[Federal Register Volume 83, Number 191 (Tuesday, October 2, 2018)]
[Notices]
[Pages 49616-49621]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-21359]


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SOCIAL SECURITY ADMINISTRATION

[Docket No. SSA-2016-0034]


Social Security Ruling, SSR 18-3p; Titles II and XVI: Failure To 
Follow Prescribed Treatment

AGENCY: Social Security Administration.

ACTION: Notice of Social Security Ruling (SSR).

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SUMMARY: We are providing notice of SSR 18-3p. This Ruling provides 
guidance about how we apply our failure to follow prescribed treatment 
policy in disability and blindness claims under Titles II and XVI of 
the Social Security Act (Act).

DATES: We will apply this notice on October 29, 2018.

FOR FURTHER INFORMATION CONTACT: Dan O'Brien, Office of Vocational, 
Evaluation, and Process Policy in the Office of Disability Policy, 
Social Security Administration, 6401 Security Boulevard, Baltimore, MD 
21235-6401, 410-597-1632. For information on eligibility or filing for 
benefits, call our national toll-free number at 1-800-772-1213, or 
visit our internet site, Social Security online, at http://www.socialsecurity.gov.

SUPPLEMENTARY INFORMATION: Although 5 U.S.C. 552(a)(1) and (a)(2) do 
not require us to publish this SSR, we are publishing it in accordance 
with 20 CFR 402.35(b)(1).
    We use SSRs to make available to the public precedential decisions 
relating to the Federal old age, survivors, disability, supplemental 
security income, and special veterans benefits programs. We may base 
SSRs on determinations or decisions made in our administrative review 
process, Federal court decisions, decisions of our Commissioner, 
opinions from our Office of the General Counsel, or other 
interpretations of law and regulations.
    Although SSRs do not have the same force and effect as law, they 
are binding on all components of the Social Security Administration in 
accordance with 20

[[Page 49617]]

CFR 402.35(b)(1), and are binding as precedents in adjudicating cases.
    This SSR will remain in effect until we publish a notice in the 
Federal Register that rescinds it, or until we publish a new SSR in the 
Federal Register that rescinds and replaces or modifies it.

(Catalog of Federal Domestic Assistance, Programs Nos. 96.001, 
Social Security--Disability Insurance; 96.002, Social Security-- 
Retirement Insurance; 96.004, Social Security--Survivors Insurance; 
96.006--Supplemental Security Income.)

Nancy A. Berryhill,
Acting Commissioner of Social Security.

Policy Interpretation Ruling

Titles II and XVI: Failure To Follow Prescribed Treatment

    This Social Security Ruling (SSR) rescinds and replaces SSR 82-59: 
``Titles II and XVI: Failure to Follow Prescribed Treatment.''
    Purpose: To provide guidance on how we apply our failure to follow 
prescribed treatment policy in disability and blindness claims under 
titles II and XVI of the Social Security Act (Act).
    Citations (Authority): Sections 216(i), 223(d) and (f), and 1614(a) 
of the Act, as amended; 20 CFR 404.1530 and 416.930.
    Dates: We will apply this notice on October 29, 2018.\1\
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    \1\ Our adjudicators will apply this ruling when we make 
determinations and decisions on or after October 29, 2018. When a 
Federal court reviews our final decision in a claim, we expect the 
court will review the final decision using the rules that were in 
effect at the time we issued the decision under review. If a court 
finds reversible error and remands a case for further administrative 
proceedings on or after October 29, 2018, the applicable date of 
this ruling, we will apply this ruling to the entire period at issue 
in the decision we make after the court's remand. Our regulations on 
failure to follow prescribed treatment are unchanged.
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Overview

A. Background
B. When we decide whether the failure to follow prescribed treatment 
policy may apply in an initial claim
    Condition 1: The individual is otherwise entitled to disability or 
statutory blindness benefits under titles II or XVI of the Act
    Condition 2: There is evidence that an individual's own medical 
source(s) prescribed treatment for the medically determinable 
impairment(s) upon which the disability finding is based
    Condition 3: There is evidence that the individual did not follow 
the prescribed treatment
C. How we will make a failure to follow prescribed treatment 
determination
    Assessment 1: We assess whether the prescribed treatment, if 
followed, would be expected to restore the individual's ability to 
engage in substantial gainful activity (SGA)
    Assessment 2: We assess whether the individual has good cause for 
not following the prescribed treatment
D. Development procedures
E. Required written statement of failure to follow prescribed treatment 
determination
F. When we make a failure to follow prescribed treatment determination 
within the sequential evaluation process
    Adult claims that meet or equal a listing at step 3
    Title XVI child claims that meet, medically equal, or functionally 
equal the listings at step 3
    Adult claims finding disability at step 5
    G. Reopening a determination or decision
H. Continuing Disability Reviews (CDR)
I. Duration in disability and Title II blindness claims
J. Duration in Title XVI blindness claims
K. Claims involving both drug addiction and alcoholism (DAA) and 
failure to follow prescribed treatment

