Written By: Gayle Gonzalez Conner
Somatic symptom disorder is characterized by an extreme focus on physical symptoms — such as pain or fatigue — that causes major emotional distress and problems functioning. The individual has excessive thoughts, feelings and behaviors relating to the physical symptoms. The physical symptoms may or may not be associated with a diagnosed medical condition, but the person is experiencing symptoms and believes they are sick (that is, not faking the illness).
Somatic symptom disorder cause symptoms of illnesses and/or physical injuries that cannot be traced to a definitive cause or apparent reason. Since somatic symptom disorders cannot be attributed to a physical condition, such as diabetes, heart, lung or kidney disease, they are considered a type of mental disorder.
Somatic disorders include things like conversion disorder (where people experience things like seizures, blindness or paralysis without a known cause), pain disorders (where the underlying cause of your pain is unknown) and hypochondria (where you often misinterpret your physical symptoms and constantly worry that you have a life-threatening condition). These can be disabling conditions when accompanied by symptoms that prevent a person from working or completing normal daily tasks. Health concerns may become such a central focus of your life that it’s hard to function, sometimes leading to disability.
How Can Symptoms Interfere With Competitive Employment?
Somatic symptom disorder can significantly interfere with a person’s ability to maintain full time employment due to the nature and impact of its symptoms. Here’s how:
1. Persistent Physical Symptoms
People with somatic symptom disorder experience chronic physical symptoms—such as pain, fatigue, weakness, dizziness, or gastrointestinal issues—that may not have a clear medical explanation. These symptoms are real and distressing, often leading to frequent absences from work or reduced productivity.
2. Excessive Health-Related Anxiety
Individuals with somatic symptom disorder often have intense anxiety about their health, which can lead to:
- Frequent medical appointments and tests
- Difficulty focusing on tasks
- Avoidance of work-related stressors due to fear of worsening symptoms
3. Cognitive and Emotional Impairments
The disorder is often accompanied by depression or anxiety, which can impair:
- Decision-making
- Memory and concentration
- Emotional regulation in workplace interactions
4. Functional Impairment
Somatic symptom disorder can cause significant disruption in daily functioning. This includes:
- Inability to meet job demands consistently
- Difficulty maintaining regular work hours
- Challenges in sustaining interpersonal relationships at work
5. Social and Occupational Withdrawal
Due to the distress and preoccupation with symptoms, individuals may withdraw from social and occupational roles, further reducing their employability
Diagnosis
A diagnosis of somatic symptom disorder requires the person experiencing
- One or more physical symptoms that are distressing or cause disruption in daily life.
- Excessive thoughts, feelings or behaviors related to the physical symptoms or health concerns with at least one of the following:
- Ongoing thoughts that are out of proportion with the seriousness of symptoms
- Ongoing high level of anxiety about health or symptoms
- Excessive time and energy spent on the symptoms or health concerns.
- At least one symptom is constantly present, although there may be different symptoms and symptoms may come and go.
People with somatic symptom disorder typically go to a primary care physician rather than a psychiatrist or other mental health professional. Individuals with somatic symptom disorder may experience difficulty accepting that their concerns about their symptoms are excessive. They may continue to be fearful and worried even when they are shown evidence that they do not have a serious condition. Some people have only pain as their dominant symptom.
How The Social Security Administration Evaluates Somatic Symptom Disorders?
The Social Security Administration has a list of medical conditions called the “Blue Book.” Somatic disorder is found under Listing 12.07. To meet the listing, you must have all of the following:
- Medical documentation of one or more of the following:
- Symptoms of altered voluntary motor or sensory function that are not better explained by another medical or mental disorder;
- One or more somatic symptoms that are distressing, with excessive thoughts, feelings, or behaviors related to the symptoms; or
- Preoccupation with having or acquiring a serious illness without significant symptoms present.
AND
- Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning:
- Understand, remember, or apply information
- Interact with others
- Concentrate, persist, or maintain pace
- Adapt or manage oneself
All elements of the listing must be shown in your medical records. The medical record must also show that you have a somatic condition that is going to last or that will last longer than 12 months.
What If Your Somatic Disorder Does Not Meet A Listing?
If your somatic disorder does not meet the criteria under Listing 12.07 of the Social Security Administration’s Blue Book, you may still qualify for disability benefits—but you’ll need to prove your case another wa
If your condition doesn’t match or equal the severity of a listing, the Social Security Administration will evaluate your case using a medical-vocational allowance. Here’s how that works:
1. Residual Functional Capacity (RFC) Assessment
SSA evaluates what you can still do, despite your symptoms.
They consider things like:
- How long you can sit, stand, or walk
- Your ability to concentrate, follow instructions, and interact with others
- How often your symptoms (e.g., fatigue, pain, focus issues) interfere with basic tasks
2. Can You Do Past Work?
They’ll ask: Can you still do any of the work you’ve done in the past 5 years?
If yes → claim is denied.
If no → they move to the next step.
3. Can You Do Any Other Work?
Social Security Administration looks at your:
- Age
- Education
- Work experience
- RFC
If they decide there are no jobs you can reasonably perform, you may be approved for benefits even if your condition does not meet Listing 12.07.
What Do I Need To Get Disability For Somatic Symptom Disorder?
A disability claim based on a somatic symptom disorder will require documentation from an acceptable medical source, as well as evidence that the disorder precludes the claimant from working. Disability adjudicators will look to objective medical evidence established by medically acceptable clinical diagnostic techniques or laboratory findings. They must also evaluate your symptoms, looking to see whether there is an underlying medical condition that could reasonably cause such symptomology.
You will need extensive, objective documentation, such as:
- Psychiatric evaluations
- Therapy notes
- Medication history (e.g., antidepressants, anti-anxiety meds)
- Records of emergency visits, hospitalizations, or specialist referrals
- Statements from your doctor about how your symptoms affect your daily and work functioning
If you are no longer able to work because of your persistent but yet-unexplained symptoms, it is possible that you may qualify for Social Security Disability benefits due to a somatic disorder.
