Is The Combined Effect Of Your Patient’s Multiple Conditions Disabling?
If your patient has applied for Social Security disability and is being treated for more than one condition, consider and address in your chart notes the combined impairing effect of all conditions. This includes both physical and mental conditions.
For example, your patient may suffer from a chronic pain syndrome related to a vertebrogenic disorder. It interferes with his/her ability to work. Indeed, it may have caused your patient to lose a job. This patient may also manifest symptoms of depression. The Federal Court of Appeals of the Ninth Circuit (which includes Oregon and California) has specifically recognized that in chronic pain syndromes, it may be impossible to separate the physical effects from the mental. Therefore, they must be considered together when evaluating whether a person is disabled under Social Security law.
This rule applies to all potentially disabling conditions. If a Social Security disability claimant suffers from more than one condition, those evaluating the claim must consider whether he/she is disabled not only by each individually, but also by their combined effect. Obesity is another impairment which must be considered in this way, even though it is no longer a “listed” impairment. (See accompanying article in this issue.)
Even if another physician and/or mental health professional is treating your patient for the other condition(s), it would be helpful for you to take into account the potential effect of the other condition(s) when you give your opinion on the degree of impairment caused by the condition you are treating.
The whole truth about whether your patient is disabled is found in the total effect of all conditions, not solely in the effect of each one considered individually.
This article was prepared by Arthur W. Stevens, III.