Does Opting Not To Have Surgery Affect Your Social Security Disability Claim?

Picture of a person laying down in a hospital bed

If your doctor has recommended that you have surgery, but you refuse, the Social Security Administration could deny you SSD or SSI benefits. However, if you have a good reason for opting out of surgery, there are exceptions to this rule.

Denying Benefits Based On Failure To Follow Prescribed Treatment

One popular question is whether the SSA can make you have surgery. The answer is, no, they cannot. However, if a doctor has approved surgery as a part of your treatment, and it would restore your ability to work, and you are refusing, then the SSA does not have to pay benefits for an impairment that could improve with the surgery. You have the final say over whether or not you choose to have surgery.

Your credibility is often a factor in the Social Security Administration’s decision to award you benefits. One way the SSA evaluates your credibility is by looking to see whether you have sought treatment for your condition. If you have failed to follow your recommended treatment, the SSA will assume that your condition is not as limiting or severe as you claim it is and may deny you disability benefits if the surgery would allow you to work full time.

Exceptions For Opting-Out of Surgery

Although it’s every individual’s right to choose what health care procedure they have performed, the SSA doesn’t have to pay you benefits if you don’t get surgery that could improve your impairment. However, there are a few exceptions to the failure to follow the prescribed treatment rule. These exceptions include the following:

  • You do not have health insurance, or your coverage is insufficient.
  • You cannot afford the out-of-pocket cost of the treatment and do not have access to low-cost or free medical services.
  • The treatment is high risk because of the extreme or unusual nature of the surgery.
  • A doctor has told you that no treatment would be effective.
  • You can get by without treatment by structuring your activities to minimize or avoid symptoms.
  • You have already had the same procedure or another major surgery for the impairment, which was unsuccessful.
  • The prescribed surgery is against your religion.
  • The surgery requires amputation of an extremity or a major part of an extremity.

These are only a few of the most popular exceptions; however, this is by no means an exhaustive list. If you haven’t followed your doctor’s care recommendations but can show that your refusal is justified, Social Security may still approve your claim.

We Help People Across Michigan Get the Benefits They Deserve

Waiting on Social Security disability benefits in Michigan can leave you hopeless and anxious. If your claim has been denied, you may feel overwhelmed about what to do next. Before you give up, consult with a skilled Michigan Social Security disability lawyer for guidance. At the Disability Attorneys of Michigan™, our Social Security attorneys are ready to get to work on your claim today.

To learn more, contact the Disability Attorneys of Michigan today by filling out the free consultation form below or calling us for a free case consultation at 800-949-2900.

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