Millions of Americans apply for Social Security disability benefits each year.  Only 30% of applications are approved at the initial stage of the disability claim process.

One of the leading reasons for denial of Social Security is the failure to follow treatment prescribed by your treating source.   If you fail to follow the treatment prescribed to you by your doctors, the SSA will likely deny your claim for disability benefits.  The main reason for this denial is that the examiner will not be able to determine whether your condition prevents you from being able to work or whether it is your unwillingness to cooperate with the treatment prescribed.

The SSA’s decision to award you benefits depends in large part on the authenticity and credibility of what you have stated in your application.  The agency must be able to verify through your medical records what you allege when you state that your condition makes it difficult or even impossible for you to carry out basic work-related activities such as walking, sitting,  lifting, seeing,  hearing, or communicating.

One of the first things the SSA evaluates is whether you have sought treatment for your condition by consulting a doctor or any other medical practitioner.   If you have failed to seek treatment, the SSA might conclude that your condition is not severe.

Another way the SSA assesses the credibility of your statements is by determining if you have adhered to the doctor’s prescribed treatment.

Even if you have what otherwise would be a disabling impairment, if you have refused to follow prescribed treatment that would restore your ability to perform full-time work, then your claim could be denied.

It is in your best interests to enlist the services of an experienced North Carolina disability lawyer to represent and guide you through the appeal process.

LEADING ACCEPTABLE REASONS FOR NOT FOLLOWING PRESCRIBED TREATMENT

Given below are several situations in which your failure to follow treatment may not be held against you.

  • RELIGIOUS BELIEFS

The established teachings and tenets of your religion prohibit you from following the prescribed treatment.   You are required to identify your religion, provide evidence of your membership and affiliation, and also provide evidence showing that your religion’s teachings and beliefs do not permit you to follow the prescribed treatment

  • UNAFFORDABLE TREATMENT

You are willing to follow the prescribed treatment but are unable to bear the costs of the treatment.  There are no free or low-cost medical facilities available for you to seek the prescribed treatment and there is no other alternative treatment available to you which is affordable.

  • PRIOR HISTORY

You failed to follow the prescribed treatment because you had previously undergone complicated procedure/s or major surgery for the same impairment unsuccessfully. 

  • FEAR OF SURGERY

The SSA will require a written statement from your own doctors confirming an extreme and unrelenting fear of the surgery.  

  • CONFLICTING PRESCRIBED TREATMENTS

When you have more than one doctor treating you and these doctors differ on what treatment is best to treat an impairment. You can use this lack of consensus among your doctors to avoid following the prescribed treatment.

  • FEAR OF UNDERGOING HIGH-RISK MEDICAL PROCEDURES

When the prescribed treatment involves amputation of one of your extremities or the level of surgical risk involved is very high, your refusal to undergo such a procedure will likely not harm your disability case.

 

CAN YOUR DISABILITY BENEFITS BE TAKEN AWAY FOR NOT FOLLOWING PRESCRIBED TREATMENT?

Yes.  If you (without good reason) failed to follow treatment prescribed that would have improved your medical condition, your benefits can be taken away.

Continuing Disability Review (CDR)

Every so often, a recipient’s case undergoes a continuing disability review.  The CDR is conducted by the SSA to make sure the recipient still meets the eligibility requirements for disability. 

Once a CDR is scheduled, the case is sent to the recipient’s local Disability Determination Services (DDS).  The DDS will scrutinize any fresh medical evidence made available and may send the recipient for examination by a Social Security doctor.

Disability benefits can be taken away if the recipient failed to follow prescribed medical treatment which would have restored his or her ability to engage in Substantial Gainful Activity (SGA).

Do You Have Questions?

Give Attorney Charlie Hall a call.  Our Social Security Disability attorney has handled hundreds upon hundreds of disability cases.  Give us a call. We can help.