A. Background

    Under the Act, an individual who meets the requirements to receive 
disability or blindness benefits will not be entitled to these benefits 
if the individual fails, without good cause, to follow prescribed 
treatment that we expect would restore his or her ability to engage in 
substantial gainful activity (SGA).\2\
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    \2\ Sections 223(f) and 1614(a) of the Act. The ability to 
engage in SGA is the standard in adult disability claims. However, 
when this policy is applied in title XVI child disability claims, 
the standard is ``the prescribed treatment is expected to eliminate 
or improve the child's impairment so that it no longer results in 
marked and severe functional limitations.'' Similarly, for claims 
based on statutory blindness, the standard is the prescribed 
treatment would be expected to ``restore vision to the extent that 
the individual will no longer be blind.''
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    We apply the failure to follow prescribed treatment policy at all 
levels of our administrative review process when we decide an initial 
claim for benefits based on disability or blindness. We also apply the 
policy when we reopen a prior determination or decision involving a 
claim for benefits based on disability or blindness, when we conduct an 
age-18 redetermination, and when we conduct a continuing disability 
review (CDR) under titles II or XVI of the Act.
    This SSR explains the policy and procedures we follow when we 
decide whether an individual has failed to follow prescribed treatment 
as required by the Act and our regulations.\3\
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    \3\ See 20 CFR 404.1530 and 416.930.
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B. When We Decide Whether the Failure To Follow Prescribed Treatment 
Policy May Apply in an Initial Claim

    We will determine whether an individual has failed to follow 
prescribed treatment only if all three of the following conditions 
exist:
    1. The individual would otherwise be entitled to benefits based on 
disability or eligible for blindness benefits under titles II or XVI of 
the Act;
    2. We have evidence that an individual's own medical source(s) 
prescribed treatment for the medically determinable impairment(s) upon 
which the disability finding is based; and
    3. We have evidence that the individual did not follow the 
prescribed treatment. If all three conditions exist, we will determine 
whether the individual failed to follow prescribed treatment, as 
explained below.\4\
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    \4\ There are two exceptions at step 3 of the sequential 
evaluation process, explained in section F (below), when we will not 
make a failure to follow prescribed treatment determination even if 
these three conditions are met.
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Condition 1: The Individual Is Otherwise Entitled to Disability or 
Statutory Blindness Benefits Under Titles II or XVI of the Act

    We only perform the failure to follow prescribed treatment analysis 
discussed in this SSR after we find that an individual is entitled to 
disability or eligible for statutory blindness benefits under titles II 
or XVI of the Act, regardless of whether the individual followed the 
prescribed treatment. We will not determine whether an individual 
failed to follow prescribed treatment if we find the individual is not 
disabled, not blind, or otherwise not entitled to or eligible for 
benefits under titles II or XVI of the Act.

Condition 2: There Is Evidence That an Individual's Own Medical 
Source(s) Prescribed Treatment for the Medically Determinable 
Impairment(s) Upon Which the Disability Finding Is Based

    If we find that the individual is otherwise entitled to disability 
or eligible for statutory blindness benefits under titles II or XVI of 
the Act, we will only determine if the individual has failed to follow 
prescribed treatment for the medically determinable impairment(s) upon 
which the disability finding is based if the individual's own medical 
source(s) prescribed the

[[Page 49618]]

treatment.\5\ We will not determine whether the individual failed to 
follow prescribed treatment if the treatment was prescribed only by a 
consultative examiner (CE), medical consultant (MC), psychological 
consultant (PC), medical expert (ME), or by a medical source during an 
evaluation conducted solely to determine eligibility to any State or 
Federal benefit.
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    \5\ See 20 CFR 404.1502 and 416.902 for the definition of 
``medical source.''
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    Prescribed treatment means any medication, surgery, therapy, use of 
durable medical equipment, or use of assistive devices. Prescribed 
treatment does not include lifestyle modifications, such as dieting, 
exercise, or smoking cessation. We will consider any evidence of 
prescribed treatment, whether it appears on prescription forms or is 
otherwise indicated within a medical source's records.
    We will consider treatment a medical source prescribed in the past 
if that treatment is still relevant to the individual's medically 
determinable impairments that are present during the potential period 
of entitlement or eligibility and upon which the disability finding was 
based. We will evaluate whether the individual failed to follow the 
prescribed treatment, and whether there is good cause for this failure, 
only for the period(s) during which the individual may be entitled to 
benefits under the Act.
    For example: On January 2, 2017, an individual filed for disability 
benefits based on an impairment related to a lower-extremity 
amputation. The individual is no longer wearing a prosthesis that her 
medical source prescribed in 2015. We determine that the individual 
meets all of the other criteria for disability. In this scenario, we 
will evaluate whether the individual is failing to follow the 
prescribed treatment to wear the prosthesis during the potential 
entitlement period and whether the individual has good cause for not 
following the prescribed treatment during this period. However, we will 
not consider whether the individual failed to follow prescribed 
treatment prior to the first possible date of entitlement.

