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What Happens To Your SSDI Claim If You Don't Follow Your Doctor's Orders?

by Lois Gibson

The path to a successful claim for Social Security Disability (SSDI) benefits is long and hard, but some claimants make it harder on themselves than it has to be. All too often, disability applicants make simple, avoidable mistakes that can absolutely tank their claims.

One of the worst mistakes you can make, for example, is not following your doctor's recommended course of treatment. Here's what you need to know about how that will affect your claim.

Social Security Disability Claims Are Won or Lost on the Evidence

There's not any magic that you can do to make your claim get approved. Although the Social Security Administration denies plenty of claims unfairly and forces them into appeals, no claim is approved unless there is enough medical evidence in the file to support the decision.

If you aren't following up with your doctors and continuing to receive the treatment that they recommend, your file is going to be missing a lot of medical evidence. That doesn't give the claims examiner much to use. In fact, the examiner may well conclude that your condition isn't really that severe -- otherwise, you'd be more proactive about treatment.

Social Security Is Purposefully Restrictive About Following a Doctors' Orders

Social Security regulation SSR 18-3P provides rules for the way your claim will be decided if you aren't following your doctor's recommended course of treatment. The claims examiner is required to:

  1. Make an assessment about whether treatment, if followed, would likely make it possible for you to perform substantial gainful activity
  2. Determine if you have any "good cause" for not doing as your doctor prescribed

What does that mean? Essentially, if there's any possibility that your doctor's treatment could restore your ability to be gainfully employed, your SSDI claim will be denied. Furthermore, if you haven't followed your doctor's treatment plan, you have no way to prove that it won't work.

SSA Doesn't Accept Many Excuses

What does SSA consider a "good" reason to ignore your doctor's orders? It varies from person to person, but the only acceptable reasons are usually:

  • The recommended treatment is invasive and dangerous to your life.
  • You don't have insurance or the financial means to obtain the treatment.
  • The treatment violates a deeply held tenement of your religion.

The smart move is always to be cooperative and compliant with your doctor's orders. You don't want to give Social Security any easy openings through which they can deny your claim.

If you have struggled to get your disability claim approved, a Social Security law firm may be able to help you.