How Social Security Evaluates Chronic Pain in Disability Claims

Chronic pain is ongoing or recurrent discomfort that continues longer than expected beyond the usual recovery period from an injury or illness. Chronic pain can occur in any area and is often associated with back problems, headaches, arthritis, and fibromyalgia, among other conditions. If you have ongoing pain without a specific physical cause (etiology), you may be diagnosed with complex regional pain syndrome—also known as reflex sympathetic dystrophy—or somatoform disorder.

When accompanied by an impairment such as peripheral neuropathy, ilioinguinal neuralgia, or carpal tunnel syndrome, chronic pain can form the basis of a successful Social Security disability claim. But in order to qualify for disability benefits, your medical records must establish a source of chronic pain that keeps you from working full-time for at least one year. Simply stating that you experience pain won't be enough by itself to get benefits, so it's important to know what your records should contain in order to win your disability claim.

When Is Chronic Pain a Disability?

Chronic pain can prevent you from engaging in substantial gainful activity, an earnings level that the Social Security Administration (SSA) considers full-time work. For the SSA to find you disabled, your medical records first need to show that you have a medically determinable impairment that causes your chronic pain. Then, your records must include evidence that demonstrates functional limitations severe enough to either meet a "listing" or rule out all jobs.

Evidence Showing That You Have a Medically Determinable Impairment

"Medically determinable" impairments are health conditions that can be documented by clinical techniques such as lab tests, physical examinations, or objective imaging. (20 C.F.R. 404.1521) (2025). The SSA looks at your records for evidence that you have a physical impairment that could be "reasonably expected" to produce pain. An X-ray of your spine that shows disc degeneration in your lower back, for example, would be sufficient to establish that you have a medically determinable impairment that causes pain.

Showing that you have a medically determinable impairment is just one step in qualifying for disability, however. Because many people have medically determinable impairments that produce no symptoms or are easily treated with basic remedies, the SSA will need to see additional evidence that your chronic pain interferes with your life in a more consequential way.

Evidence Showing That You Meet a Listing

Social Security maintains a "Blue Book" of medical impairments that the agency considers especially severe. If your chronic pain is very intense, you may qualify for disability automatically based on the underlying condition provided that it's one of the "listed impairments" in the Blue Book. Rheumatoid arthritis, for example, is evaluated under listing 14.09 for inflammatory arthritis, while nerve damage in the spine may be addressed by listing 1.15 or listing 1.16 for nerve root compression.

Getting disability automatically by meeting a listing is difficult by design. You'll typically need to have a strong medical record with lab test results below certain specific values or other objective evidence that shows you have a significant loss of physical functioning. But even if you don't meet (or equal) the requirements of a listing, you can still qualify for benefits if your chronic pain keeps you from performing any job on a regular basis.

Evidence Showing That Your Residual Functional Capacity Rules Out Work

Most people who are awarded disability benefits are able to show that they have a residual functional capacity (RFC) that prevents them from working full-time. Your RFC is a paragraph describing your maximum physical and mental capabilities. It represents Social Security's assessment of the most you're safely capable of doing in a work environment despite your pain.

Your RFC might include exertional restrictions on how long you can sit, stand, and walk, as well as how much weight you can lift and carry. Because chronic pain often affects your ability to concentrate, your RFC may also contain non-exertional limitations on the type of mental tasks you can perform. Social Security will compare your current RFC with the demands of your past work to see whether you do those kinds of jobs today. If not, the agency will then see whether other jobs exist that you can still do despite the restrictions in your RFC.

If you're younger than 50 years old, you'll typically need an RFC for "less than sedentary work" in order to be found disabled. But if you're 50 years of age or older, you may have an easier time qualifying for benefits under a special set of rules known as the medical-vocational grid. In addition to your RFC, the grid rules use factors such as your educational background and skill set to determine whether you could be expected to switch to a less demanding line of work before you hit full retirement age.

Social Security Policy on Evaluating the Effects of Chronic Pain

Because pain is a subjective experience, it can be difficult to tell when complaints of pain are serious enough to be considered disabling. The claims examiners and administrative law judges who decide disability claims have to go off of what your medical records say about your health, and it's unfortunately common for doctors to dismiss complaints of pain or fail to include descriptions of pain in their treatment notes.