Condition 3: There Is Evidence That the Individual Did Not Follow the 
Prescribed Treatment

    If we have any evidence that the individual is not following the 
prescribed treatment, this condition is satisfied. For example, a 
medical source may include in a treatment note that the patient has not 
been compliant with a prescribed medication regimen.

C. How We Will Make a Failure To Follow Prescribed Treatment 
Determination

    If all three conditions exist, we will determine whether the 
individual has failed to follow prescribed treatment in the claim. To 
make a failure to follow prescribed treatment determination, we will:
    1. Assess whether the prescribed treatment, if followed, would be 
expected to restore the individual's ability to engage in SGA.
    2. Assess whether the individual has good cause for not following 
the prescribed treatment.
    We may make either assessment first. If we first assess that the 
prescribed treatment, if followed, would not be expected to restore the 
individual's ability to engage in SGA, then it is unnecessary for us to 
assess whether the individual had good cause. Similarly, if we first 
assess that an individual has good cause for not following the 
prescribed treatment, then it is unnecessary for us to assess whether 
the prescribed treatment, if followed, would be expected to restore the 
individual's ability to engage in SGA.

Assessment 1: We Assess Whether the Prescribed Treatment, if Followed, 
Would Be Expected To Restore the Individual's Ability To Engage in SGA

    This assessment focuses on the prescribed treatment. We will 
determine whether we would expect the prescribed treatment, if 
followed, to restore the individual's ability to engage in SGA. We are 
responsible for making this assessment, and we will consider all the 
relevant evidence in the record. At the initial and reconsideration 
levels of the administrative review process, an MC or PC will make this 
assessment. At the hearings and Appeals Council (AC) levels, the 
adjudicator(s) will make this assessment. Although the conclusion of 
this assessment ultimately rests with us, we will consider the 
prescribing medical source's prognosis.
    If we first determine that following the prescribed treatment would 
not be expected to restore the individual's ability to engage in SGA, 
then it is unnecessary for us to assess whether the individual had good 
cause for failing to follow the prescribed treatment. If we determine 
that following the prescribed treatment would restore the individual's 
ability to engage in SGA, we will then assess whether the individual 
has good cause for not following the prescribed treatment.

Assessment 2: We Assess Whether the Individual Has Good Cause for Not 
Following the Prescribed Treatment

    This assessment focuses on whether the individual has good cause 
for not following the prescribed treatment.
    In adult claims, the individual has the burden to provide evidence 
showing that he or she has good cause for failing to follow prescribed 
treatment.
    In child claims, the parent or guardian has the burden to provide 
evidence showing that the child has good cause for failing to follow 
prescribed treatment. If the child has a representative payee and the 
parent, guardian, or child asserts that the child would have followed 
prescribed treatment but for the actions of the representative payee, 
we will determine whether to obtain a new representative payee. If we 
decide to obtain a new representative payee, we will provide additional 
time for the child to follow the prescribed treatment before we 
continue considering the claim.
    To assess good cause in both adult and child claims, we will 
develop the claim according to the instructions in the Development 
procedures section below. The following are examples of acceptable good 
cause reasons for not following prescribed treatment:
    1. Religion: The established teaching and tenets of the 
individual's religion prohibit him or her from following the prescribed 
treatment. The individual must identify the religion, provide evidence 
of the individual's membership in or affiliation to his or her 
religion, and provide evidence that the religion's teachings do not 
permit the individual to follow the prescribed treatment.
    2. Cost: The individual is unable to afford prescribed treatment, 
which he or she is willing to follow, but for which affordable or free 
community resources are unavailable. Some individuals can obtain free 
or subsidized health insurance plans or healthcare from a clinic or 
other provider. In these instances, the individual must demonstrate why 
he or she does not have health insurance that pays for the prescribed 
treatment or why he or she failed to obtain treatment at the free or 
subsidized healthcare provider.
    3. Incapacity: The individual is unable to understand the 
consequences of failing to follow prescribed treatment.
    4. Medical disagreement: When the individual's own medical sources 
disagree about whether the individual should follow a prescribed 
treatment, the individual has good cause to not follow the prescribed 
treatment. Similarly, when an individual chooses

