By Brian Mittman, Markhoff & Mittman, PC

Chronic pain can affect every aspect of your life, especially your ability to work. When pain makes work unsustainable, Social Security Disability Insurance (SSDI) is designed as a safety net.

However, applying for SSDI with chronic pain is complex, since the Social Security Administration (SSA) does not approve claims based on having pain alone. This guide explains, in plain language, how SSA evaluates chronic pain-related claims, how to strengthen your application, and what to expect throughout the process. (This is not legal advice; consult a qualified attorney for personalized help.)

How SSA Views Pain

The SSA does not grant benefits for “pain” itself. Instead, it requires a medically determinable impairment—a diagnosed condition, supported by objective medical evidence such as imaging or lab findings—that could reasonably cause your pain. Examples include spine disorders, neuropathy, inflammatory arthritis, fibromyalgia, complex regional pain syndrome (CRPS), and other well-documented pain syndromes.

Once a qualifying diagnosis is established, SSA looks at your symptoms: how severe and frequent your pain is, how long it has persisted, and how it impacts your ability to function. Your own statements are important, but SSA cross-checks them with your medical records, imaging, physical exams, medication lists, and sometimes reports from family or coworkers. The goal is to see a consistent story of how pain has altered your life—not just a list of medical terms.

Crucially, SSDI is not about whether you can push through pain for a short period. It is about whether you can work reliably, full-time, week after week. If pain causes you to miss work, need frequent breaks, or prevents you from maintaining a consistent work schedule, that can be disabling.

The Five-Step Disability Evaluation

Every adult SSDI claim is reviewed using a five-step “sequential evaluation.” Chronic pain does not change the steps, but it influences how you present your case and the evidence needed at each stage.

Step 1: Are You Working Above the Earnings Limit?

SSA first checks if you are performing substantial gainful activity (SGA)—earning more than a set monthly amount, which changes yearly. If you are, you are not considered disabled at Step 1, regardless of your pain or diagnoses. If you are not working, or earning below SGA, your claim moves forward.

Are you pushing yourself despite your pain because of bills and obligations? When you finally reduce hours or stop altogether, the timing should be supported in the medical records—notes about increased flares, missed days, reduced productivity, not just a sudden work stoppage with no context.

Step 2: Do You Have a ‘Severe’ Medically Determinable Impairment?

Here, SSA looks for at least one medically determinable impairment that has significantly limited, or is expected to significantly limit, your physical or mental ability to do basic work activities for at least 12 continuous months. Pain, by itself, is not enough; there must be a documented medical condition behind it. Conditions like degenerative disc disease, rheumatoid arthritis, or CRPS, supported by imaging or clinical findings, often meet this requirement. “Severe” means your condition significantly limits basic work activities like standing, walking, lifting, concentrating, or staying on a schedule.

For chronic pain, this is where clear documentation starts to matter. If your records show only “doing well” or “stable” with minimal detail, SSA may decide your pain is not severe—even if your day‑to‑day reality is very different. A clear diagnosis along with comments about pain will move you forward.

Step 3: Does Your Condition Meet or Equal a “Listing”?

SSA maintains a list of impairments (the “Listings”) that are considered automatically disabling if certain criteria are met. There is no Listing for “chronic pain” itself. Some chronic pain conditions, like spine disorders or inflammatory arthritis, may meet a Listing. Other pain syndromes like fibromyalgia rarely do. Even if your condition doesn’t fit a Listing exactly, SSA considers whether your combined symptoms are as severe as a listed impairment.

If you do not meet or equal a Listing, Social Security simply moves on to Step 4 to look more closely at what you can still do.

Step 4: What is Your RFC—And Can You Do Your Past Relevant Work?

SSA will assign you a residual functional capacity (RFC)—its assessment of what you can still do on a regular, sustained basis despite your impairments. This includes:

• How long you can sit, stand, and walk in a workday
• How much weight you can lift and carry
• How often you need to change positions or lie down
• Whether you can stay focused, concentrate, and keep pace
• How many days you would likely miss due to flares, fatigue, or medical appointments

At Step 4, SSA compares your RFC to the easiest job you have done in the recent 5 years. If they believe you could still perform that job as it’s generally done, you will be found not disabled. If you cannot do that work, then you move on to Step 5.