In order to help examiners and judges determine the extent to which chronic pain restricts your functioning, Social Security Ruling SSR 16-3p provides guidance in assessing subjective symptoms. According to this ruling, disability adjudicators must evaluate the "intensity, persistence, and limiting effects" of your pain symptoms on your ability to do basic work activities. This means they need to take the following factors into account:

• the location, duration, frequency, and intensity of your pain
• how pain affects your daily activities
• what triggers your pain and makes it worse
• the type, dosage, effectiveness, and side effects of medication that you take for pain
• other treatments you've used to relieve symptoms, such as acupuncture or physical therapy, and
• other ways you relieve pain, such as lying down or applying ice.

Your doctors should include information on the above factors in their treatment notes so that they appear in your medical record. They should also include their professional opinions on the functional limitations you have that are caused by your pain, and how long your chronic pain is expected to limit your ability to function.

Ideally, your doctor will be willing and able to complete a medical source statement and submit it to Social Security. The agency values the opinions of your regular doctors, who have greater insight into the nature of your pain and how it limits your ability to function.

What You Can Do to Tell Social Security About Your Pain

Aside from your medical records, the best way for the SSA to evaluate your pain is through what you tell them about the struggles you have with your activities of daily living. When you apply for disability benefits, you'll be asked to submit a questionnaire describing what you can and can't do because of your pain.

As you fill out the form, be sure to consider all the ways that your chronic pain makes life difficult. For example, you may be able to do the same household chores you always did—such as cooking, cleaning, and mowing the lawn—but now they take three times as long to complete because you have to frequently stop and rest. Or maybe you're able to go grocery shopping, but you need to have somebody accompanying you who can carry the bags. Chronic pain can change your social life, so don't neglect to mention if you've stopped visiting with friends because it hurts too much to travel even short distances.

Remember that Social Security will use your self-described limitations to help determine your RFC, so if there's something you can do only once per week or by gritting your teeth against the pain, let the agency know. When describing how much of an activity you can do, use quantities wherever possible. ("I can only walk for 15 minutes before I need to sit down" or "I can lift one gallon of milk to place on the refrigerator shelf and that's it", for example, rather than "I can't walk for long" or "I can't lift anything heavy".)

It's important to be honest with yourself about your limitations and realistic about your ability to work. Keep in mind that all the things you do to relieve pain during the day might not be tolerated by potential employers. Putting your feet up, lying down, and applying heat or cold packs to relieve pain are limitations that impact your ability to work, so you'll want to discuss them in your application.

What If Social Security Doesn't Believe My Pain Is Disabling?

In general, pain isn't something that can be established by objective testing or observation. Only you can know whether and how much it hurts. While the SSA no longer uses the term "credibility" when assessing pain, the agency does need to see that your statements are consistent with the medical evidence as a whole. If you have an X-ray that shows nothing wrong with your back, for example, but your activities questionnaire says that you're bedridden all day due to pain, the SSA will be skeptical of your claim.

For this reason, it's important not to exaggerate your symptoms. But don't downplay them, either—if your activities of daily living appear normal, the SSA will find it hard to believe that your chronic pain is disabling. Going to the doctor regularly and receiving continuous medical treatment is one of the best ways you can prove to Social Security that your complaints are legitimate, so if you haven't seen a doctor, you should start now. And be sure to document everything you do to relieve pain, including massage, acupuncture, or yoga. The agency will consider all relevant treatment methods when assessing the scope of your pain.

Getting Legal Help With Your Disability Claim

Unless you have exceptionally strong medical records, it can be difficult to get disability benefits for chronic pain on your first try. But if Social Security denies your application because it doesn't believe your symptoms are as bad as you say they are, the agency must explain why in the denial letter. You can then address these issues in your appeal.

You aren't required to hire an attorney in order to appeal a disability denial, but it's usually a smart thing to do. It's statistically likely that you'll receive another denial at the reconsideration level, which is the next step before you can get a hearing with an administrative law judge (and where you have the best chance of winning your case). A disability lawyer can help you prepare for your hearing, prepare a brief summarizing your case's strengths, and cross-examine the vocational expert about potential jobs. Most representatives offer free consultations, so don't hesitate to ask around to find a lawyer who is a good match.