Treatment FAQ

how to stop disability benefits no longer eant medical treatment

by Prof. Joy Beahan I Published 2 years ago Updated 2 years ago

If you've decided you no longer need disability insurance, you can easily cancel a policy by contacting your insurance provider or by letting your coverage lapse due to nonpayment. Before choosing to cancel your policy, make sure you're financially protected if you do become disabled. Ready to shop for disability insurance? Get started

Full Answer

What happens if my disability benefits are stopped?

So what happens if an individual receives a notice that their disability benefits are being stopped because Social Security has determined that they are no longer medically disabled? If an individual receives a notice that Social Security is stopping their disability benefits, they have the right to appeal that decision.

How much can I earn to stop my disability benefits?

Two things can cause us to decide that you are no longer disabled and to stop your benefits: if you work at a level we consider "substantial." In 2021, average earnings of $1,310 or more per month ($2,190 or more per month if you are blind) are usually considered substantial. The amount of earnings that we consider substantial changes each year.

Can my employer cancel my health insurance while on short-term disability?

Research the laws in the state where you work and read your employee handbook for answers. Your employer has less freedom to cancel your health insurance while you are out on short-term disability due to an off-the-job accident or illness. FMLA rules protect a larger portion of people with temporary medical conditions.

Can I still work if I'm on disability?

If you're like most people, you would rather try to work than live on disability benefits. There are special rules that help you keep your cash benefits and Medicare while you test your ability to work. We call these rules work incentives. For more information about Social Security work incentives, read Working While Disabled: How We Can Help.

How do I stop my disability benefits?

To voluntarily suspend your benefits, you will need to submit a signed statement to Social Security. A Benefits Counselor can help you with this process, or you can contact your Social Security Field Office directly.

Can you suspend disability benefits?

Hi, No, you can't voluntarily suspend Social Security disability (SSDI) benefits, nor could you opt to forego using a 9 month trial work period (TWP).

Do you have to take medicine to be on disability?

If you don't take prescribed medications or other treatment, Social Security can deny you disability benefits.

Can I stop my Social Security disability and restart later?

Can I suspend Social Security benefits and restart them at a higher value? Yes. If you have reached your full retirement age (the age at which you are entitled to 100 percent of the benefit calculated from your lifetime earnings) but are not yet 70, you can request a suspension of retirement benefits.

Who is eligible for file and suspend?

The first of two creative claiming strategies to bite the dust was known as “file and suspend.” It allowed individuals at full retirement age or later to file for their Social Security benefits and then immediately suspend them, allowing their retirement benefits to grow by 8% per year for every year they postponed ...

Can SSDI force you to have surgery?

Disability Benefits and Refusing Surgery Everyone has the right to refuse medical treatment. The Social Security Administration (SSA) cannot force you to have surgery.

What does it mean when Social Security sends you to a doctor?

If social security sends you a letter asking you to see a doctor at their expense, it means that the disability examiner thinks there is not enough medical evidence on the disabilities that you are alleging. Most of the time, this is because you are not getting medical treatment on your own.

Why is SSDI sending me to a psychologist?

Why does SSA want a psychological evaluation? Generally speaking, Social Security will ask for a psychological evaluation if you allege any kind of mental impairment as a factor in your disability claim, whether it's your sole disabling condition or just part of what keeps you from working.

Why do people switch doctors?

The insurance company will seize on any opportunity to attack your credibility and accuse you of “doctor-shopping.” Of course, there are many legitimate reasons why people switch doctors. For example: 1 Dissatisfaction with treatment 2 Dissatisfaction with bedside manner 3 Dissatisfaction with technology and testing available within the medical practice 4 Changes in insurance 5 Convenience of location 6 Hours of practice and availability of the doctor

Can you get disability if you are disabled?

In some cases, the initial medical evidence is so strong that the insurance company will agree you're disabled and grant your long term disability benefits. But, after this, the insurance company may carefully monitor your treatment process and look for any gaps or inconsistencies. If the insurer finds any gaps or inconsistencies, the insurer may assume that your condition has improved – perhaps even to the point of returning to work.

Can missed appointments discredit your own doctor?

Sadly, missed appointments and infrequent treatment may discredit the reliability of your own physician’s assessment. For example, the insurer may claim that your doctor isn’t familiar enough or qualified to comment on your disability status because he or she doesn't see you regularly. This may also lead to the insurer’s demand for an IME.

