Refusing Medical Treatment Can Affect Your SSDI Benefit Eligibility

Obtaining Social Security Disability Insurance (SSDI) benefits is not an easy feat. For some individuals, especially those whose disability may not fit into a traditionally recognized mental or physical impairment category, the process of getting SSDI benefits can be exhausting.

During the application process, there is more than one way by which your SSDI application can be derailed. One easy way to have your application denied is by refusing medical treatment and procedures deemed necessary by your medical providers.

Your Medical History and the Story Your Records Tell

Your medical history plays a significant role in determining whether your application for SSDI benefits is approved or denied. The Social Security Administration (SSA) relies on the notes and observations of your treatment providers to assess the severity of your disability and the impact it has on your ability to work.

Medical records will tell the SSA when you first started reporting symptoms and what those symptoms looked like. If your symptoms have changed or worsened over time, your medical history will reveal this as well. Your records also contain a history of the treatments and procedures you have received and their effectiveness.

The Story Told by a Missed Appointment or Surgery

While you understand that your medical records tell a story about your condition and its impact on your life, you may wonder what is communicated when you fail to follow your doctor’s advice. Simply put, not following your doctor’s advice calls into question the severity of your condition. 

There are several reasons the SSA might assume your condition is not as serious as you claim when you fail to follow doctors’ orders:

You Are Refusing Treatment Because Your Condition Has Improved

The first assumption the SSA might make is that you are not getting the treatment you need because your disabling condition has improved. 

You do not need to have a tooth removed, for example, if the pain has subsided and there is no underlying infection. In the same way, the SSA might believe that your refusal to get the treatment or procedure recommended by your doctor is due to an improvement in your situation.

You Do Not Trust Your Doctor

The SSA may determine that you are refusing your doctor’s recommendations due to a distrust of your provider. 

If you do not trust your doctor, it is more difficult for the SSA to believe your doctor’s assessments of your condition’s severity. The SSA may have trouble believing your doctor, their diagnosis, and their reports if it seems like you are not giving them much credence, either.

You Just Do Not Want to Work

Social Security disability benefits exist to support those individuals who cannot work due to a mental or physical condition. Those who receive benefits have shown enough evidence that they cannot work even if given accommodations and support.

But if your records show you are refusing to try appropriate treatments and procedures, the SSA may conclude that you are attempting to game the system. Your claim may be denied because the SSA believes you have not sufficiently demonstrated that you will remain unable to work even when your condition is appropriately treated.

What to Do If You Cannot or Will Not Get the Treatment You Need

Sometimes you are not able to follow your doctor’s orders or keep appointments. If this happens, do not treat these incidents lightly. Make sure your medical records tell the whole story by:

Talking to Your Provider

First, tell your doctor why you are not keeping appointments or scheduling the procedure they recommended. Do not remain silent. If you have concerns about the procedure, ask your medical doctor about them; do not rely merely on your internet sleuthing skills to investigate the proposed treatment or procedure.

If you still do not agree with the proposed course of treatment, or if you cannot afford it, discuss treatment alternatives with your doctor.

Getting a Second Opinion

Try to get a second opinion from another doctor if you are not certain the proposed course of treatment is right for you. This shows the SSA that you are not ignoring your doctor’s advice but rather that you are trying to make an informed decision and receive only the treatments or procedures that will truly help you.

Contact a Knowledgeable Social Security Disability Attorney

If you have questions or concerns about your SSDI benefits application or what you need to do to maximize your chances for approval, turn to SocialSecurityDisability.com for assistance. When you call us at (833) 613-0618 or complete our online evaluation form, we will help you find a qualified attorney in your area who can provide you with the answers and representation you need.