How Can Prescribed Treatment Affect a Social Security Disability Claim?

 Posted on November 16, 2021 in Social Security Disability

There are many different types of health issues that may cause a person to be disabled. For those who suffer from serious health conditions, government benefits can be an essential resource that will allow them to cover their ongoing expenses. Social Security disability benefits can provide much-needed assistance, but to qualify for these benefits, a person will need to demonstrate that they meet Social Security’s standards for disability. One issue that can affect eligibility for benefits is whether a person has followed the prescribed medical treatment for their condition.

When Social Security May Consider a Failure to Follow Prescribed Treatment

If a person does not follow the treatment plan prescribed by a doctor, this may affect their ability to receive disability benefits. However, Social Security will only consider a failure to follow prescribed treatment in certain situations. This issue may be considered when determining whether a person’s condition is included in or is functionally equivalent to an entry in the Listing of Impairments. If a person would not meet the criteria for a listing if they had followed a doctor’s prescribed treatment, disability benefits may be denied. This issue may also be considered when determining whether a person has the residual functional capacity to perform work that is available. If Social Security determines that a person would be able to work if they had followed a doctor’s prescribed treatment, they may be denied disability benefits.

In these situations, only certain types of prescribed treatment may be considered. Social Security will look at a failure to follow prescribed treatment if all of the following conditions are met:

• A person is otherwise entitled to receive disability benefits - Issues related to treatment may only be considered after Social Security determines that a person is eligible to receive disability benefits. After determining that a person’s condition qualifies as a disability, Social Security may look at whether the person has failed to follow medical treatment that was prescribed.

• Treatment was prescribed by the person’s own medical source - Social Security will only consider treatment prescribed by a doctor or medical professional who has established a relationship with a person. Treatment prescribed by a medical expert, a consulting physician or psychologist, or a doctor performing an evaluation will not be considered. Forms of treatment that may be considered include surgery, medications, or the use of durable medical equipment or assistive devices, but lifestyle modifications such as dietary or exercise recommendations may not be considered.

• Evidence shows that treatment recommendations were not followed - Social Security must have a reason to believe that a person has not followed prescribed treatment, such as a doctor’s notes in medical records.

If the conditions for addressing the failure to follow prescribed treatment are met, Social Security will look at whether the treatment would affect a person’s ability to qualify for disability benefits. It will also consider whether a person has good cause for refusing to follow a doctor’s recommendations, such as religious objections or an inability to pay for certain forms of treatment.

Contact Our Dallas Social Security Disability Appeals Attorneys

If your ability to receive disability benefits has been affected by a failure to follow a doctor’s recommendations, The Law Offices of Coats & Todd can help you determine your best options. If your disability claim has been denied for invalid reasons, we can help you file an appeal, and we will fight to make sure you receive the benefits you need. Contact our Plano SSD benefits lawyers at 972-671-9922 to set up a free case evaluation.

Sources:

https://www.ssa.gov/OP_Home/rulings/di/02/SSR2018-03-di-02.html

https://www.ssa.gov/OP_Home/cfr20/404/404-1502.htm