Understanding the SSA’s Definition of Disability

To qualify for Social Security Disability benefits in Wisconsin, your condition must meet the SSA’s definition of disability. The SSA defines disability as:

• Severe: The condition must significantly limit your ability to perform basic work tasks, such as standing, walking, lifting, or concentrating.
• Long-Term: Your condition must last for at least 12 months or be expected to result in death.
• Inability to Work: You must be unable to engage in substantial gainful activity (SGA), meaning you are not earning more than the SSA’s monthly income threshold (in 2025, $1,470/month for non-blind individuals).

Chronic pain, when severe enough, can meet these criteria, but you’ll need to provide sufficient documentation to prove the extent of your disability.

Can Chronic Pain Qualify for Social Security Disability?

Chronic pain in itself is not listed as a specific impairment in the SSA’s Listing of Impairments, but it can still qualify for SSD benefits if it results from a medical condition that meets SSA’s definition of disability. Common causes of chronic pain that may qualify for Social Security Disability include:

• Back pain from conditions such as degenerative disc disease, herniated discs, or spinal stenosis.
• Arthritis or joint pain, especially if it severely limits mobility and the ability to perform work activities.
• Fibromyalgia, a condition characterized by widespread chronic pain, fatigue, and other symptoms.
• Neuropathy or nerve damage that causes chronic pain, such as sciatica or diabetic neuropathy.
• Headaches, including severe migraines that significantly impact your ability to function.

Even though chronic pain alone isn’t listed in the SSA’s guidelines, if it results from one of these or other qualifying conditions, you may be able to qualify for SSD benefits.

Proving Your Disability Due to Chronic Pain

To be successful in your SSD claim, you must provide detailed medical evidence demonstrating that your chronic pain is severe enough to prevent you from working. The SSA will evaluate the severity of your condition using both medical and non-medical evidence. Here's what you can do:

• See Your Doctor Regularly: Regular medical visits help build a solid record of your condition. Be sure to follow prescribed treatments, undergo recommended tests, and document your pain levels.
• Gather Medical Records: Provide medical records, such as X-rays, MRIs, lab results, and doctor’s notes that show the underlying cause of your chronic pain. The more detailed and thorough your records are, the stronger your case will be.
• Pain Documentation: The SSA will evaluate how your chronic pain affects your ability to perform work tasks. Document how the pain interferes with your daily activities, such as walking, sitting, standing, or lifting. Consider keeping a pain diary to track the intensity and frequency of your pain, along with how it affects your ability to function.
• Functional Limitations: Your doctor’s opinion is crucial. A letter from your treating physician that explains how your chronic pain limits your ability to work can be very helpful. Be sure your doctor explains the severity of your pain, what activities it limits, and how it impacts your ability to work.

SSA’s Disability Evaluation Process

The SSA evaluates disability claims through a five-step process. Here's how it applies to chronic pain:

• Step 1: Substantial Gainful Activity (SGA): If you are working and earning more than the SSA’s monthly income limit ($1,470 for non-blind individuals in 2025), your claim may be denied. If you’re not working or earn below this threshold, the SSA will move to the next step.
• Step 2: Severe Condition: Your chronic pain must be severe enough to limit your ability to perform basic work activities. The SSA will evaluate whether your pain prevents you from completing tasks like standing, sitting, walking, or concentrating.
• Step 3: Meet a Listed Impairment: While chronic pain is not a listed impairment, the SSA will consider whether your condition is severe enough to meet the criteria for another impairment, such as a back disorder or arthritis. If your condition results in limitations that are as severe as those listed in the SSA’s Listing of Impairments, you may qualify.
• Step 4: Past Work: The SSA will evaluate whether you can still perform your previous job. If you can no longer do your past work due to chronic pain, the SSA will move to the next step.
• Step 5: Other Work: If you cannot perform your past work, the SSA will evaluate whether you can do other types of work based on your age, education, and skill set. If your chronic pain limits your ability to perform any work, you may qualify for benefits.

How to Apply for Social Security Disability in Wisconsin

Once you’ve gathered the necessary medical evidence, you can apply for Social Security Disability benefits. You can apply:

• Online: The easiest way to apply is through the SSA’s website at www.ssa.gov.
• In Person: You can apply in person at your local Social Security office in Wisconsin. Use the SSA’s office locator tool to find the nearest office.
• By Phone: You can also apply by calling the SSA at 1-800-772-1213.

Be sure to provide accurate information and submit all required medical documentation to avoid delays.

What to Do If Your Claim Is Denied

It’s common for Social Security Disability claims to be denied, even if you have a valid claim. If your claim for chronic pain is denied, you can appeal the decision. Here’s what you can do:

• Request Reconsideration: This is the first level of appeal, where the SSA will review your claim again.
• Request a Hearing: If your reconsideration is denied, you can request a hearing before an Administrative Law Judge (ALJ). This is an important step where you can present your case in person and provide additional evidence.
• Appeals Council: If the ALJ denies your claim, you can request a review from the Appeals Council.