Best Practices for Social Security Disability Cases: Compliance With Your Doctors Treatment & Medication Recommendations

Published on: June 22, 2017

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The main basis of a social security disability claim is the presence of an impairment that prevents you from engaging in any substantial gainful activity. In order for the SSA to approve your disability claim,it must be convinced that you have sought after all types of treatment in your power for your medical condition.

In attempting to prove the credibility of your application, SSA officials will review the treatment plans that have been prescribed for you by your doctors, and whether you have followed them. This article will provide insights into the best practices for social security disability cases, particularly the importance of complying with your doctor’s treatment plans and medication.

Compliance with Treatment Plans Strengthens your Disability Application

When you make a disability application to the SSA, your goal is to try and show how your condition impairs your ability to work. Part of this process involves showing evidence of steps you have taken to seek treatment for your medical condition. Treatment plans can include the proper use of medical devices or taking prescription medication in the correct doses.

Compliance with taking medication and other treatment plans shows that you have attempted to seek treatment for your condition. In fact, if you are able to show an extensive record of how you have sought treatment over a long period of time, your application gains much more credibility with the SSA. When you are able to show evidence of how your condition has not improved even after seeking treatment, the SSA is more likely to view your condition as severe, long lasting, and disabling.

How Non-compliance Affects your Disability Application

When making a disability application, the SSA checks what treatment was recommended by your doctor and if you have followed the recommended treatment plans. Failure to comply, such as not taking prescribed medication, not undergoing a recommended surgery, or a lifestyle change (such as advice to cease smoking or use of alcohol) can cause your disability application to be denied. There are 4 circumstances under which non-compliance with treatment can lead to a denied disability application. These are:

  • You have an impairment that is preventing you from working full-time
  • Your condition is expected to last for at least 12 months, or result in death
  • You've been prescribed treatment by the doctor that if taken correctly, would fully restore your ability to work
  • You have refused to follow the prescribed treatment plans

When considering these circumstances, it is important to note that the recommended treatment for your condition should be the difference between being healed and having your ability to work restored and you continuing to experience the condition that you are facing.

Therefore, a minor deviation from your treatment plans is not enough reason for the SSA to deny your application. In addition, recommended lifestyle changes (such as advice to quit smoking or using alcohol) should directly result in an improvement of your condition and the restoration of your ability to work. Otherwise, the advice does not qualify as a prescribed treatment.

Failure to Follow Treatment is Sometimes Justified

There are several circumstances under which a refusal to follow the recommended treatment can be justified and the SSA will not use this as grounds to deny your application. Some of these circumstances include:

  • The medication prescribed goes against your religious beliefs: if a prescribed medication violates your religious practices, you can provide evidence of this violation from a church authority outlining how the treatment goes against the teachings of your religion.
  • Conflicts between physicians treating you: sometimes, different physicians may recommend conflicting treatments for your condition. Such a situation is a common scenario for refusing treatment and it is an acceptable reason for the SSA.
  • Inability to access the recommended treatment: if you are not able to access the recommended treatment for reasons such as finances, this can be sufficient grounds for non-compliance. Treatment can be expensive and you may not able to access the required medication even from subsidized clinics, charity or public programs.
  • An unusually risky procedure has been recommended by a doctor: in some cases, your doctor may recommend a high-risk procedure such as open-heart surgery or an organ transplant as the only effective treatment for your condition. You may elect to refuse to undergo such a procedure due to the risks involved, and the SSA will not hold this against your application.

In conclusion, a refusal to follow the recommended treatment for your condition can result in the denial of your disability application unless the refusal is justified. It is recommended to always be compliant with the treatment your doctor has prescribed, or to provide sufficient evidence to the SSA for a justified refusal to follow recommended treatment plans.

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