Can insurance companies treat you less frequently?

If your doctor recommends frequent treatment, the insurance company may interpret less frequent treatment as “noncompliance” with your doctor’s treatment plan. The insurer may argue that the recommended treatment frequency may have helped you, and by not following that plan you're purposely sabotaging your potential for improvement – all to remain on benefits.

What happens if you stop paying your disability insurance?

And that’s it — if you stop paying your premiums, after a grace period set by your insurance company (usually 31 days), your policy will be terminated. You can no longer make a claim against it, and you will have forfeited all paid premiums, but you will have canceled your disability insurance.

Why cancel my disability insurance?

There are several reasons why you might consider canceling your disability insurance policies. Some are better reasons to cancel than others, but here are the most common: A new job provides disability insurance. You can no longer afford the premiums. You no longer rely on your income (due to a windfall or inheritance, for example) ...

What happens if you can't work and bring in money?

Disability insurance is an important safeguard, and other cuts to your budget may be more prudent — if you become disabled and can’t work and bring in money, you won’t be able to afford anything

What happens if you change your mind on your insurance?

If you change your mind, you’ll likely have to apply for a new policy, but it’s worth contacting your insurance company to ask about reinstatement: some companies may reinstate the policy if you pay back all past due premiums.

What happens if you file a claim and are receiving benefits?

If you’ve filed a claim and are receiving benefits, there are some things that can trigger a review and cancellation of benefits, however: If your insurer finds out you lied on your application. If your insurer finds out you’ve made a false claim.

Can you cancel a policy if you pay the premium?

Some people are also worried about whether their policy could be canceled by the insurer. Most policies are guaranteed renewable, which means your insurance company cannot cancel your policy as long as you pay the premium. As long as you are honest with your insurance company during the application process and continue to pay your premiums, ...

Does employer disability insurance take bonus?

Employer-provided disability coverage may not take into account bonus or commission income, again leaving you with an income gap. Your employer-provided coverage may have significant limitations compared to your private policy.

What happens if you don't have health insurance?

The prescribed treatment involves the amputation of one of your extremities. You have a very extreme fear of surgery. This justification is rarely accepted by Social Security, but you may have a chance ...

How long does impairment last?

Your impairment prevents you from doing any substantial gainful activity (SGA). Your impairment has lasted or will last at least 12 months, or can be expected to end in death. Your treating doctor has prescribed treatment that would clearly restore your ability to perform full-time work. You have refused to follow your treating doctor's prescribed ...

What happens if you don't follow prescribed treatment?

If you fail to follow prescribed treatment, take prescribed medication, or undergo recommended surgery, this may prevent you from getting Social Security or SSI disability benefits, but only when the following four criteria are met. Your impairment prevents you from doing any substantial gainful activity (SGA).

Can Social Security deny disability?

If you don't take prescribed medications or other treatment, Social Security can deny you disability benefits. If you're applying for disability benefits but not complying with the medical treatment prescribed by your doctor, Social Security may be able to deny your claim for "treatment non-compliance.". This is because Social Security can find ...

Is failure to follow treatment a symptom of mental illness?

You have a mental illness, and failure to follow treatment is a symptom of the disease. This argument will be much more persuasive coming from your treating mental health provider. Ask him or her to give an opinion to Social Security on this point if non-compliance with medical treatment is an issue in your case.

Can you afford a prescription?

You cannot afford the prescribed treatment or medication, and there are no free or low-cost clinics reasonably available to you. Disability claimants are often unable to afford medications or treatments prescribed by their doctors.

Can a minor deviation from a doctor's prescription be denied?

For this reason, a minor deviation from your doctor's prescribed treatment is usually not a sufficient basis for Social Security to deny your claim.

Why would you be denied disability benefits?

In this case, you would be denied disability benefits because your drug or alcohol abuse is a material factor that contributes to your medical impairment. For more information, see our article on getting disability despite drug or alcohol abuse.

Why did Social Security reject my disability application?

Federal courts have overturned denials of disability benefits on that basis, requiring Social Security to reevaluate a disability application that was rejected because the mentally ill applicant failed to seek or comply with treatment.

How does Social Security evaluate your credibility?

One of the ways Social Security evaluates your credibility is by looking to see whether you have sought treatment for your condition. If you have not spoken with a doctor or other medical practitioner about your symptoms, Social Security will conclude that your condition is not as severe or limiting as you say it is.

