No matter how serious or debilitating your disability may be, not following your doctor’s orders regarding the treatment of your illness or condition could ruin or lower your chances for securing Social Security disability benefits. According to Social Security law, your disability claim can be denied if you are not following a doctor-prescribed treatment plan that could restore your health and your ability to work.
In other words, if you want to maintain your health and if you want to be awarded Social Security disability benefits, it is vital that you follow your doctor’s orders.
What Does That Mean?
Every treatment plan is unique. However, you should follow your doctors’ recommendations for:
- Follow-up appointments
- Physical therapy sessions
- Counseling sessions
- Medical tests
- Procedures or surgeries
The following excuses will not work with the Social Security Administration:
- I didn’t think the treatment would work.
- I kept forgetting to fill the prescription or to look into treatment.
- I tried the treatment for a few days but then decided to stop.
- I could afford the treatment, but didn’t continue it because of the extra expense.
- The treatment had a side effect, and I stopped taking it without telling my doctor.
- The treatment took too much time or didn’t fit into my schedule.
If you have questions about your treatment plan or you cannot follow through with recommended treatment, you should notify your doctor right away.
Along with information regarding all of your medical doctor appointments, diagnoses, and recommended treatments, include documentation from consultations with anyone who has examined you for anything related to your condition, including:
- Nurse practitioners
- Physical therapists
- Mental health practitioners
- Social workers
Alternative medicine treatments you’ve used to cope with symptoms should also be documented. This may include:
- Over-the-counter medications
- Assistive devices, such as braces or canes
- Herbal supplements
- Therapeutic exercises
- Relaxation techniques
It is important to show every effort you’ve made to find treatment or deal with symptoms resulting from your condition if you aren’t complying with a recommended course of treatment.
Exceptions to the Compliance Rule
While compliance with doctor-recommended treatments is typically important for a person’s recovery of Social Security disability benefits, there are some situations in which medical non-compliance won’t hurt your disability claim. Specifically, you may not have to comply with recommended treatments if:
- The treatment goes against your religious beliefs.
- You have an extreme fear of surgery.
- You cannot afford a treatment, and there are no outside resources or programs that make the treatment affordable.
- The treatment is not available in your community.
- You have two treating sources that do not agree on a prescribed treatment.
- You are disabled because of a failed major surgery, and the prescribed treatment is another major surgery.
- You refuse treatment because of the high risk of the treatment such as an open-heart surgery or organ transplant surgery.
- You refuse a surgery that involves the amputation of an extremity.
The SSA may determine that you have failed to follow prescribed treatment only when:
- The treatment is clearly expected to restore the claimant’s ability to engage in substantial gainful activity (that is, that the therapy can restore your ability to work).
- The treatment is prescribed by your treating source (that is, that your doctor prescribed the therapy).
- The treatment was refused by the patient without a justifiable excuse (that is, the therapy was ignored without good reason).
If you are applying for Social Security disability benefits but have not sought any form of treatment for your disabilities, your claim will be denied. This rule is hard and fast and our firm won’t take cases where the client hasn’t sought diagnosis or treatment.
In evaluating a claim, the Social Security Administration looks for basic evidence that the applicant’s disabilities have made it extremely difficult or even impossible to find or maintain sufficient employment. Therefore, demonstrating a history of attempting to find help—even when those attempts ultimately proved unsuccessful—will be crucial to the success of your claim.
by Paul B. Burkhalter Managing Partner of Morgan & Weisbrod, Board Certified in Social Security Disability Law.