Can You be Denied Disability Benefits if You Refuse Surgery?

The Short Answer

Yes.

The Long Answer

There are a lot of exceptions to this rule, but if a doctor recommends that you are a candidate for surgery and it will likely improve your condition, then the Social Security Administration (SSA) can determine that you are being “non-compliant” with your method of treatment.

The Really Long Answer!

When you file for disability, they will start evaluating your current health condition. Were you injured? Is your health declining? Did you receive a new diagnosis? How far along have your symptoms progressed?

As with most government agencies, they’re not going to take your word on everything. You’ll need to back your claims with proof from medical doctors, psychiatrists, and other professionals.

Additional Tips: 5 Reasons Why Social Security Claims are Denied

5 Things They Have to Prove

When the SSA is evaluating whether your surgery does or does not have grounds for dismissal, these are the 5 basic concepts they consider:

Your condition makes it difficult or impossible to maintain full-time work
Your doctor expects that your condition will last at least a year
Your doctor’s treatment plan includes a surgical procedure
The surgery will restore your ability to return to work in a full-time capacity
Your official medical records notate that you refused the surgery/treatment plan

After your disability officer determines that all of these factors are true, they will submit their findings to the SSA for consideration. In many cases, they will determine that you do not qualify for disability benefits.

Are There Exceptions?

There are exceptions to this rule. If it can be argued that the surgery is “reasonable” to refuse, then you’ll have a much stronger case.

Should You Ask a Representative About the Surgery?

Absolutely. Surgery is a personal decision, but it’s also an important one that will heavily impact your future–even if it’s considered a minor procedure.

Whether you’ve already begun incorporating prior or multiple conditions, or are just getting started, we encourage you to schedule a consultation to help determine the best strategy for your case.