When does Social Security believe you?

Updated October 2 ,2018. The Social Security Administration's decision to award you benefits often depends on the credibility of your statements. That is, to get benefits the agency must believe you when you say that you experience symptoms such as pain, memory loss, or exhaustion, or when you say that your condition makes it difficult ...

Can Social Security deny you SSI?

When Social Security Can Deny Benefits for Failing to Follow Prescribed Treatment. When you fail to follow pre scribed treatment, take prescribed medication, or undergo recommended surgery, Social Security can deny you SSDI or SSI disability benefits if the prescribed treatment, medication, or surgery would be expected to restore you ...

Do you have to follow the treatment recommendations of your own doctor?

You aren't required to follow treatment recommendations from any doctor or examiner who works for Social Security or Disability Determination Services, ...

Can Social Security be used to determine if you are not seeking treatment?

Social Security is not allowed to draw any conclusions about your failure to seek or comply with treatment without considering whether there are good reasons for it. Acceptable reasons include:

What happens if you have 24 months of disability?

When 24 months have elapsed, the definition of disability can narrow to "the inability to perform any occupation .". That means that if you're medically capable of performing virtually any job that exists in the economy, your LTD benefits may be terminated.

How long does it take for a disability to change?

Many LTD policies contain a provision that changes the meaning of "disability" after 24 months. Initially, disability can be defined as "the inability to perform your own occupation " due to a physical or psychological impairment. When 24 months have elapsed, the definition of disability can narrow to "the inability to perform any occupation .".

How long can you get LTD benefits?

If you're receiving LTD payments due to depression, anxiety, post-traumatic stress disorder, chronic fatigue syndrome, or a similar impairment, you may be limited to receiving 24 months of benefits. There are often, but not always, exceptions for organic mental disorders like dementia and organic brain disease, as well as illnesses such as schizophrenia and bipolar disorder. The rationale behind this limitation, from the insurance company's perspective, is that most of these impairments can be exaggerated or outright faked. While this policy does keep premiums lower than they otherwise would be, this comes as cold comfort to the vast majority of LTD recipients with bona fide mental illnesses whose benefits are terminated after only two years.

Why is my LTD terminated?

One of the most common reasons LTD benefits are terminated is that the person has failed to receive regular medical treatment. Even if your doctor has told you there's "nothing else that can be done for you," if you stop seeing a doctor, your insurance company may interpret your lack of treatment as proof that your condition has improved. ...

Can you terminate your LTD benefits?

If you're receiving long-term disability (LTD) benefits, keep in mind that your insurance company can terminate your monthly payments for any number of reasons. It's important to be familiar with the most common reasons that LTD benefits are cut off so that you can try to continue to receive benefits for as long as you're disabled. ...

When does LTD end?

Your LTD benefits will usually end when you reach your Social Security normal retirement age (66 or 67) or upon your death. If you're over 60 when you're approved for LTD, your benefits may continue past your normal Social Security retirement age, but generally only for a few years.

Can LTD insurance track you?

It is possible that your LTD insurer will arrange a surve illance team to track you for several days. This can include following you on your daily errands and to doctor's appointments, parking outside your house, and recording you. This can be a disconcerting experience, and LTD recipients should exercise caution when interacting with anyone they suspect to be an investigator. If you're observed engaging in activities that are inconsistent with your impairments, the insurance company may determine that your condition has improved and your benefits could be discontinued.

When will Social Security stop SSI?

Social Security will automatically review the cases of children receiving SSI when they turn 18. Benefits will be discontinued when the beneficiary fails to meet the adult standards of disability, although this decision may be appealed.

How long does it take to appeal a cessation of benefits?

Appealing a Cessation of Benefits. You have 60 days to request an appeal, which consists of a relatively informal hearing before a Hearing Officer. At this hearing, you can present additional evidence, call witnesses, and testify about your condition.

What happens if the claims examiner does not find medical improvement?

If the claims examiner does not find medical improvement, the CDR is closed and your benefits continue. If the claims examiner finds that your condition has improved and that you're able to work, you will no longer be considered disabled.

What to do if you receive a notice from Social Security?

If you receive notice from Social Security that your case is being reviewed, contact an experienced disability attorney immediately. While a CDR can be a frightening prospect for a disability recipient, having a knowledgeable representative on your side will increase your chances of retaining your much-needed benefits.

