Does non-compliance with your medical care hurt your Social Security Disability case?

 How Non-compliance Affects your Disability Application

When making a disability application, the SSA checks what treatment was recommended by your doctor and if you have followed the recommended treatment plans. Failure to comply, such as not taking prescribed medication, not undergoing a recommended surgery, or a lifestyle change (such as advice to cease smoking or use of alcohol) can cause your disability application to be denied. There are 4 circumstances under which non-compliance with treatment can lead to a denied disability application. 

These are:

-You have an impairment that is preventing you from working full-time

-Your condition is expected to last for at least 12 months, or result in death

-You've been prescribed treatment by the doctor that if taken correctly, would fully restore your ability to work

-You have refused to follow the prescribed treatment plans

When considering these circumstances, it is important to note that the recommended treatment for your condition should be the difference between being healed and having your ability to work restored and you continuing to experience the condition that you are facing.

Therefore, a minor deviation from your treatment plans is not enough reason for the SSA to deny your application. In addition, recommended lifestyle changes (such as advice to quit smoking or using alcohol) should directly result in an improvement of your condition and the restoration of your ability to work. Otherwise, the advice does not qualify as a prescribed treatment.

Failure to Follow Treatment is Sometimes Justified. There are several circumstances under which a refusal to follow the recommended treatment can be justified and the SSA will not use this as grounds to deny your application. Some of these circumstances include:

The medication prescribed goes against your religious beliefs: if a prescribed medication violates your religious practices, you can provide evidence of this violation from a church authority outlining how the treatment goes against the teachings of your religion.

Conflicts between physicians treating you: sometimes, different physicians may recommend conflicting treatments for your condition. Such a situation is a common scenario for refusing treatment and it is an acceptable reason for the SSA.

Inability to access the recommended treatment: if you are not able to access the recommended treatment for reasons such as finances, this can be sufficient grounds for non-compliance. Treatment can be expensive and you may not able to access the required medication even from subsidized clinics, charity or public programs.

An unusually risky procedure has been recommended by a doctor: in some cases, your doctor may recommend a high-risk procedure such as open-heart surgery or an organ transplant as the only effective treatment for your condition. You may elect to refuse to undergo such a procedure due to the risks involved, and the SSA will not hold this against your application.

In conclusion, a refusal to follow the recommended treatment for your condition can result in the denial of your disability application unless the refusal is justified. It is recommended to always be compliant with the treatment your doctor has prescribed, or to provide sufficient evidence to the SSA for a justified refusal to follow recommended treatment plans.

If you need helping applying for Social Security Disability or SSI, please contact me at joshben99@gmail.com. I have over 25 years experience with Social Security Disability cases.

Location: Michigan, USA

Comments

Post a Comment

Popular posts from this blog

Sample questions you may be asked at your social security hearing

  Every case is different; no list will contain EVERY question an administrative law judge might ask, and the questions may not be asked in exactly this way, or in this order, but this information should help prevent you from feeling like questions are coming at you from “left field.” Going over this list will also spur you to think about things you might not have previously considered (such as how long you can sit, stand, walk or concentrate). You will NOT be asked every single question on this list and it is NOT useful to try to memorize answers to the questions. Just read over the list in the days before your hearing. Of course, this list should NOT be construed as legal advice pertaining to your case, and by providing it, I am not acting as your lawyer. My intention is just to provide some really helpful, general information. I. INTRODUCTORY INFORMATION Name – address – date of birth Marital Status and maiden name Former spouse information Do you live in a house, apar...
Read more

Frequency of Medical Treatment

The frequency of your medical treatment is an important factor in your Social Security disability claim. A diagnosis is a first step, but a judge must evaluate your functional limitations due to your medical condition. And when evaluating the seriousness of your functional limitations, regular doctor visits are helpful. Looking at the cases of mine that were not granted in the past year or so, the lack of medical treatment played a role in almost every one. There a lots of reasons not to go to the doctor. There are co-pays. Sometimes there is little the doctor can do for you. Perhaps you do not want to complain to the doctor about your daily struggles. But without regular doctor visits, you may have an uphill battle for disability benefits. Also, the more the doctor sees you and is familiar with your condition, the more likely that the doctor will provide an opinion regarding your functional limitations. Those opinions are often the most persuasive medical evidence available to a perso...
Read more

Covid Long Haul and Social Security Disability

Social Security Disability is a federal program to assist individuals who suffer from long-term disabilities that will keep them from working for 12 months or longer. This program is funded through payroll taxes that everyone sees on their pay stubs.  Applying for SSDI as a COVID long-hauler is a bit of a complex topic at this point. Due to the associated symptoms of long COVID, it is reasonable to connect having the disease and qualifying for disability benefits. However, every case is individually considered by the Social Security Administration (SSA) before approval, and there are plenty of cases that are later approved after being initially denied.  Long COVID, or long-haul COVID, is a term to describe a syndrome where symptoms continue months after a coronavirus infection. Researchers think that 10% to 30% of patients who had COVID infections might suffer from long COVID, or "post-COVID syndrome," whether their initial illness was serious or not. Some researchers define ...
Read more