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SSA Disability - Do I have to take medication to win benefits?

Many Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) applicants wonder how much medical care is necessary to win SSDI or SSI? How many times do they have to see the doctor? How much evidence do they need to prove their disorder? Do they have to follow their doctor’s treatment plan? Recently on our SSA disability forum a user asked, “Can I win SSDI benefits if I do not take medication?”

Denied Social Security Disability for Refusing proper medical treatment

The basic question if you refuse to take your medication is whether or not the Social Security Administration (SSA) believes that taking medication would restore you to a level that you that would allow you to perform substantial gainful activity.  If, however, the SSA determines that following your doctor’s treatment plan and not taking medication would not restore to a point that you could perform work they are likely to find you disabled (assuming you meet all other medical and nonmedical criteria).

Let’s look at an example. If you are severely depressed and you are receiving treatment from a mental health doctor and they have prescribed Cymbalta or Paxil, assuming there is substantial medical evidence that these medications have helped thousands of claimants overcome severe depression, but you decide not to take the medication, it is likely that the SSA would determine that if you were following the doctor’s treatment plan you could work and they would find you not disabled.

But what happens if your doctor prescribes medication or suggests a treatment plan that is not recognized as appropriate? In this case, the SSA would evaluate if the medication or treatment plan offered by your doctor is considered a “standard medical opinion.”  It the doctor, for instance, prescribed a drug for a mental disorder that is not generally used to treat your condition the Social Security Administration (SSA) is likely to disregard their opinion.

Valid Reasons to not take medication for Social Security Disability

If you are not taking your prescribed medications it also possible to convince the SSA that you have a valid reason for not doing so. For instance, the SSA lists several reasons that you may be allowed to refuse medical treatment:limited I.Q., severe phobia of surgery, severe mental illness, repetitive surgeries for similar conditions when surgery has been unsuccessful in the past, the treatment plan is too risky, the medical opinions vary on the treatment plan, you have a lack of funds and the SSA cannot find an acceptable alternative or you have religious objections to treatment.

For instance, using the example above, if you have been severely depressed for twenty years and have tried a variety of medications but have not successfully overcome your depression despite treatment, the SSA may accept that refusing more medication is understandable.

Hiring a Social Security Disability Lawyer

The best thing to do if you have questions about the rules and regulations about Social Security Disability is to talk to a disability lawyer. They will generally provide a free consultation to review your disability case and determine if they will be able to help you win SSDI or SSI benefits.
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