When I prepare my clients to talk about their pain in a Social Security disability setting, I try to completely avoid the 1-to-10 pain scale. You know the one, the smiley face at the 1, the frowny face at the 10. It's everywhere in medicine, but it's a bad way to explain how you're actually doing to a disability decision maker. Let me walk through why, and what I think you should do instead.

Rate your pain anywhere from a 1 to a 5 and it sounds like you're not disabled. It sounds like it's just not that bad. That number, sitting by itself, works against you.

Now go the other direction. Say your pain is a 9 or a 10. The disability judge or decision maker is going to think: if the pain was really that bad, how come you didn't seek medical attention? Ten out of ten pain, why didn't you go get help? Even when your pain is real, you come across as exaggerating.

So that really only leaves 6, 7, or 8 as the numbers you can list without hurting yourself. And what does a 6, 7, or 8 actually mean? Nobody knows. If your pain truly is a 10 and medical treatment can't help you, you end up calling it an 8 and just hoping the judge gives you the benefit of the doubt. That's not a great position to be in.

Talk about your pain in terms of the effect it has on you. Describe what it makes you do and what it stops you from doing. Some examples of what that sounds like:

That kind of description tells the decision maker something real about your life. It shows how your pain changes your behavior and limits what you're able to do, which is exactly what the SSA is trying to figure out.

The 10-point scale was never designed to decide a disability case. If you're asked to rate your pain, don't just hand over a number and stop there. Explain what the pain does to you, how long it lasts, and what you have to do to get through it. That's how you make your pain understood.

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