Step 5: Can You Do Any Other Work?

If you can’t do your past work, SSA considers your RFC, age, education, and transferable skills to determine if there is other work you could do in the national economy. At this stage, the burden shifts: SSA must show there are jobs you can still perform.

This is often where chronic pain cases are decided. SSA may point to sedentary, simple jobs and say, “You can sit and do these.” To overcome that, the record must show that even sedentary work is not sustainable—for example, because you cannot sit long enough, must lie down unpredictably, cannot maintain pace and concentration, or would miss too many days due to flares and treatment. Medication side effects and mental health issues related to pain also play a key role.

Again, SSDI is about sustainability, not isolated moments of functioning. If you are just braving it out in short bursts, SSA needs to see why that is not realistic full‑time.

For older individuals (especially over age 50 or 55), the rules are more favorable if pain limits you to less demanding work. However, for applicants of any age, if pain and your RFC prevent you from sustaining any full-time work, you may be found disabled.

Building a Strong Chronic Pain Claim

Chronic pain is often invisible and variable. That makes the quality of your documentation central to your claim. SSA focuses on several key areas.

1. Diagnoses and exam findings

A medically determinable impairment supported by clinical findings, such as:

• Abnormal range of motion, weakness, or reflex changes
• Tender points, swelling, or muscle spasms
• Nerve findings like numbness, tingling, or loss of sensation
• Relevant imaging or test results (even if they don’t fully explain the level of pain)

Specialist records (such as pain management, neurology, rheumatology, orthopedics, mental health) can help explain why your symptoms look the way they do and the appropriateness of certain treatments.

2. Treatment history and response

What you have tried to manage your pain and how you responded, including:

• Medications (doses, side effects, and changes over time)
• Injections, procedures, or surgeries
• Physical or occupational therapy
• Counseling, pain psychology, or behavioral pain programs
• Use of assistive devices or workplace accommodations

The goal is not to show that treatment cured you, but that you have engaged in reasonable treatment and your limitations persist despite those efforts—or that side effects themselves create additional problems, such as brain fog, dizziness, or excessive fatigue.

3. Functional limitations over time

The heart of most chronic pain claims is function: what you can do, for how long, how often, and at what cost. Helpful documentation includes:

• How long you can sit before needing to stand or change positions
• How long you can stand or walk, even at a slow pace
• How much you can safely lift and carry
• How pain, fatigue, or medications impact focus, memory, and pace
• Whether you need to lie down during the day
• How often pain or flares would cause you to miss work or leave early

Ideally, these details appear in your treatment notes, not just on SSD forms.

4. Consistency of your story

SSA evaluates your symptoms under a framework that focuses on consistency rather than judging your character. Decision‑makers look at whether your reports of pain and limitations line up with:

• The timing and frequency of your visits
• The types of treatment tried and adjusted
• What you tell different providers over time
• Any statements from family, friends, or former coworkers

Gaps in treatment, sudden changes in your story, or very “rosy” notes (like “doing great” or “no complaints”) can be used to argue that your pain is not as limiting as you say. If there is a good reason for gaps—cost, transportation, caregiving responsibilities, or discouragement—tell your providers so it is documented.

Practical Documentation Tips for People Living with Chronic Pain

You cannot rewrite Social Security’s rules, but you and your providers can help shape the evidence that will be used to apply those rules to your life.

