Effective March 28, 2016, the Social Security Administration (SSA) has published a new rule for the evaluation of symptoms in disability claims. Social Security Ruling 16-3p clarifies that judges are not to assess your personal character; but instead, are to assess how consistent your subjective complaints of pain and other symptoms are with the other evidence of record.
The agency distinguishes between medical signs, laboratory findings and symptoms. Medical signs are the observations of a doctor. Laboratory findings are medical tests. Symptoms are your complaints.
Before any of your complaints can be considered, medical signs or laboratory findings must establish that there is a medical abnormality that could reasonably produce the symptom. In other words, there must be objective medical evidence of a medical problem. For example, if you complain of debilitating headaches, you cannot have your headaches considered unless there’s an abnormal MRI of the brain, a history of surgery, or some other objective condition that could reasonably be expected to produce your headaches.
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Once, however, medical signs or laboratory findings establish there is a medical abnormality, your subjective complaints can be considered. The SSA recognizes that some individuals may experience symptoms differently. For example, if you have a major depressive disorder, you might experience heightened pain from a spinal condition. In contrast, a person who is otherwise healthy would be more broadly functional, with the same abnormality.
The new ruling cautions that symptoms should not be assessed solely on the basis of what is objective. However, there should broadly be some consistency between the objective abnormality and your complaints. In all cases, however, once objective evidence establishes that there is a medical abnormality, your statements cannot be disregarded. This means that some inquiry must be made into your daily activities; the location, duration, frequency, and intensity of the pain; factors that precipitate or aggravate the symptoms; the type, dosage, effectiveness, and side effects of medications; other treatments you receive; and self-help remedies.
The agency will also assess the consistency of your statements, with each other. However, inconsistencies in your statements made at varying times do not necessarily mean they are inaccurate.
Your consistency in following treatment is also recognized as a major factor in assessing credibility. However, if you don’t follow the treatment recommendations of your doctor, the agency must consider the possible reasons for that. These could include the inability to afford treatment, religious considerations, statements made by the doctor about the likely effectiveness of treatment, and your medical impairments.
The ruling clarifies that the decision must contain specific reasons, clearly articulated, to assess how consistent the subjective complaints are. It won’t suffice to simply brush off your testimony with a conclusory statement, saying that it’s been considered.
Above all, the new ruling clarifies that the focus of the evaluation is not upon your personal character, or whether you are a truthful person. It should not, for example, detract from your credibility that you’re an ex-convict.
It’s also improper for the agency to look at your Facebook page, or sources outside of the evidence of record.
In sum, the new ruling gets the agency away from assessing your personal character, sticking to assessing the consistency of your complaints with the evidence as a whole.
If you need help with your Social Security Disability claim, call the attorneys at Don Pilzer Law, P.C.