities the claimant enjoyed doing she testified that she enjoyed making clothes on her sewing machine, an activity that requires the ability to sit more than a few minutes at a time.

All of the claimants in the above examples were denied disability because of their inconsistent statements. It is important to be honest in all statements about your pain or other symptoms regardless of who you are speaking to. For information on what to do if you have inconsistent evidence in your medical records (such as different opinions by different doctors), see our article on how disability attorneys deal with medical evidence.

Lack of Medical Treatment or Inconsistent Medical Treatment

Gaps in a claimant’s medical history -- that is, periods of time when the claimant didn't visit a doctor -- may affect his or her credibility. This is because the SSA may think that the claimant's medical condition was not serious enough to need help. However, the SSA will consider the claimant’s explanation for the gap when assessing credibility. Here are some examples where lack of medical treatment did not affect the claimant’s credibility.

Example 1

The claimant suffered from severe bipolar disorder that prevented him from working. He had been successfully treated by a psychiatrist for many years until his employment was terminated and he lost his insurance. Although he began treatment again shortly before filing his claim, he had no medical treatment during the months he lacked coverage. Since the claimant provided evidence to the SSA that he was without insurance during this time period, his credibility was not affected.

Example 2

In another case, a claimant suffered from chronic migraines. After trying numerous medications prescribed by her neurologist, the claimant was prescribed a medication that successfully treated the headaches. However, shortly after beginning treatment, the claimant developed an allergic reaction to the medication and was forced to stop the treatment. The SSA considered this when evaluating her claims about her pain, and the agency concluded that her statements about her pain were credible.

Example 3

The claimant suffered from carpal tunnel syndrome in both hands. She had undergone surgery and physical therapy, but tests still indicated significant nerve damage. In addition, the claimant had taken pain medication and a nerve blocker that was only minimally effective. Her treating physician eventually advised her that there was nothing else that could be done to treat her pain; therefore, the claimant stopped treatment for her hands.

In all three examples above, the claimants effectively explained to the SSA why there were periods of time where they didn’t seek treatment. The gaps in medical treatment, therefore, did not affect their credibility. For more information on how to deal with gaps in medical treatment, see our article on developing medical evidence when you haven't see a doctor.

Factors That Help Your Credibility

The SSA will also use the following to assess the credibility of a claimant’s statements about his or her symptoms.

Showing Symptoms at the Hearing

An ALJ will pay close attention to the claimant’s body language during a hearing. For example, in one case a claimant filed for disability due to a back injury. The ALJ observed that the claimant frequently shifted in his chair and stretched his legs. The claimant also asked to be able to occasionally stand. In this case, the claimant’s body language during the hearing convinced the ALJ that his statements about pain were truthful. However, a judge is not allowed to hold it against you if you don't show any signs of pain or discomfort during the hearing because this could encourage claimants to exaggerate or even fake symptoms. (This is called the "sit and squirm" principle.)

Work History

The SSA will give more credence to a claimant who has a long work history. For example, in one case, the claimant filed for disability based on emphysema and chronic bronchitis. The claimant had worked with the same company as a welder for over 20 years. The SSA considered his long-term employment as evidence that he was a hard worker and that the claimant’s statements about his breathing difficulties were credible.

Unsuccessful Work Attempts

If, before you filed a claim for disability, you tried to do different kinds of work to avoid having to apply for benefits, this will reflect well on the validity of your claims. For instance, if you had to quit your job as a delivery truck loader because of back pain, but you tried to work as a driver and dispatcher for a couple of months each, this shows you were trying to work but couldn't (and having worked won't hurt your claim because the work will count as an unsuccessful work attempt).

Reluctance to Apply

Another factor the SSA will consider is the claimant’s attitude about applying for disability. For example, in one case, a claimant applied for disability based on severe mental illness including anxiety and depression. During her hearing, the claimant expressed embarrassment because of her inability to work. She also testified that she had lived off of savings and only applied for disability as a last resort. These statements gave additional credibility to her statements about the effects of her condition on her ability to work by showing she wasn't just trying to get out of working.

Getting the Help of a Disability Attorney

Credibility is especially important if you suffer from symptoms that are hard to document with objective medical evidence. If you have a condition that involves subjective complaints like chronic pain, back pain, migraines, carpal tunnel syndrome, fibromyalgia, chronic fatigue syndrome, or various other syndromes, having good credibility is critical to your case. Simply put, if the SSA believes you are being untruthful or exaggerating your symptoms, you will be denied. To avoid this, ask an experienced disability attorney to review your case so that you can ensure the best possible outcome.

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