• Be specific at appointments: Replace “I hurt all over” with concrete information: location, type of pain, intensity, frequency, triggers, and recovery time. For example: “If I sit more than 15–20 minutes, my pain spikes and I need to stand or lie down,” or “If I do light housework for an hour, I need the rest of the day to recover.”
• Describe function, not just pain scores: A “7 out of 10” means different things to different people. Talk about what that pain does to your day: how it affects cooking, dressing, driving, focusing, or even getting out of bed. This is the language SSA uses in RFC determinations.
• Track your good days and bad days: A simple pain or activity journal can help you and your doctors see patterns: what triggers flares, how often they occur, how long they last, and what you can do in between. When that information makes its way into your medical notes, it helps explain why you cannot count on being “work‑ready” five days a week.
• Explain variability: Many people with chronic pain have a few better hours or days, followed by a crash. Your records should show that you might manage some activities briefly but pay for them with increased pain and fatigue. The question is not “Can you ever do this?” but “Can you do this repeatedly, on a schedule, without frequent breaks or absences?”
• Document side effects and mental health: Medications and poor sleep can cause drowsiness, fogginess, irritability, or slowed thinking. Pain often contributes to depression and anxiety. Tell your providers about these issues; they also affect your ability to work, especially in jobs requiring concentration, interaction with others, or safety‑sensitive tasks.
• Address gaps and changes: If you stop a medication, skip therapy, or decline a recommended procedure, explain why. Side effects, cost, lack of benefit, or fear of surgery are all real‑world reasons. Having them written down helps prevent SSA from assuming you simply did not want to get better.

Common Pitfalls and How to Avoid Them

• Insufficient Medical Evidence: SSA denies claims when records lack objective findings or there are long gaps in care. Keep all appointments and follow your doctor’s advice.
• Inconsistent Statements: If your reports of pain vary between visits, or if you describe severe pain but continue physically demanding activities, SSA may question your credibility. Be honest and consistent.
• Relying on Diagnoses Alone: The diagnosis is just the start. The key question is: How does pain keep you from working reliably, full-time?
• Stopping Work Too Soon: SSA values evidence that you tried to keep working, with declining performance or increased absences. If you stop work before seeking treatment, your case is weaker.

The Appeals Process

Most SSDI claims (especially for chronic pain) are denied at first. Do not give up. You usually have 60 days to appeal each denial. The process may include:

• Reconsideration: Another review of your file, often with similar results.
• Hearing by an Administrative Law Judge (ALJ): The most important stage. You can testify about your pain and how it affects you. Consider having a disability attorney or advocate represent you.
• Appeals Council and Federal Court: If denied by the ALJ, further appeals are possible, but success rates drop.

At the hearing, the ALJ considers your testimony, medical records, and often a vocational expert’s opinion about your ability to work. Prepare to tell your story clearly, focusing on reliability and the real-world impact of your pain.

Tips for Application Success

• Keep a symptom diary. Daily notes about your pain, treatment, and its effects can support your case.
• Stay engaged in treatment, even if progress is slow.
• Be honest about your limitations, but do not exaggerate. SSA values credibility.
• Consider legal representation, especially at the hearing stage. Experienced attorneys know what evidence the SSA needs.

Key Takeaways

• SSDI does not award benefits for pain alone; a medically determinable impairment must be present.
• Your ability to work reliably, full-time, is at the heart of the decision—not just your diagnosis or occasional flare-ups.
• Consistent, detailed medical evidence and honest accounts of your daily life are essential.
• Most claims are denied at first, so persistence and appeals are often necessary.

Living with chronic pain reshapes every part of your day, including your relationship with work. When pain becomes too much and work is no longer sustainable, Social Security Disability Insurance (SSDI) is meant to be a safety net—but the process often does not match how chronic pain behaves.

Chronic pain cases are rarely denied because the pain is “minor.” They are often denied because the evidence does not clearly show how that pain limits your ability to work reliably, day by day. By understanding how Social Security’s five‑step process works, working with your providers to prepare thorough evidence and document your functional limits over time, and seeking support when needed, you can help the record tell the full story of your life with pain.

Disclaimer: This article is for general educational purposes only and is not legal advice. It does not address any specific case or guarantee any outcome and reading it does not create an attorney–client relationship.

Learn more during a FREE webinar, “Preparing for Your Social Security (SSA) Disability Claim,” at 1 p.m. ET on Thursday, March 12. Register today.

About the Authors:

Brian Mittman, Managing Partner, Markhoff & Mittman, P.C.

Brian Mittman is a New York attorney who focuses on Social Security Disability matters, helping individuals pursue benefits through the claims and appeals process. He is also experienced in related disability and injury matters, including workers’ compensation. Admitted in New York since 1995, Brian has spent decades guiding clients through complex systems with an emphasis on practical, client-centered advocacy.