Can You Get Social Security Disability for Chronic Pain?

Important: We updated this article in September 2024 after fact checking against Social Security Administration guidelines and statistics. If you suffer from chronic pain, you may occasionally feel a sense of hopelessness — but don’t despair. First of all, you’re definitely not alone, and it is possible to get monthly Social Security disability for chronic pain. The U.S. Centers for Disease Control conducted a 2019 National Health Interview Survey (NHIS) asking Americans to describe their pain issues. The survey found an estimated 50.2 million adults (20.5%) are almost daily chronic pain sufferers. Worse, 10% of U.S. adults (24.4 million people) experience chronic pain so severe it limited their ability to work.

Chronic Pain Affects More Americans Than Most People Realize

Unfortunately, many different injuries, illnesses and diseases are also chronic pain conditions. Chronic pain symptoms may arise from a singular cause, such as a surgical procedure or radiation treatment for cancer. But there are also several disabling conditions where chronic pain is the primary symptom, like fibromyalgia or inflammatory arthritis.

The truth is, more Americans suffer from chronic pain than diabetes, heart disease, and cancer combined. Fortunately, there is help available for individuals who suffer from this very common problem.

Is Your Pain-Related Physical or Mental Impairment Eligible for Disability Payments from the Social Security Administration?

The three medical conditions that most frequently qualify for Social Security disability for chronic pain include:

• Fibromyalgia
• Arthritis (including spondylosis, osteoarthritis, gout, and rheumatoid arthritis)
• Back injuries

In addition, applicants with shingles may also wish to apply for disability for chronic pain. However, there are a few other medical that can qualify for disability benefits, depending on their severity.

Read on for information on how to qualify and apply for either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).

Related: How to Explain Your Disability’s Limitations Using the Spoon Theory

Fibromyalgia Pain

The Social Security Administration published SSR 12-2p, “Evaluation of Fibromyalgia,” for individuals who wish filing a disability claim. This policy explains how to develop medical evidence establishing you have a medically determinable impairment (MDI) of fibromyalgia (FM).

Generally, you can establish an MDI of FM with strong evidence from a licensed physician (a medical or osteopathic doctor). This evidence must prove that your physician reviewed your medical records and then conducted a physical exam. The agency then reviews your physician’s treatment notes to see if they’re consistent with a fibromyalgia diagnosis. Then, the SSA claims examiner determines whether your symptoms have improved, worsened, or stayed the same with continuous medical treatment.

According to the SSA, you must have a history of widespread pain in order receive disability benefits. You must experience pain for at least three months in all body quadrants. You must also have axial skeletal pain in one of the following areas:

• Cervical spine
• Anterior chest
• Thoracic spine
• Lower back

Your pain may fluctuate in intensity, and it may not always be present. Whenever you file a disability claim, the SSA needs objective medical evidence to establish an MDI’s presence before approval.

Arthritis (Including Rheumatoid Arthritis) Pain

The SSA defines arthritis as persistent inflammation or deformity affecting one or more major peripheral weight-bearing joints. This inflammation or deformity must then make it extremely difficult or impossible for you to walk on your own. You can also file an arthritis claim for joint inflammation or deformity in both arms, provided you cannot effectively perform fine and gross motor skills. In plain English, this means you cannot handwrite an essay or carry a heavy dictionary across the room without help.

In order to prove your arthritis qualifies for disability for chronic pain, the SSA claims examiners needs copies of your:

• Medical records
• Physical examination report(s)
• Lab tests
• In some instances, appropriate medically acceptable imaging or tissue biopsy reports

Back Pain

Regardless of what caused your back injury, you must prove that chronic pain limits your daily activities, like:

• Walking a few feet or climbing stairs without help
• Bending over or stooping to picking up a pencil
• Carrying anything that weighs more than a few pounds across the room

Back pain is something that affects a huge number of people. What the SSA needs to determine is whether your pain limits your ability to function daily. Ask your doctor to complete and sign a Residual Functional Capacity (RFC) form. This RFC assessment helps the SSA understand your functional limitations when it comes to completing work tasks.

