A common question asked by prospective clients is, “can I qualify for disability benefits without having undergone medical treatment?” Generally speaking, the answer is no. Individuals are not eligible for disability benefits unless they’ve received at least some medical treatment.
Getting necessary medical treatment, and documenting your illness with doctors and providers who understand your condition is essential to winning a disability case.
Social Security Guidelines for Medical Treatment
The Social Security Administration (SSA) maintains rules and guidelines about the need to follow prescribed medical treatment. Under SSA’s guidelines, if you are prescribed treatment and you fail to follow that treatment as prescribed by one of your own providers, you are often unable to obtain benefits… even if you would be found disabled.
Social Security specifically looks at whether the treatment, if followed, would be expected to restore an individual’s ability to engage in competitive work.
Can I Establish that I’m Limited without Medical Treatment?
The answer to this question is also no. In the majority of disability benefit cases, you will not be able to prove that you are limited without any medical treatment to substantiate your claim, even if you can show you have a good reason for not following prescribed treatment.
In order to be found disabled you need medical evidence to support that 1. You have a “medically determinable” impairment, and 2. That it is severe enough to cause observable functional limitations. This means that simply being diagnosed with, or having complaints of a serious impairment are not enough.
In order for a medical problem to meet this standard, it has to be shown by clinically acceptable tests and examinations and diagnosed by a medical source. In order to document functional limitations, a medical source usually has to offer an opinion providing a description of your medically necessary limitations on a function-by-function basis.
You cannot obtain that documentation if you are not treating with a doctor or appropriate provider.
Interested in Applying for Disability Benefits? Contact Bross & Frankel.
Applying for disability benefits can be overwhelming, particularly if you are already dealing with a new or worsening diagnosis. Bross & Frankel are ready and able to stand by your side throughout the application process, helping you avoid some of the most common pitfalls and fighting for your right to disability benefits. Our disability benefits lawyers have decades of combined experience advocating for people with disabilities in New Jersey and Pennsylvania.
