Here’s a “catch-22” for you: you do not have to be taking any prescribed medications in order to qualify for Social Security Disability Insurance benefits (“SSDI” or “disability benefits”). But if you are not taking any medicines to treat your symptoms and you are applying for disability benefits based on a medical condition that could be improved by medication, your claim just may get denied.
Medical records play a vital part in any disability claim. To qualify for SSDI, you must have a medical condition that meets the SSA’s definition of “severe.” Your condition (or combination of conditions) must prevent you from working at all or consistently enough to meet the SGA level (monthly income level), and must have lasted, or be expected to last, 12 months.
To make its determination of disability, the SSA looks for objective medical evidence, such as test results, x-rays, MRIs, etc. It also requires that your medical records be current (no more than 90-days old).
Another important aspect of qualifying for disability benefits is that you must seek treatment for your condition. You are also expected to follow your doctor’s orders. If you do not seek medical treatment and follow doctor’s orders, then the SSA will simply assume that your condition “can’t be that bad” (otherwise you would see a doctor) and will find that you are not disabled.
While there can be a number of reasons for not seeking medical treatment —cost being one that many clients recite as their reason, but which the SSA is not sympathetic to— if you don’t seek medical treatment, you won’t have any medical records to prove your disability. As a result, it is very likely that you will be denied benefits.
Along with seeking proper medical treatment, the SSA expects that you will take any prescribed medicines. While there is no rule that says you must take medications, and you certainly don’t need to be on medication in order to qualify for SSDI benefits, the general idea is that if your doctor prescribes treatment for your condition (i.e., medication) and (absent good cause) you do not follow that treatment, (i.e., you don’t take the medication) then your condition cannot be so bad that you need disability benefits.
Generally speaking, then, if you have been prescribed medication which could improve your condition, and you refuse to take it or are not consistently taking it, it is likely that your claim will be denied.
The medications you may be taking play a significant role in the SSA’s review of your disability claim. Disability examiners and Administrative Law Judges (“ALJ”) pay attention to what medications are listed on a person’s claim. This is because some medications can help to establish that a person is disabled. For example, some disabling conditions (epilepsy) remain disabling even when medication is prescribed. Other medications can have known side effects that make it impossible for a person to engage in certain tasks.
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If you are thinking of applying for SSDI or have been denied benefits, call us. We are experienced social security disability counsel. We offer FREE consultations and we do not get paid unless you win your claim. We have offices in Springfield, Kansas City, Mountain Grove, Liberty, and other cities in Missouri. We also have offices in Overland Park, Topeka and other cities Kansas. We also have offices in Belleville/Swansea, Illinois, and in Tulsa and Oklahoma City, Oklahoma. Call us at 855-727-8625 or send us an e-mail or connect with us on Facebook.