Are your symptoms consistent with the objective medical evidence?

The Social Security Administration (SSA) likes to see symptoms which fit into the range expected for your medical condition.

If your symptoms are outside this range, it is likely that you either 1) have an undiagnosed additional physical impairment, 2) need to have more medical tests exploring a diagnosed impairment, or 3) have an undiagnosed mental impairment that accounts for the alleged symptom.

In the usual case it is the judge’s job to weigh the medical opinions on the consistency of symptoms with the objective evidence; and it is, of course, the judge’s job to examine the consistency of the alleged symptoms with other evidence in the record. But often the record contains no medical opinion whatsoever on whether or not the alleged symptoms are reasonably consistent with the objective medical evidence.

Although some judges may take upon themselves the task of assessing the degree to which your symptoms are reasonably consistent with the objective evidence, this evaluation often requires a medical opinion.  It is up to your attorney to be sure the record contains such opinion evidence in support of your claim.

Where there is already a medical opinion in the record that raises a question about the degree to which a claimant’s symptoms are consistent with the objective evidence, it may be necessary for your treating doctor to address this issue in more detail.

Questions for your doctor to answer include:

  • What factors indicate that your symptoms are reasonably consistent with the objective evidence?
  • Has the objective evidence been correctly analyzed by SSA’s doctor?
  • Why does your doctor not conclude that you are malingering?
  • Has your doctor seen patients with similar objective findings who describe similar symptoms?
  • What is the range of symptoms which could be described as reasonably consistent with the objective evidence in this case?
  • Are there additional indicia of reliability (other than the objective medical evidence) that lend credence to your description of symptoms?
  • Are there personality factors that help explain any possible discrepancy between symptoms and objective evidence?
  • Is there a “functional overlay”?
  • Is there depression, anxiety or any other mental impairment that may enhance your symptoms?
  • If your symptoms really are inconsistent with the objective medical evidence, is there the possibility of a somatoform disorder?