Disability claims based on back pain are the most common types of SSDI applications seen by judges. Because of this you can assume that your judge is familiar with lumbar, thoracic and cervical spine injuries, and treatments available for these medical problems.
In most cases, back surgery is the last resort for treatment of chronic back pain. Most of the time, treating orthopedics or neurosurgeons will start your treatment with physical therapy, muscle relaxants, and pain medications, then move to epidural injections and facet injections.
If you injury is appropriate for surgery, your doctor may then recommend back surgery like a laminectomy or a fusion. What happens if your doctor recommends surgery but you decide against it? Will this prompt your Social Security judge to deny your disability claim?
Social Security Law is Clear – Your Judge May Not Punish You for Deciding to Forego Surgery
Social Security law is clear that a judge is not supposed to punish you or deny your claim because you decide not to undergo surgery, whatever your reasons. You may not have the money or insurance for sugery, or you may not have the money or insurance for post-surgical rehabilitation.
You may have decided that the risk of undergoing surgery is too great, or you may have religious beliefs against surgical procedures. I once represented a client who chose not to undergo surgery because her home life – spouse and teenage children – was too chaotic.
Be Prepared to Explain Your Decision to the Judge
Whatever your reason, I think that you need to be prepared to explain your reasoning to the judge. Your should be able to express your decision clearly and rationally to demonstrate to the judge that you have thought through your choices.
You should also be prepared to explain to the judge how you plan to move forward – will you pursue long term pain management, or will you cope by limiting your movement and dealing with the pain as best you can.
Declining surgery is much different than refusing a non-invasive treatment or failing to try to improve your situation. For example, if you claim that you are disabled because you cannot see well, a judge will not look kindly on your refusal to wear glasses. Similarly if your doctor tells you to lose weight or to stop smoking, your judge will expect that you have at least made a good faith effort to comply.
I think you need to be able to explain to the judge that you understand the implications of your decision. Sometimes this means that you will testify to the judge that you have decided not to undergo surgery now, but you are keeping the option open if the pain gets too bad or your financial or life circumstances change.
If you are my client and I am preparing you to testify about your decision not to undergo surgery, we will practice your response to the judge’s likely questions so that you will know what to expect and how to word your answers to express yourself clearly.