The agency looks for clues that you might exaggerate your symptoms in order to get disability for chronic pain. With that in mind, here are some back injuries that may qualify for monthly benefits:

• Degenerative or herniated discs
• Spinal stenosis
• Nerve root compression
• Scoliosis
• Spondylolisthesis

Shingles Pain

While shingles can cause severe pain in the short term, the SSA doesn’t list it in the Blue Book of eligible disabilities. To get disability for chronic pain from shingles, you must also have one of the following eligible secondary health issues:

• Lymphoma
• Leukemia
• An autoimmune disorder (e.g., Hashimoto’s thyroiditis, lupus)
• Human immunodeficiency virus (HIV)
• Cancer
• Hepatitis B or Hepatitis C

Inflammatory Bowel Disease Pain

This underlying medical condition appears in Social Security’s Blue Book under Section 5.06, Digestive Disorders. However, it needs to be fairly advanced to qualify for monthly payments. Your chances of benefit approval are much better off if you:

• Were hospitalized twice within the past year
• Needed surgery for an adhesion in either your intestines or colon during the past 12 months
• Require a feeding tube
• Missed at least two weeks of work 3-4 times within the past year, specifically due to your pain symptoms
• Have severe pain that is not well controlled with routine medical treatment or prescription pain medication

Qualifying for Social Security Disability Insurance (SSDI) Payments

To qualify for these benefits, you must:

• Have worked at least 5 in the last 10 years while paying into Social Security through payroll tax deductions
• Not currently receive any other Social Security benefits, such as early or regular retirement
• Prove you cannot engage in substantial gainful activity (i.e., work enough to support yourself financially) for 12+ months
• Show your pain disorder diagnosed by a qualified medical professional will last a year or longer
• Have individual monthly income that is less than $1,550 (or $2,590 if you are blind)
• Be between the ages of 18 and 67 when you file your claim

Qualifying for Supplemental Security Income (SSI) Benefits

Chronic pain claims for SSI must show three things to secure monthly disability benefits:

1. You are blind, disabled, or at least 65 years old.
2. Your entire monthly household income is less than $1,550 (the SSA counts earnings from everyone who lives in your home).
3. You own fewer than $2,000 in total assets, including bank account balances, jewelry, etc. For couples who apply, you must have no more than $3,000 in financial resources combined.

How Much Money Can I Get in Disability for Chronic Pain if I’m Successful?

In 2024, the most you can receive in SSDI benefits is $3,822. However, most people receive somewhere between the average payment of $1,537 and that amount.

After 24 months of SSDI payments, you will also qualify for Medicare coverage.

For SSI, there is a set maximum payment of $943 per individual, or $1415 for couples. You also get access to Medicaid health coverage the same month your SSI payments begin.

How to Apply for Benefits with a Chronic Pain Condition

In general, you have 3 ways to apply for disability benefits from the SSA:

1. For free through a Social Security attorney in your area. This is the only method that significantly increases your odds of success within 180 days of you filing date.
2. In person at your local Social Security office.
3. Over the phone by calling 1-800-772-1213 Monday through Friday, 8am-7pm Eastern.

If you want to apply for SSDI only, you can also start an application online at SSA.gov.

How to Triple Your Chances to Receive Disability Benefits at the Initial Application Stage

If you’re unable to work for one year due to chronic pain, you may be awarded benefits. Having a disability attorney help you file triples your odds of success the first time you apply. We can connect you with an attorney for a free consultation to learn whether you may qualify before you file. Already denied benefits? An attorney can appeal your denial and even appear in court before an administrative law judge on your behalf.

Disability applicants who file on their own without professional assistance typically wait 2-3 years for their first payment. However, you should also know that less than 1 in 3 people who apply ever receive SSA disability benefits.

If your claim isn’t successful, then you owe your attorney $0. But if you do receive benefits, you only owe one small fee after you receive your award. Most people also qualify for up to a year’s worth of back payments, which also provides the money for your legal fees.

Wondering if you’ll qualify before you apply? Click the button below to start your free online benefits quiz and see if you may qualify:

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