If you're applying for disability benefits but not complying with the medical treatment prescribed by your doctor, Social Security may be able to deny your claim for "treatment non-compliance." This is because Social Security can find that you would be able to work if you took the medicine, had the surgery, or otherwise followed the treatment recommended by your doctor. While there are some exceptions to this rule, it is important to follow your physician's prescribed course of treatment to the extent possible so that you can avoid this matter entirely.
If you fail to follow prescribed treatment, take prescribed medication, or undergo recommended surgery, this may prevent you from getting Social Security or SSI disability benefits, but only when the following four criteria are met.
There are several important points to remember here. First, the treatment or medication in question must be prescribed by the doctor who treats you, not by a consulting examiner or a physician for Disability Determination Services (DDS). Also, the treatment instructions must consist of something more specific than general lifestyle advice. If your doctor has advised you to lose weight, stop smoking, and exercise more — and whose hasn't? —this advice does not constitute prescribed treatment. (If, however, your doctor advises you to stop using drugs and alcohol, failure to follow this advice certainly could impact your claim. Read Nolo's article on when drug or alcohol use prevent you from getting disability benefits).
Also note that the treatment or medication your doctor has prescribed must be clearly expected to restore your ability to do full-time work. It literally must be able to make the difference between whether or not you can work. For this reason, a minor deviation from your doctor's prescribed treatment is usually not a sufficient basis for Social Security to deny your claim.
If Social Security determines that you meet the four criteria above, the agency can deny your disability claim unless you can show that you were justified in failing to follow treatment. Here are several situations in which your failure to follow treatment will not be held against you.
While these are some of the most common justifications, this is not an exhaustive list. If you haven't been compliant with the treatment recommended by your doctor but can provide evidence that your refusal is justified, Social Security may still approve your claim.
If Social Security denied your claim for failing to follow prescribed treatment, talk to an attorney about your chances of winning on appeal. You can arrange a free consultation with a disability lawyer here. If Social Security denied your claim because you haven't had any treatment at all, read our article about getting disability benefits when you haven't had consistent medical treatment.
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