Somatoform Pain Disorders and Disability

Facts

This decision of the Swiss Federal Tribunal concerns an appeal by an insured person (J.) against the decision of the Disability Insurance Office of the Canton of Solothurn and the Insurance Court of the Canton of Solothurn. The main issue is to determine whether the insured person's somatoform pain disorders can be considered a disability within the meaning of the Disability Insurance Act (GSSLA).

Considerations

The Federal Tribunal recalls that impairments to mental health can just as much as physical impairments lead to a disability within the meaning of Art. 4 para. 1 GSSLA in conjunction with Art. 8 InvIA. However, limitations on earning capacity that could be avoided by an effort of will on the part of the insured person are not considered to be consequences of mental health damage and are therefore not relevant in terms of disability insurance law.

The recognition of mental health damage, such as persistent somatoform pain disorder, first requires a diagnosis established by a specialist physician (psychiatrist) according to a scientifically recognized classification system. However, such a diagnosis alone is not sufficient to establish disability. There is a presumption that somatoform pain disorder or its consequences can be overcome by a reasonable effort of will. Certain circumstances that intensely and constantly impede the control of pain may, however, make the professional reintegration of the insured person unreasonable, as they would then not have the necessary resources to cope with their pain.

To determine whether such an exceptional case is proven, various criteria must be examined, in particular the presence of a severe, persistent and marked comorbid mental illness, as well as other factors such as concomitant chronic physical illnesses, a chronic course of the disease without lasting improvement, social withdrawal, a fixed and inaccessible psychological dynamic, or the failure of outpatient or inpatient treatment despite the cooperation of the insured person.

Conversely, when the limitation of earning…