[Federal Register Volume 60, Number 210 (Tuesday, October 31, 1995)]
[Notices]
[Pages 55406-55407]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-26930]



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SOCIAL SECURITY ADMINISTRATION


Social Security Ruling (SSR) 95-5p. Titles II and XVI: 
Considering Allegations of Pain and Other Symptoms in Residual 
Functional Capacity and Individualized Functional Assessments and 
Explaining Conclusions Reached

AGENCY: Social Security Administration.

ACTION: Notice of Social Security ruling.

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SUMMARY: In accordance with 20 CFR 422.406(b)(1), the Commissioner of 
Social Security gives notice of Social Security Ruling 95-5p. This 
Policy Interpretation Ruling restates and clarifies that our 
longstanding policies of considering allegations of pain in assessing 
residual functional capacity (RFC) and of requiring explanations of the 
conclusions reached about pain, apply to the evaluation of all 
symptoms, not just pain. The Ruling also restates and clarifies that 
these policies apply to the preparation of the individualized 
functional assessment in the evaluation of disability for individuals 
under age 18 claiming benefits under Title XVI (Supplemental Security 
Income for the Aged, Blind, and Disabled) of the Social Security Act 
(the Act) as well as to the assessment of RFC for other persons 
claiming benefits based on disability under Title II (Federal Old-Age, 
Survivors, and Disability Insurance Benefits) or title XVI of the Act, 
and that an explanation of the functional impact of symptoms, such as 
pain, when applicable, is required.
    This Ruling supersedes SSR 88-13 (C.E. 1988, p. 90) and SSR 90-1p 
(C.E. 1990-1991, p. 67), both entitled ``Titles II and XVI: Evaluation 
of Pain and Other Symptoms.''

EFFECTIVE DATE: October 31, 1995.

FOR FURTHER INFORMATION CONTACT: Joanne K. Castello, Division of 
Regulations and Rulings, Social Security Administration, 6401 Security 
Boulevard, Baltimore, MD 21235, (410) 965-1711.

SUPPLEMENTARY INFORMATION: Although we are not required to do so 
pursuant to 5 U.S.C. 552(a)(1) and (a)(2), we are publishing this 
Social Security Ruling in accordance with 20 CFR 422.406(b)(1).
    Social Security Rulings make available to the public precedential 
decisions relating to the Federal old-age, survivors, disability, 
supplemental security income, and black lung benefits programs. Social 
Security Rulings may be based on case decisions made at all 
administrative levels of adjudication, Federal court decisions, 
Commissioner's decisions, opinions of the Office of the General 
Counsel, and other policy interpretations of the law and regulations.
    Although Social Security Rulings do not have the force and effect 
of the law or regulations, they are binding on all components of the 
Social Security Administration, in accordance with 20 CFR 
422.406(b)(1), and are to be relied upon as precedents in adjudicating 
other cases.
    If this Social Security Ruling is later superseded, modified, or 
rescinded, we will publish a notice in the Federal Register to that 
effect.

(Catalog of Federal Domestic Assistance, Program Nos. 96.001 Social 
Security--Disability Insurance; 96.002 Social Security--Retirement 
Insurance; 96.004 Social Security--Survivors Insurance; 96.005 
Special Benefits for Disabled Coal Miners; 96.006 Supplemental 
Security Income)

    Dated: October 23, 1995.
Shirley S. Chater,
Commissioner of Social Security.

Policy Interpretation Ruling--Titles II and XVI: Considering 
Allegations of Pain and Other Symptoms in Residual Functional Capacity 
and Individualized Functional Assessments and Explaining Conclusions 
Reached

    This Ruling supersedes SSR 88-13 (C.E. 1988, p. 90) and SSR 90-1p 
(C.E. 1990-1991, p. 67), both entitled ``Titles II and XVI: Evaluation 
of Pain and Other Symptoms.''
    Purpose: To restate and clarify that the longstanding policies of 
the Social Security Administration (SSA) of considering allegations of 
pain in assessing residual functional capacity (RFC), and of requiring 
explanations of the conclusions reached about pain, apply to the 
evaluation of all symptoms, not just pain; that they apply to the 
preparation of the individualized functional assessment (IFA) in the 
evaluation of disability for individuals under age 18 claiming benefits 
under title XVI of the Social Security Act (the Act) as well as to the 
assessment of RFC for other persons claiming benefits based on 
disability under title II or title XVI of the Act; and that an 
explanation of the functional impact of symptoms, such as pain, when 
applicable, is required.
    Citations (Authority): Sections 216(i), 223(d), and 1614(a) of the 
Social Security Act, as amended; Regulations No. 4, sections 404.1508, 
404.1528, 404.1529, and 404.1545; and Regulations No. 16, sections 
416.908, 416.924(b), 416.924d, 416.928, 416.929, and 416.945.
    Pertinent History: On November 14, 1991, we published final 
regulations regarding the evaluation of symptoms, including pain, for 
all disability claims under titles II and XVI (56 FR 57928). These 
regulations codified the policy interpretations set out in SSR 88-13 
and SSR 90-1p, making it unnecessary to retain the statements of policy 
interpretations in these Rulings. We are publishing this Ruling, which 
supersedes SSR 88-13 and SSR 90-1p, to replace the section of these 
earlier Rulings that is entitled ``Importance of Considering 
Allegations of Pain in Assessing RFC and Explaining Conclusions 
Reached,'' which provides procedures which we determined were not 
appropriate for inclusion in the regulations (see 56 FR 57934).
    Policy Interpretation: Symptoms, such as pain, fatigue, shortness 
of breath, weakness, or nervousness, are the individual's own 
description of the effects of a physical or mental impairment(s). Under 
title XVI, in the case of an individual under age 18 who is unable to 
adequately describe his or her symptoms, the description of the 
symptom(s) given by the person who is most familiar with the 
individual, such as a parent, other relative, or guardian, will be 
accepted as a statement of the individual's symptoms.
    Because symptoms sometimes suggest a greater severity of impairment 
than can be shown by objective medical evidence alone, careful 
consideration must be given to any available information about 
symptoms.
    The RFC assessment or, in the case of an individual under age 18 
claiming benefits based on disability under title XVI, the IFA, must 
describe the relationship between the medically 

[[Page 55407]]
determinable impairment(s) and the conclusions regarding functioning 
which have been derived from the evidence, and must include a 
discussion of why reported daily activity limitations or restrictions 
are or are not reasonably consistent with the medical and other 
evidence.
    In instances in which the adjudicator has observed the individual, 
the adjudicator is not free to accept or reject that individual's 
complaints solely on the basis of such personal observations. Rather, 
in all cases in which pain or other symptoms are alleged, the 
determination or decision rationale must contain a thorough discussion 
and analysis of the objective medical and the other evidence, including 
the individual's complaints of pain or other symptoms and the 
adjudicator's personal observations. The rationale must include a 
resolution of any inconsistencies in the evidence as a whole and set 
forth a logical explanation of the individual's ability to work or, in 
the case of an individual under age 18 claiming benefits based on 
disability under title XVI, the individual's ability to function 
independently, appropriately, and effectively in an age-appropriate 
manner.

EFFECTIVE DATE: The policy interpretation and procedures explained 
herein are effective October 31, 1995.

Cross-References: Program Operations Manual System, sections DI 
24515.061, DI 24515.062, DI 24515.064, DI 25225.001 and DI 26516.015.

[FR Doc. 95-26930 Filed 10-30-95; 8:45 am]
BILLING CODE 4190-29-P