Failure to Follow Prescribed Therapy

Lawyers for SSDI Claims in Chicago

The Social Security Administration’s (SSA) decision to award benefits hinges partially on your compliance with medical treatment prescribed by your doctor or specialist for your disability. Your credibility as a claimant is partially contingent on your willingness to follow a health care provider’s course of care. A failure to follow prescribed therapy can work against you. At Katz, Friedman, Eisenstein, Johnson, Bareck & Bertuca, our experienced Chicago Social Security attorneys may be able to represent you in an SSDI claim.

Failure to Follow Prescribed Therapy

In evaluating your claim for benefits, the SSA will look at whether you’ve gotten treatment for the condition you state is disabling. Failure to comply with prescribed therapies consists of the following elements: (1) you have an impairment that stops you from doing substantial gainful activity, (2) your impairment has lasted or will last at least 12 months or can be expected to end in death, (3) your doctor has prescribed treatment that would clearly return you to a condition in which you could work full time, and (4) you refused to comply your doctor’s prescribed treatment.

You should seek medical care from a licensed health care provider. Your provider’s prescribed therapy could include regular attendance at medical appointments, taking medications, using a brace, or using a cane. If you haven’t followed your recommended treatment, the agency will determine your condition isn’t as restrictive or severe as you claim. If you have a recorded history of seeing a healthcare provider and trying various options to treat your disability, it’s likely the agency will find your SSDI claim credible.

Failure to follow the prescribed treatment of your own doctor or specialist may result in an SSDI denial. You won’t be required to follow the treatment recommendations for a doctor the SSA wants you to see or be examined by.

The issue in assessing whether you have failed to follow prescribed therapy is whether what was prescribed would have made you able to work full-time again. In other words, when you fail to follow prescribed treatment, take prescribed medication, or undergo recommended surgery, Social Security can deny you SSDI or SSI benefits, but only if what was prescribed would be anticipated to put you back into being involved in substantial gainful activity. Exercise or losing weight through dietary changes wouldn’t count as prescribed therapy.

Social Security isn’t permitted to reach any conclusions about your failure to comply with treatment or seek treatment without first contacting you to determine whether you had good reasons not to do so. For example, if you don’t have sufficient insurance coverage for the treatment, you aren’t expected to comply with prescribed therapy in order to obtain SSDI. As another example, there are some medications for which the side effects are worse than the symptoms, and this would be considered a good reason not keep going with a prescribed therapy. There are certain reasons for which it may also be permissible not to undergo a surgery that was prescribed. It can be helpful to have an attorney to make sure that the agency receives a full explanation as to why you failed to follow a particular treatment.

Mental Health and Failure to Follow Prescribed Therapy

Often people with disabling mental health conditions don’t comply with prescribed therapy such as going to psychiatrist’s appointments or taking prescribed medication. This behavior is often considered a symptom of the disabling mental illness. There have been situations in which the SSA’s rejection of a mentally ill applicant’s claim for benefits was sent to be reevaluated where the applicant had a mental health disability.

Knowledgeable SSDI Attorneys Serving Chicago

If you’re concerned about being denied SSDI benefits or losing your benefits for failure to follow prescribed therapy in Chicago, you can talk to a seasoned SSDI lawyer. At Katz, Friedman, Eisenstein, Johnson, Bareck & Bertuca, we represent workers in Rockford, Aurora, Champaign, and Quincy, as well as Winnebago, Sangamon, Cook, Adams, and Kane Counties. We look closely at each client’s situation to determine whether there are other forms of relief available in addition to SSDI or SSI. Contact us at 312-724-5846 or by completing our online form.