Social Security may refuse disability payments if you do not take recommended drugs or other therapy.
If you apply for disability benefits but do not adhere to your doctor's treatment plan, Social Security may deny your claim for "treatment noncompliance." This is because Social Security may find that if you took the medicine, had the surgery, or otherwise followed your doctor's instructions, you would be able to work. While there are certain exceptions to this rule, it is vital to follow your doctor's recommended course of treatment to the maximum extent possible in order to completely avoid this condition.
Disability Benefits Denied Due to Noncompliance with Treatment
If you fail to follow prescribed therapy, take prescribed medicine, or undertake advised surgery, you may be denied Social Security or SSI disability payments, but only if the four requirements listed below are satisfied.
- - Your disability precludes you from engaging in any considerable gainful activity (SGA).
- - Your disability has lasted or is projected to persist at least 12 months or will result in death.
- - Your treating physician has recommended treatment that will obviously restore your capacity to work full-time.
- - You have refused to follow your medical doctor's treatment plan.
There are a few key elements to note here. First, the therapy or drug in question must be recommended by your treating doctor, not by a consulting examiner or a physician for Disability Determination Services (DDS). Furthermore, the therapy recommendations must be more precise than generic lifestyle counsel. If your doctor has told you to lose weight, quit smoking, and exercise more — and who hasn't? — this is not prescribed treatment. (However, if your doctor instructs you to quit using drugs and alcohol, failure to do so may have an influence on your claim.)
Furthermore, your doctor's therapy or medication must clearly be expected to restore your ability to work full-time. It must be able to identify whether or not you are able to work. As a result, even minor deviations from your doctor's recommended therapy are rarely grounds for Social Security to refuse your claim.
Possible Justifications For Not Following Treatment
If Social Security determines that you meet the four criteria outlined above, the government may deny your disability claim unless you can show that your refusal to comply with treatment was justified. Here are some instances of situations in which your reluctance to comply with treatment will not be used against you.
- - Your religious convictions are violated by the medical therapy prescribed.
- - You cannot afford the necessary therapy or medicine, and there are no adequately accessible free or low-cost clinics.
- - Your treating physician's therapy contradicts the recommendations of another treating source.
- - You have a severe aversion to surgery.
- - One of your limbs will be amputated as part of the treatment plan.
- - The doctor recommended an exceptionally dangerous procedure.
- - You have a mental disorder, and not following therapy is a sign of it.
While these are some of the most prevalent explanations, they are not all-inclusive. If you have not followed your doctor's treatment recommendations but can give proof that your rejection is warranted, Social Security may nevertheless approve your claim.
If Social Security denied your claim because you did not comply with prescribed therapy, consult with an attorney about your possibilities of prevailing on appeal. For more information, you may seek legal help from our expert disability attorneys at the Law Office of Irene Ruzin.