Facts about Somatoform Disorders and Filing for Disability
These selected pages answer some of the most basic, but also some of the most important, questions for individuals who are considering filing a claim for disability benefits.
Facts about the condition
1. Somatoform disorder refers to several conditions that all involve physical symptoms that have no physical cause, but rather are caused by psychological factors.
2. Those with somatoform disorder experience very real symptoms, but medical evaluations and laboratory results show no illness, or results do not match the symptoms. Symptoms are often similar to particular illness, and can go on for years.
3. There are four main types of conditions characterized as somatoform disorders, that include symptoms ranging from pain to paralysis. These are called somatization disorder, hypochondriasis, body dysmorphic disorder, and conversion disorder.
4.Somatization disorder causes pain, as well as symptoms including headache, fatigue, a variety of stomach problems including nausea and diarrhea, and sexual dysfunction. These symptoms all begin before the age of 30, and patients generally will have a medical history full of doctors and specialists and a variety of prescribed medications.
5. Somatization disorder used to fall under the generalized term 'hysteria' before psychological disorders became more widely studied and understood.
6. Hypochondriasis occurs when minor discomforts, such as a mild stomach ache or headache, are perceived to be major illnesses such as cancer. Hypochondriasis often occurs with depression, and may be triggered by learning about a condition. Seeing a doctor quells fear about a particular symptom or condition, but does not stop the fear from reoccurring.
7. Body dysmorphic disorder causes the affected individual to be upset over a perceived physical flaw. This is commonly focused on weight, the nose or eyes, skin blemishes, body hair or loss of hair, breasts and thighs. The perceived flaw causes constant self consciousness.
8. Conversion disorder involves physical symptoms of a neurological problem when none exists. This could mean paralysis of one part of the body, coordination and movement problems, loss of vision or hearing, and seizures, while the patient is more indifferent or less concerned about the condition than one would expect.
Qualifying for disability benefits with this condition
Whether or not you qualify for disability and, as a result, are approved for disability benefits will depend entirely on the information obtained from your medical records.
This includes whatever statements and treatment notes that may have been obtained from your treating physician (a doctor who has a history of treating your condition and is, therefore, qualified to comment as to your condition and prognosis). It also includes discharge summaries from hospital stays, reports of imaging studies (such as xrays, MRIs, and CT scans) and lab panels (i.e. bloodwork) as well as reports from physical therapy.
In many disability claims, it may also include the results of a report issued by an independent physician who examines you at the request of the Social Security Administration.
Qualifying for SSD or SSI benefits will also depend on the information obtained from your vocational, or work, history if you are an adult, or academic records if you are a minor-age child. In the case of adults, your work history information will allow a disability examiner (examiners make decisions at the initial claim and reconsideration appeal levels, but not at the hearing level where a judges decides the outcome of the case) to A) classify your past work, B) determine the physical and mental demands of your past work, C) decide if you can go back to a past job, and D) whether or not you have the ability to switch to some type of other work.
The important thing to keep in mind is that the social security administration does not award benefits based on simply having a condition, but, instead, will base an approval or denial on the extent to which a condition causes functional limitations. Functional limitations can be great enough to make work activity not possible (or, for a child, make it impossible to engage in age-appropriate activities).
Why are so many disability cases lost at the disability application and reconsideration appeal levels?
There are several reasons but here are just two:
1) Social Security makes no attempt to obtain a statement from a claimant's treating physician. By contrast, at the hearing level, a claimant's disability attorney or disability representative will generally obtain and present this type of statement to a judge.
Note: it is not enough for a doctor to simply state that their patient is disabled. To satisy Social Security's requirements, the physician must list in what ways and to what extent the individual is functionally limited. For this reason, many representatives and attorneys request that the physician fill out and sign a specialized medical source statement that captures the correct information. Solid Supporting statements from physicians easily make the difference between winning or losing a disability case at the hearing level.
2) Prior to the hearing level, a claimant will not have the opportunity to explain how their condition limits them, nor will their attorney or representative have the opportunity to make a presentation based on the evidence of the case. This is because at the initial levels of the disability system, a disability examiner decides the case without meeting the claimant. The examiner may contact the claimant to gather information on activities of daily living and with regard to medical treatment or past jobs, but usually nothing more. At the hearing level, however, presenting an argument for approval based on medical evidence that has been obtained and submitted is exactly what happens.
About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.
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