One of the most important things when it comes to an individual’s right to receive Social Security Disability (SSD) benefits is his or her medical records. In fact, the Social Security Administration (SSA) will take a look at your medical records in order to determine just how serious your disability may be.
Demonstrating Attempts to Minimize Your Condition
This is important because, in order for someone to receive SSD benefits, he or she must have an impairment that has last or is expected to last for 12 consecutive months. Medical records are so important because they demonstrate your diagnoses and treatment plans. Following a physician’s treatment plan is important as it shows that you are trying to minimize or overcome your condition as best as possible.
Therefore, when the SSA sees that you have an outstanding gap in your treatment without a legitimate reason, it will assume that you are better and no longer disabled. For this reason, it’s important that you stick with your treatment plan and discuss any potential breaks in treatment with your doctor so that he or she can okay it and include the legitimate reasoning in your medical records.
Legitimate Reasons for Treatment Gaps
While it’s ideal to finish your treatment plans without taking breaks from treatment, there are some legitimate reasons for doing so:
1. You’ve improved as much as possible.
While treatment can do wonders, it can’t always perform miracles. Sometimes there is only so much that medical treatment can do for your condition. Sometimes physicians may actually decide that you’ve reached the maximum improvement that you will be able to reach based upon your disability, its severity, and your symptoms. If this is the case your doctor will make a note in your medical records, which will then be used in determining your eligibility for SSD benefits.
2. You can no longer afford your treatments.
Treatment isn’t always cheap and with so many other expenses going on, sometimes it becomes unaffordable for the claimant. This is often compounded by the claimant’s inability to work in the first place due to the disability. If you have stopped treatment due to insufficient health insurance or your inability to obtain lower-cost treatment, the SSA will not infer anything about your condition.
3. You’re concerned about having surgery.
While the SSA may view it as non-compliance when you fail to undergo surgery recommended by your treating physician, this is not always the case. Rather, it depends upon the facts of each situation. For example, if someone has had the same surgery four times previously with no results, it may be reasonable that he or she is reluctant to have yet another procedure of the same kind.
4. You are suffering from a mental disability or impairment.
Sometimes a claimant may not seek treatment per his or her physician’s recommendation if he or she is dealing with a mental disability or impairment. If this is the sole reason as to why you have not sought treatment as recommended, it doesn’t mean that you are no longer eligible for benefits. This is especially true if the condition for which you are seeking SSD benefits is a mental one.
Just because you’ve taken a break from your recommended treatment doesn’t mean that you are ineligible for SSD benefits. Instead, you must demonstrate one of these valid reasons in your medical records for the SSA to understand. You can do so by ensuring that your records include all relevant details.
The Pennsylvania SSD Attorneys at Nikolaus & Hohenadel, LLP Can Help
When you are struggling with a disability that prevents you from working, you may not know what to do. Luckily, the attorneys at Nikolaus & Hohenadel, LLP can help. We understand the impact that a disability can have on your ability to make ends meet. That’s why we’re here to help you. To learn more, or to schedule a consultation, contact us today!