Alcorn, Sage, Schwartz &
Magrath LLP

Your duty to get treated and a Social Security Disability claim

When you file for Social Security Disability (SSD) benefits, one of the questions that the disability examiner is going to ask is, "Have you gotten treatment for your condition?"

It's an important question.

Many mental and physical conditions do respond well to appropriate medical care. The right care may even restore an individual's capacity to work. Plus, the fact that you have sought various treatments for your condition over time is a fairly strong indicator that you have a condition that is genuinely troublesome to you. Since objective medical evidence of someone's disability can be difficult to obtain, especially when chronic pain is a big factor, repeated attempts to find a workable treatment also provide proof of your disability.

Sometimes, however, people haven't obtained treatment for their condition at all -- or they get a doctor's recommendation, but they fail to follow through. Does that mean an automatic end to your disability claim?

Not necessarily.

Social Security regulations address this exact issue. Essentially, it gives official recognition to the fact that sometimes there's a reasonable justification for people to not obtain medical care for their condition -- even if it is recommended by a doctor. While this is just a partial list of the reasons that the agency considers acceptable, reasonable justifications include:

  • A valid religious objection to the treatment (such as those given by Christian Scientists)
  • The disabled individual has received conflicting opinions from two different doctors about whether or not the treatment should proceed
  • The recommended treatment is surgical, and the patient was previously disabled due to a prior surgery or has an intense fear of surgery to the point that its contraindicated
  • The recommended treatment requires the amputation of one or more extremity
  • The individual has no insurance coverage or has insurance but still cannot afford the recommended care

Even physical barriers to treatment -- like the lack of an available treatment center within a reasonable distance from the disabled individual's home -- can be considered a true justification for not obtaining treatment.

If you're concerned that your lack of treatment and lack of medical documentation means that you can't qualify for Social Security Disability benefits, talk your situation over with an experienced attorney today. You may be surprised at what's possible.

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