What happens if you go back to work?

If you experience medical improvement that would allow you to go back to work, Social Security may decide to terminate your disability benefits. The SSA makes this determination through a process known as a Continuing Disability Review (CDR). If you're selected to undergo a CDR, you'll receive a notice in the mail from Social Security stating ...

How long is the trial period for SSDI?

Individuals receiving SSDI are allowed one nine-month trial work period (TWP) to experiment with working while still drawing their full monthly benefits. In 2021, monthly earnings over $940 will trigger a trial work period month. The nine months occur over a 60-month period, but the months need not be consecutive.

Does work count toward the SSI limit?

Not all income from work counts toward the income limit, however (in fact, the SSA ignores more than half of your wages when counting your income). But some "in-kind" income, like free housing or food, does count against the limit, and keep in mind that some portion of spousal income and resources will be "deemed" to the SSI beneficiary.

What happens if you lose your disability appeal?

An individual should be mindful of the fact that if they lose their disability cessation appeal, they are financially liable for any disability benefits paid to them while they were going through the appeal process. This means that a very substantial overpayment to the Social Security Administration could be created while a disability beneficiary ...

How long do you have to file for disability?

If an individual chooses to file for disability benefit continuation, they have ten days, plus the five days for mailing of the decisional notice, to request payment continuation . Now this option seems good and it is good if an individual has no other money coming in to pay their financial obligations.

How long does it take to appeal a disability denial?

The appeal period begins with the date of the denial notice plus an extra five days for the time it take for the beneficiary to receive the notice. Therefore, the total timeframe for requesting an appeal for a cessation of disability benefits is 65 days.

Can work activity trigger a CDR?

Other than periodic continuing medical reviews, work activity can sometimes trigger a CDR, or continuing disability review, for Social Security Disability beneficiaries.

Can a cessation of disability be overturned?

As long as an individual appeals their disability cessation, there is a chance that their cessation could be overturned at a state disability agency hearing or at an administrative law judge disability hearing.

What happens after you exhaust FMLA?

After you exhaust FMLA, your employer no longer has to pay its portion of the group health costs. In order to meet the criteria for continuation your group plan must be covered by COBRA, a qualifying event must occur; and you must be a qualified beneficiary for that event. [2] Covered Groups: Have 20 or more employees.

How long does FMLA last?

Your employer has more freedom to cancel your health insurance while you are out on long-term disability due to a non-occupational accident or sickness. By definition, a long-term disability lasts much longer than 3 months. FMLA legal rights end after only 12 weeks – which is about 3 months.

Can you not return to work?

Not Returning to Work: The employer may require the employee to pay the employer share of the premiums if the person fails to return to work ( maternity leave example ). However, this person is exempt from circumstances that are beyond his or her control (ongoing disability).

Is FMLA a life event?

The Family Medical Leave Act (FMLA) requires temporary group health insurance continuation for a portion of workers – not all. You could easily fall into one or both of these cracks. Fortunately, the loss of coverage is a qualifying life event! Begin a new plan immediately during a special enrollment period.

Is an employee's own serious medical condition a qualifying reason?

An employee’s own serious medical condition is a qualifying reason. In addition, the Department of Labor rules states the following. “A covered employee is entitled to the continuation of the group health insurance coverage on the same terms as if he or she had continued to work.”. [1]

Can you cancel your health insurance while on disability?

Can your employer cancel your health insurance while you are out on disability? The sad reality is that many people can lose their coverage when they need it the most – when an accident, illness, or maternity leave prevents them from earning an income – and they need access to medical care in order to recover.

How old do you have to be to get a long term disability?

Most long term disability policies have an age limit. It’s usually retirement age between 62-67 years old. There are some exceptions to this – like if you apply for benefits over the age of 60, your benefits may have a “minimum benefit period” that may extend into the claimant’s initial retirement years. Check your policy for the exact wording on age out dates and restrictions.

Can you terminate your LTD?

When receiving long term disability (LTD) benefits, you need to be aware that your insurance company can terminate – or cut-off – your benefits. If the insurance company decides that you are no longer disabled, they can reduce or terminate your benefits with very little notice. It’s always important to review your policy for reasons your benefits can be terminated. Here we will touch on the most common reasons why benefits are canceled.

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