A disabled woman in Knoxville, Tennessee, is dealing with a frustrating situation common to those receiving social-security benefits: she has recently been told that her benefits will stop because her medical condition is now controlled by medication. While she feels that she’s in a somewhat impossible situation, since her disability benefits include the medical coverage she uses to obtain the medications, it’s important to understand the rules that social-security benefits follow in order to anticipate any similar problems with your own claim, whether you are just now filing or have been receiving benefits for a while.

When Your Condition Is Controlled by Medication

Simply having a medical condition that requires you to take medication doesn’t qualify you for social-security disability benefits—there are many people who are working full-time jobs despite their medical problems. For example, many of the 29.1 million diabetics in the U.S. are still able to work despite their condition. 

Instead, the Social Security Administration evaluates your overall capacity to function and hold down a job despite your impairment and any medications you may take. If your medications are able to effectively control your medical condition, you won’t qualify for benefits.

Similarly, if you began receiving benefits at a time when medications weren’t able to control your condition but new medication becomes available that does control it, your benefits will eventually be stopped once the SSA conducts a medical review of your case. (You can generally expect your case to have a medical review every three or seven years, depending on the severity of your condition and the likelihood that you’ll improve.)

When You Don’t Take Medication That Could Control Your Condition

The woman in Tennessee’s situation is understandably frustrating because she relies on Medicare, the medical benefit she’s entitled to as a result of being on social-security disability, to pay for her medication. Unfortunately, from the government’s perspective, that doesn’t mean she’s still entitled to disability benefits. Essentially, the government’s position is that she should return to the workforce and obtain health insurance through other means in order to afford her medication since the medication has restored her capacity to work.

Similarly, you may have a hard time getting approved for benefits in the first place if you’ve never tried medication for your condition, aren’t taking medication that’s prescribed to you that could control your condition, or don’t have the money to pay for your medication. The SSA will sometimes find the inability to afford your medication compelling, but only if you can show that you’ve exhausted all the possibilities for financial and medical assistance available, including Medicaid and medical subsidy programs.

When Your Medications Actually Contribute to Your Impairment

In some cases, the medication  you take may actually contribute to your disability—for example, someone with an epileptic condition, like the woman in Tennessee, may be able to function better while on medication, but still not be able to work. In some cases, the medication will completely control the main condition but cause side effects that make it impossible to hold a job.

For example, some anti-seizure drugs used to treat epileptics control the seizures but cause a host of other symptoms. One common anti-seizure drug, Topamax, causes blurred vision, drowsiness, memory problems, nervous problems, weakness, speech problems, confusion, and dizziness, among other issues. The side effects of that drug alone could qualify someone for disability even if the drug controls their seizures.

That makes it very important for you to explain to the SSA exactly what problems your medications cause you, even if they totally control the condition that they’re prescribed to treat. It’s possible that the woman in Tennessee suffers from a number of side effects from her anti-seizure drugs that weren’t taken into consideration during her medical review because she didn’t clearly explain them in her paperwork or because they weren’t documented in her medical records. (This is also why it’s important to always tell your doctor about any side effects you experience from your medications.)

If you need more help understanding how your particular situation may affect your right to social-security benefits, discuss the case with an attorney, such as one from Gieg Law Offices, as soon as possible.