Depression, Chronic Pain and Social Security Disability

In my practice over the years, there is a mistake made by people applying for Social Security disability benefits that I see over and over again. Many people attempting to get SSDI or SSI suffer from chronic pain due to many different medical conditions. It is extremely common for someone who is suffering from chronic pain whether it be from a back condition, fibromyalgia, RSD, or any other medical condition that involves pain to also suffer from some degree of depression as a result. Chronic pain by itself can cause depression, but many people also become depressed due to lifestyle changes caused by the severe pain. I can't tell you how many people have come to me with chronic pain conditions and were told by their doctors to seek help for depression and anxiety from a psychiatrist as part of their treatment. Many of these claimants do not follow their doctor's advice and seek treatment for depression for various reasons. I have been told things such as "I'm not crazy I'm just in pain". Many people also don't want to be labeled with a diagnosis of depression for different reasons. I am writing this post to tell you that it is very important to follow your doctor's advice and get treated for depression or anxiety if your doctor recommends it. It will not only help your Social Security disability or SSI claim, but hopefully help your overall well-being. Many people don't realize they are depressed, because they are so focused on their physical problems. Since this post is about Social Security disability and depression I will explain why it is important that you claim depression as a medical condition along with your physical problems to give yourself the best chance to win. Let me first say that everyone who has chronic pain does not also have depression but if your doctor tells you you do or advises you to be checked by a psychiatrist you should do so. In a Social Security disability claim for some of you your physical problems and pain can cause many limitations and be enough to prove to Social Security you are unable to work. For others, your physical problems and pain may severely limit you to the point where you would be unable to perform many jobs but Social Security may find there is light or sedentary work that you could perform. If you are getting treated for depression and you can show you have mental limitations from depression or anxiety these additional limitations may mean the difference between winning or losing your SSDI or SSI claim. For example, particularly if you are under 50 years old Social Security frequently will say that although you are limited from performing heavier work you can still perform sedentary work. If your psychiatrist or a Social Security psychiatrist finds you have mental limitations these mental work limitations must be considered by Social Security just as your physical limitations are. So if Social Security finds you are limited to be able to do sedentary work but you have additional mental limitations, then depending on how severe these mental limitations are they may prevent even a significant number of sedentary jobs and therefore you can be found disabled. Some mental limitations that would significantly impact your ability to perform work related activities would be your ability to interact with the public, ability to interact with supervisors and take direction, ability to complete tasks, difficulties with concentration, difficulties with memory, ability to handle stress, inability to deal with changes in work setting, inability to perform complex tasks, inability to form simple tasks, and many other possible limitations. Depending on how severe your depression is I hope you can see how getting treatment for depression and getting an opinion from your psychiatrist can greatly improve your chances of winning if you suffer from this condition and include it in your claim for disability. There is no shame in suffering from depression it is a medical condition just like your physical impairments are. I do want to caution you, that if you do not suffer from depression, do not claim that you do, for this will hurt your case. I am writing this post because of the great number of people trying to get disability benefits and their records clearly show they have depression and they do not included this condition in their claim or get treatment for it.

Social Security Disability and Obesity

Years ago, the Social Security Administration eliminated obesity from the medical listings of impairments. I think this has caused some confusion. Just because obesity is no longer a listed impairment does not mean you cannot be found disabled based on obesity. Obesity is still to be considered in a Social Security disability claim as an individual impairment and the effects it has on other impairments are also to be considered. In fact, many of the listed impairments make special note of the fact that obesity could adversely affect many medical conditions in the listings. So the effects of obesity must be considered when Social Security determines if you meet or equal listed impairment and when determining whether you are disabled at step 4 or 5 of the process. Severe obesity by itself can cause an individual many limitations that would prevent them from working. However, in most Social Security disability cases obesity is just one of the medical conditions being claimed. In this situation, obesity can clearly have a negative impact on many medical conditions such as heart disease, back impairments, sleep apnea, depression and many others. Since obesity was eliminated from the medical listings of impairments many at Social Security appear to disregard its effects on one's ability to work. It is very clear however, that the decision makers of your claim have a duty to consider the impact of obesity on your Social Security disability claim. If you are claiming obesity as one of your impairments it may be a good idea to get a lawyer to make sure that the limitations from this condition are considered when Social Security makes a decision on your case. I also believe, that there is a general bias against obesity as a disabling impairment. It can help your claim if you're being treated for your obesity and following your doctors advice for treatment. However, sometimes a doctors advice might be for you to undergo serious surgery to help treat your obesity. I am often asked if your refusal to get surgery will hurt your claim for Social Security disability for obesity. This is a difficult question to answer because I am sure there are those at Social Security that would look at your refusal to get the surgery as a negative but I have seen many clients with complications from this type of surgery who are worse off after the surgery. Whether or not you decide to get surgery is a matter between you and your doctor and you should base your decision on what you think is best for you. I can tell you that being denied based on refusal to get such a surgery would give you a strong case for a remand or reversal of that decision.

List all medical conditions that cause functional limitations

I am sometimes asked if one should mention only their main medical condition when pursuing Social Security Disability or SSI. No, you should list all the medical conditions you have that cause functional limitations. Some have said they feel if they list to many medical conditions that they think SSA will give less credibility to their most debilitating condition. What you have to remember is Social Security when determining if you are disabled is required to look at all your conditions combined and how it limits you from being able to work. So even though your main medical condition might cause you the most limitations any other limitations from other conditions added on to your main disability limitations may make the difference in your case. An example is, suppose you have a serious back injury that you consider to be your main disability and it severely limits your physical abilities. If you also suffer from asthma although in this case not disabling in itself it does limit you from certain types of environments like dust or smoke. You may also suffer from depression that also might not be disabling by itself in your case but does cause you some limitation in certain areas like memory and concentration. These additional limitations from your less severe conditions could make the difference in your case.