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What’s a treatment gap in an SSD claim?

On Behalf of | Feb 6, 2024 | Social Security Disability |

You can’t claim Social Security Disability (SSD) benefits unless you can demonstrate that your disability is severe and pervasive – and not abated by treatment. That makes sense. After all, if people were permitted to obtain SSD benefits for conditions they could control, merely “not being able to see without glasses” would qualify as a disability.

What happens, then, when you have a gap in your medical history? What if you haven’t sought treatment for your condition in a while? What if you refused the last treatment you were offered? Does that automatically end your SSD claim?

A treatment gap may or may not affect your claim

The Social Security Administration actually recognizes the fact that there can be perfectly valid reasons for people to have periods where they forgo medical treatment. One of the most commonly accepted reasons for a gap in medical care is simply that patients lack insurance and cannot afford care. SSA will not consider financial barriers to treatment to be an actual refusal of care.

Similarly, some people are unable to follow through with recommended care because they have mental health issues that make it hard for them to organize, plan, keep appointments or even recognize the necessity of the care. In that situation, SSA may actually consider their failure to stay on their treatment plan as further evidence of their disability.

Finally, some people refuse treatment either because they feel that the only treatment that’s being offered is too risky (such as when it involves the risk of opioid addiction) or they have already tried the treatment in the past and it failed.

Don’t let gaps in your medical history – no matter how recent or big – stop you from filing a Social Security Disability claim. Seeking legal guidance may help you to receive any compensation to which you are rightfully entitled.