Kaylbe

Terri,

Failure to follow prescribed treatment can be a basis for denial. If you have a disabling impairment and the prescribed treatment is expected to restore your ability to engage in SGA (work), you are expected to follow the prescribed treatment unless there is an acceptable justification for your failure to comply.

Acceptable justifications for failing to follow prescribed treatment include, but are not limited to the following:

--The specific medical treatment is contrary to the established teaching and tenets of the individual's religion.

--The individual is unable to afford prescribed treatment, which he or she is willing to accept, but for which free community resources are unavailable.

--An individual's fear of surgery is so intense that it is a contraindication for surgery.

--The prescribed treatment is cataract surgery for one eye, when there is severe visual impairment of the other eye that cannot be improved through treatment.

--Major surgery was previously performed with unsuccessful results and additional major surgery is prescribed for the same impairment.

--The treatment because of its magnitude (e.g., open heart surgery), unusual nature (e.g., organ transplant), or for some other reason is very risky.

--The treatment involves amputation of an extremity, or a major part of an extremity.

--An individual with a severe mental impairment is clearly unable to understand the consequences of failing to follow prescribed treatment.

--A duly licensed physician or psychologist who has treated the individual advises against the treatment prescribed for the currently disabling condition.


It looks as though you could be at risk for losing your benefits. You clearly do understand that this is possible or you wouldn't be asking the question. Therefore the statement above about having a severe mental impairment and not being able to understand the consequences of failing to take medication would not apply.

--kaylbe