20 C.F.R. § 416.930

Need to follow prescribed treatment

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(a) What treatment you must follow. In order to get benefits, you must follow treatment prescribed by your medical source(s) if this treatment is expected to restore your ability to work.

(b) When you do not follow prescribed treatment. If you do not follow the prescribed treatment without a good reason, we will not find you disabled or blind or, if you are already receiving benefits, we will stop paying you benefits.

(c) Acceptable reasons for failure to follow prescribed treatment. We will consider your physical, mental, educational, and linguistic limitations (including any lack of facility with the English language) when determining if you have an acceptable reason for failure to follow prescribed treatment. The following are examples of a good reason for not following treatment:

(1) The specific medical treatment is contrary to the established teaching and tenets of your religion.

(2) The prescribed treatment would be cataract surgery for one eye when there is an impairment of the other eye resulting in a severe loss of vision and is not subject to improvement through treatment.

(3) Surgery was previously performed with unsuccessful results and the same surgery is again being recommended for the same impairment.

(4) The treatment because of its enormity (e.g., open heart surgery), unusual nature (e.g., organ transplant), or other reason is very risky for you; or

(5) The treatment involves amputation of an extremity, or a major part of an extremity.

[45 FR 55621, Aug. 20, 1980, as amended at 59 FR 1636, Jan. 12, 1994; 62 FR 6429, Feb. 11, 1997; 82 FR 5882, Jan. 18, 2017]

Notes of Decisions

Cited in 125 cases (48 in the last 5 years), 1981–2025 · leading case: Sizemore v. Berryhill, 878 F.3d 72 (4th Cir. 2017).

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Sizemore v. Berryhill, 878 F.3d 72 (4th Cir. 2017). “” 20 C.F.R. § 416.930 (a). Thus, the ALJ’s conclusion that Size-more was not disabled and was able to work finds further support when Size-more’s alcoholism and noncompliance with prescribed treatment are considered.”

Alcantara v. Astrue, 257 F. App'x 333 (1st Cir. 2007). · cites it 2× “20 C.F.R. § 416.930 (a). Furthermore, non-compliance may be excused for good cause.”

Evelyn Grace DAWKINS, Plaintiff-Appellant, v. Otis R. BOWEN, Sec'y of the Dep't of Health & Human Servs., Defendant-Appellee, 848 F.2d 1211 (11th Cir. 1988). · cites it 2× “She also testified that she could not afford to pay the thirty-five dollars she needed to have her eyes examined.”

Annie Bell Brown v. Jo Anne B. Barnhart, Comm'r, Soc. Sec. Admin., 390 F.3d 535 (8th Cir. 2004). “; see also 20 C.F.R. § 416.930 (b). Brown claims her noncompliance is justified because she cannot afford the prescribed medication.”

Robert Sherman v. Carolyn W. Colvin, 582 F. App'x 745 (9th Cir. 2014). · cites it 4× “20 C.F.R. § 416.930 (a) & (b); see Molina v.”

Frank Aubeuf v. Richard Schweiker, Sec'y of Health & Human Servs., 649 F.2d 107 (2d Cir. 1981). “Therefore, the question whether a claimant may be required to pursue a particular course of treatment is not before us.”

Roy W. LUNA, Plaintiff-Appellant, v. Donna E. SHALALA, Sec'y of the Dep't of Health & Human Servs., Defendant-Appellee, 22 F.3d 687 (7th Cir. 1994). “See also 20 C.F.R. § 416.930 (b). In light of the previously discussed evidence, we find that the ALJ could conclude that Luna’s pain was not severe enough to prevent him from performing sedentary work.”

Mary McCall v. Otis R. Bowen, M.D. Sec'y of Health & Human Servs., 846 F.2d 1317 (11th Cir. 1988). · cites it 2× “20 C.F.R. § 416.930 ; see Patterson v. Bowen, 799 F.”

McReynolds v. Berryhill, 341 F. Supp. 3d 869 (E.D. Ill. 2018). “1530 (a) ; see also 20 C.F.R. § 416.930 (a). A "disabled person cannot qualify for benefits if she refuses to follow a prescribed course of treatment that would eliminate the disability.”

Gary W. ROTH, Appellant, v. Donna E. SHALALA, Sec'y of Health & Human Servs., Appellee, 45 F.3d 279 (8th Cir. 1995). “England’s observation during his examination of Roth sums it up when he remarks that Roth “presents a somewhat ‘poor me’ attitude and feeling that there is really no hope that .”

Roberts v. Shalala, 66 F.3d 179 (9th Cir. 1995). · cites it 2× “See 20 C.F.R. § 416.930 . For instance, the ruling states that the claimant should be given an opportunity to explain why she has failed to follow treatment, that the treating physician should be contacted to clarify the treatment the claimant was told to follow, and that the…”

Terry Alan Bellew v. Acting Comm'r of Soc. Sec., 605 F. App'x 917 (11th Cir. 2015). “20 C.F.R. § 416.930 (b). However, “poverty excuses noncompliance,” such that noncompliance does not prevent a claimant from receiving benefits where the noncom-plianee is a result of the claimant’s inability to afford treatment.”

Show all 125 citing cases →

— 20 C.F.R. § 416.930(a) — 2 cases

Robert J. PACHECO, Plaintiff-Appellant, v. Louis W. SULLIVAN, M.D., United States Sec'y of Health & Human Servs., Defendant-Appellee, 931 F.2d 695 (10th Cir. 1991).

Diane Vaughn v. Donna E. Shalala, Sec'y of Health & Human Servs., 16 F.3d 418 (10th Cir. 1994).

— 20 C.F.R. § 416.930(a)(b) — 1 case

Davis v. Astrue, 545 F. Supp. 2d 973 (D. Neb. 2008).

— 20 C.F.R. § 416.930(b) — 3 cases

Isako v. Apfel, 4 F. App'x 493 (9th Cir. 2001).

Blynn v. Saul (D. Idaho 2022).

Remelin v. Comm'r of Soc. Sec. (W.D. Wash. 2022).

— 20 C.F.R. § 416.930(c) — 1 case

Holmes v. Constantino, 999 F. Supp. 2d 345 (D.R.I. 2014).

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