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Can an Individual Be Approved for Social Security Disability or Social Security Supplemental Income If They Are Non-Compliant with Medical Treatment? - Part 2

My name is Scott Rubin and I'm a Social Security Disability attorney. I've been practicing Social Security Disability with Rubin & Badame, Attorneys at Law, P.C. for over 20 years. We practice Social Security Disability throughout Philadelphia, as well ss in all of Pennsylvania, New Jersey, Maryland, and Delaware.

Over the years, we have represented thousands of clients who were applying for SSD and SSI. Often clients are in a quandary. They've been non-compliant with their medical doctor's orders, yet they still want to get Social Security Disability.

The Old Rule Regarding Non-Compliance

The question is if a claimant is non-compliant with his or her doctor's orders, can they still be approved for Disability? The answer is, it depends. The old rule was SSR 82 59. And that rule stated that if the individual was non-compliant, yet it was not willful, a judge could not hold that against the individual.

The New Rule Regarding Non-Compliance

However, the new rule under 18-3P has more specific provisions:

Is the doctor a certified professional?

Number one: The doctor must be a medical doctor or a nurse practitioner with some type of certification, usually in medicine. They could also be certified in psychiatry.

What was prescribed?

Number two: What was prescribed? It had to be medication, treatment, or therapy. Just because a chiropractor says to lose weight, that's not a prescribed treatment. Or if a physical therapist says to stop smoking and the claimant doesn't stop smoking, that doesn't count as a prescribed treatment. And a judge cannot hold that against the client.

Acceptable reasons for non-compliance

In addition, even if a medical professional or a nurse practitioner does prescribe medication, surgery, or therapy to a claimant, there are reasons why the claimant may be non-compliant that could be acceptable. And a judge cannot hold this claimant's decision not to comply against him or her.

The acceptable reasons for non-compliance could be for religious reasons, for expense reasons, or because different doctors were stating different things. It could also be because the claimant has an extreme fear of the procedure or the surgery. In addition, it could be because he or she has done this before and it didn't work. It could also be because the person is not competent to make the decision.

Questions to ask

When we have non-compliance issues, we always ask, was it a doctor or a nurse practitioner that prescribed the treatment? And then we ask for the reason why the client was not being compliant with the treatment. Was it because of religion, costs, intense fear, or because past results didn't go well?

Perhaps there were disagreements with the doctors, or questions regarding their competency. As long as the claimant is not openly non-compliant, that is, he has no real reason to be non-compliant and just doesn't want to do what the doctor says, we can often get by with non-compliance.