1
Introduction1
Chronic pain, defined as pain that persists for more than three months, is a pervasive and debilitating condition that can significantly affect a person’s ability to work and function, potentially leading to disability.2 Understanding the relationship between chronic pain and disability is crucial for developing effective management strategies and improving the quality of life for those affected.
The Social Security Administration (SSA) administers two programs that provide cash payments to people with disabilities: the Social Security Disability Insurance program and the Supplemental Security Income program. Social Security Disability Insurance, a program for workers who contribute through payroll tax deductions, aims to protect those workers from lost earnings arising because of impairment, while Supplemental
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1 The planning committee’s role was limited to planning the workshop, and the Proceedings of a Workshop has been prepared by the workshop rapporteurs as a factual summary of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants, and are not necessarily endorsed or verified by the National Academies of Sciences, Engineering, and Medicine, and they should not be construed as reflecting any group consensus.
2 The International Association for the Study of Pain defines chronic pain as pain that persists for longer than 3 months. This type of pain often becomes the sole or predominant clinical problem in some patients. As such it may warrant specific diagnostic evaluation, therapy, and rehabilitation. Chronic pain is a frequent condition, affecting an estimated 20 percent of people worldwide, and is multifactorial—biological, psychological, and social factors contribute to the pain syndrome. https://www.iasp-pain.org/advocacy/definitions-ofchronic-pain-syndromes/ (accessed June 17, 2025).
Security Income’s goal is to guarantee a base income for low-income people with disabilities and older adults.
To better understand the effects of chronic pain, how it is treated and managed, and its implications for disability determination, the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine hosted a one-and-a-half-day workshop on April 17–18, 2025, that explored the many experiences and challenges related to chronic pain and its management, and how these experiences affect health status, functional limitations, and medical records for both children and adults. Box 1-1 provides the statement of task for the workshop, which SSA funded.
Robert Weathers, deputy associate commissioner for SSA’s Office of Disability Policy, noted in his introductory remarks to the workshop that accurately evaluating a disability claim has “been a thorn in the side of SSA adjudicators since the administration first began paying disability benefits nearly 70 years ago.” The challenge with chronic pain is that it is a wholly individualized experience, and there is no objective test or laboratory value that SSA can rely on to understand the extent to which chronic pain is interfering with an individual’s ability to work and function. That said, SSA has set policies and existing guidance on pain evaluation that it provides to its adjudicators, but Weathers asked the workshop participants to consider how SSA can give its adjudicators a better understanding of and more actionable guidance on pain evaluation while maintaining the essential flexibility and latitude needed to guide people through a uniform disability determination process.
This Proceedings of a Workshop summarizes the presentations and discussions, reflecting the speakers’, panelists’, and participants’ broad range of views and ideas. The speakers’ presentations (as PDFs and video files) are available online.3
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3 https://www.nationalacademies.org/event/43975_04-2025_exploring-the-treatment-and-management-of-chronic-pain-and-implications-for-disability-determinations-a-workshop (accessed July 24, 2025).
BOX 1-1
Statement of Task
A planning committee of the National Academies of Sciences, Engineering, and Medicine will organize and host a 1 to 2 day public workshop to explore the wide variety of experiences and challenges related to chronic pain and its management. The workshop will include presentations with a focus on how those different experiences impact an individual’s health status, functional limitations, and medical records.
The workshop will feature invited presentations and panel discussions on topics such as:
- Current best practices and professional philosophy for the management of individuals’ chronic pain;
- Methods of categorization for chronic pain and the salient factors that identify individuals’ pain as falling within particular categories;
- Recent advancements and promising developments in the measurement of chronic pain levels;
- Special considerations in how medical providers approach treatment of chronic pain with varying or episodic severity compared to pain with relatively constant severity;
- Special considerations or challenges for medical providers in the management of chronic pain in children;
- Alternative and complementary pain treatments pursued by individuals experiencing chronic pain, the efficacy of those treatments, how they may be reflected in the medical record, and implications for, or interactions with, traditional treatment paradigms;
- The lived experiences of people with chronic pain as they seek medical care and navigate the SSA disability system; and
- An overview of recent or emerging research on new or improved methods for the measurement and management on chronic pain.
The planning committee will develop the agenda for the workshop sessions, select and invite speakers and discussants, and moderate the discussions. A proceedings of the presentations and discussions at the workshop will be prepared by a designated rapporteur in accordance with institutional guidelines.
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