Every now and then at a Social Security disability hearing, the issue of failure to follow prescribed medical treatment is raised by the administrative law judge.
You don’t want this issue at your hearing. If a claimant has failed to follow prescribed medical treatment, and the prescribed treatment would restore the claimant’s ability to work at the SGA level, then the disability claim will be denied. See 20 C.F.R. 404.1530.
An individual who would otherwise be found to be under a disability, but who fails without justifiable cause to follow treatment prescribed by a treating source which the Social Security Administration (SSA) determines can be expected to restore the individual’s ability to work, cannot be virtue of such “failure” be found to be under a disability.
The issue of failure to follow prescribed medical treatment is addressed by Social Security Ruling 82-59. The Ruling is a must-read. It is important to know the details of the compliance analysis, because it can salvage a disability claim. Actual failure to follow prescribed treatment is narrowly defined; each of several requirements must be met before a denial on that basis is appropriate.
The requirements are: (1) the treatment must have been prescribed by a treating source; (2) the treatment at issue should be expected to restore the claimant’s ability to work; (3) the treatment must have been refused; (4) the refusal must have been without justifiable excuse.
A doctor’s recommendation (to stop smoking, or to lose weight, or to get more exercise) is not prescribed treatment. For more on evaluating failure to follow prescribed treatment in the context of obesity, see Social Security Ruling 02-1p at #14.