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

Some disabilities can be resolved through surgical intervention.  The option for surgical intervention can make your disability temporary. You may think that no one can be obligated to have surgery or any other procedure, and yes, that is true. However, your right to refuse surgery doesn’t mean that Social Security will approve you for Social Security Disability (SSDI). 

This article will discuss whether opting out of prescribed surgery for your disability will disqualify you from an SSDI claim. If you are worried about how refusing surgery might affect your Social Security Disability eligibility then a social security lawyer can help you make your case.

When Would You Be Denied For SSDI?

If you have a medical professional recommending a surgical procedure, then you run the risk of getting your application denied if you opt-out of surgical intervention. You will be denied if any of the following has occurred in your case:

  • You have documentation that you have been prescribed surgery in your medical records, but you refused it.
  • Your doctor may have prescribed surgery to address your condition, and the surgery will likely restore your ability to work.

Considerations

There are several considerations or caveats to this general rule:

Treating Physician
Your treating physician must prescribe the surgery, and it cannot be prescribed by a third-party physician or a Social Security prescription. Only your treating physician has authority for this prescription and no other.

Ability To Work
When you’re confronted with the decision to have surgery for your disability, consider whether it will restore your ability to work. Why is this important? Because if the surgery doesn’t restore your ability to work full time after you recover, you don’t need to have the surgery. You would likely be eligible for SSDI regardless of whether you have surgery or not.

Be prepared to provide information and documentation to SSA as to why you’re not getting the surgical procedure. They will want to know why surgery was recommended, what it was supposed to resolve, and the prognosis afterward. Also document what other options were given besides surgical intervention?

Exceptions

You will be required to have the surgery to be eligible for benefits. However, a few exceptions exist.

Fear

Many people fear surgeries. If your fear is so overwhelming that you can’t do the surgery and going through with the surgery could do more harm than good, then you may qualify for an exception. Your treating physician will be relied on to corroborate that your fear is worse than the need for the surgery. In some cases, your treating physician may not know you well enough to make that call. In those cases, SSA may assign an independent psychiatric evaluation to validate the extent of the fear.

Religion

To qualify for a religious exemption, you need to be affiliated with a religious institution that frowns upon surgical intervention. Providing proof will be required.

Affordability

Providing you do not have the financial means may be a viable exception.

Conflict

Have you received conflicting advice? This may be an exception to investigate with your Social Security Disability Lawyer.

Prior Surgery

Have you already had prior surgery for this condition? If so, and it failed previously — you may not be required to have this same surgery again to be eligible. 

High Risk

If the surgery has an inherently high risk, you may not be required to proceed.

A Social Security Lawyer Can Help You Apply

These are only some of the exceptions. You can learn about more exceptions by contacting a Social Security Lawyer who can guide you through the process. They have the experience you need, and can help ensure your personal rights are respected as part of the application process.

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