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I’m applying for Social Security Disability, should I have to follow my doctor’s advice?

One common question we are asked by our clients is: I’m applying for disability.  “Do I Have to Do What the Doctor Says? I’m having enough trouble just making ends meet.” The short answer is Yes, within reason or it will affect your eligibility to receive Social Security Benefits. “Individuals with a disabling impairment which is amenable to treatment that could be expected to restore their ability to work must follow the prescribed treatment to be found under a disability, unless there is justifiable cause for the failure to follow such treatment.” Social Security Ruling 82-59. If there is a failure to follow prescribed treatment then Social Security will determine the following: 1. whether the individual’s impairment prevents full-time work; 2. whether the impairment will last for 12 full months or more; 3. whether treatment that could restore an individual’s capacity to work has been prescribed; 4. whether there has been a refusal to follow the prescribed treatment and 5. whether the refusal was justified. SSR 82-59 If there is prescribed treatment and it was unjustifiably refused, then the individual will not be eligible for disability benefits. There are a number of reasons for not following treatment that would be considered justified.  For example; if the individual cannot afford the treatment it would not be considered an unjustified refusal. It would be a justified refusal if the treatment would be contrary to an individual’s religion. If the treatment is recommended by one doctor but another treating doctor recommends against it, it is a justified refusal to follow one doctor over another. If the treatment carries a high degree of risk because of the unusual nature of the treatment, the refusal is justified. SSR 82-59.   These are just some examples of  situations where failure to follow prescribed treatment would not be a bar to receiving benefits. This is not an exhaustive list and every person’s case is different and should be considered on its own merits. The best policy is to do what the doctor says to the best of your ability as it is often difficult enough to explain your individual circumstance without also having to explain why you didn’t listen to your doctor as well. Social Security is merely trying to determine whether an individual’s condition can be controlled by treatment.  Keeping medical appointments and following prescribed treatment is the one of the best ways to establish that your condition is severe and disabling.  

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