[[Page 49619]]

to follow one kind of treatment prescribed by one medical source to the 
simultaneous exclusion of an alternate treatment prescribed by another 
medical source, the individual has good cause not to follow the 
alternate treatment.
    5. Intense fear of surgery: The individual's fear of surgery is so 
intense that it is a contraindication to having the surgery. We require 
a written statement from an individual's own medical source affirming 
that the individual's intense fear of surgery is in fact a 
contraindication to having the surgery. We will not consider an 
individual's refusal of surgery as good cause for failing to follow 
prescribed treatment if it is based on the individual's assertion that 
success is not guaranteed or that the individual knows of someone else 
for whom the treatment was not successful.
    6. Prior history: The individual previously had major surgery for 
the same impairment with unsuccessful results and the same or similar 
additional major surgery is now prescribed.
    7. High risk of loss of life or limb: The treatment involves a high 
risk for loss of life or limb. Treatments in this category include:
    [cir] Surgeries with a risk of death, such as open-heart surgery or 
organ transplant.
    [cir] Cataract surgery in one eye with a documented, unusually 
high-risk of serious surgical complications when the individual also 
has a severe visual impairment of the other eye that cannot be improved 
through treatment.
    [cir] Amputation of an extremity or a major part of an extremity.
    8. Risk of addiction to opioid medication: The prescribed treatment 
is for opioid medication.
    9. Other: If the individual offers another reason for failing to 
follow prescribed treatment, we will determine whether it is reasonably 
justified on a case-by-case basis.
    We will not consider as good cause an individual's allegation that 
he or she was unaware that his or her own medical source prescribed the 
treatment, unless the individual shows incapacity as described above. 
Similarly, mere assertions or allegations about the effectiveness of 
the treatment are insufficient to meet the individual's burden to show 
good cause for not following the prescribed treatment.

D. Development Procedures

    If evidence we already have in a claim is insufficient to make the 
required assessment(s) in the failure to follow prescribed treatment 
determination, we may develop the evidence, as appropriate. This 
development could include contacting the individual's medical source(s) 
or the individual to ask why he or she did not follow the prescribed 
treatment. Although it may be helpful to have evidence from a CE or ME, 
we are not required to purchase a CE or obtain testimony from an ME to 
help us determine whether we expect a prescribed treatment, if 
followed, would restore the ability to engage in SGA. We are 
responsible for resolving any conflicts in the evidence, including 
inconsistencies between statements made by the individual and 
information received from his or her medical source(s). We may also 
evaluate the claim using the procedures for fraud or similar fault, if 
appropriate.

E. Required Written Statement of Failure To Follow Prescribed Treatment 
Determination

    When we make a failure to follow prescribed treatment 
determination, we will explain the basis for our findings in our 
determination or decision.

F. When We Make a Failure To Follow Prescribed Treatment Determination 
Within the Sequential Evaluation Process for Initial Claims

Adult Claims That Meet or Equal a Listing at Step 3

    Generally, if we find that an individual's impairment(s) meets or 
medically equals a listing at step 3 of the sequential evaluation 
process, and there is evidence of all three conditions listed in 
Section B above, we will determine whether the individual failed to 
follow prescribed treatment. We will determine whether an individual 
would still meet or medically equal a listing had he or she followed 
the prescribed treatment. If we determine the individual would no 
longer meet or medically equal the listing had he or she followed 
prescribed treatment, we will assess whether there is good cause for 
not following the prescribed treatment. We will determine that the 
individual is disabled if we find that he or she has good cause for not 
following the prescribed treatment. If we do not find good cause, we 
will continue to evaluate the claim using the sequential evaluation 
process by determining the individual's residual functional capacity 
(RFC).\6\
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    \6\ See 20 CFR 404.1545 and 416.945.
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    There are two instances when we will not make a failure to follow 
prescribed treatment determination at step 3 of the sequential 
evaluation process, even if there is evidence that an individual did 
not follow prescribed treatment. First, we will not make a failure to 
follow prescribed treatment determination when we find the individual 
disabled based on a listing that requires only the presence of 
laboratory findings. In these claims, treatment would have no effect on 
the disability determination or decision. Second, we will not make a 
failure to follow prescribed treatment determination when we find the 
individual is disabled based on a listed impairment(s) which requires 
us to consider whether the individual was following that specific 
treatment as part of the required listing analysis. If either of these 
exceptions apply, we will find the individual is disabled without 
making a failure to follow prescribed treatment determination.

Title XVI Child Claims That Meet, Medically Equal, or Functionally 
Equal the Listings at Step 3

    Generally, if we find that a child's impairment(s) meets, medically 
equals, or functionally equals the listings at step 3 of the sequential 
evaluation process, and there is evidence of all three conditions 
listed in Section B above, we will determine whether there has been a 
failure to follow prescribed treatment. We will determine whether the 
child's impairment(s) would still meet, medically equal, or 
functionally equal the listings had he or she followed the prescribed 
treatment. If we determine the child's impairment(s) would no longer 
meet, medically equal, or functionally equal the listings had he or she 
followed prescribed treatment, we will assess whether there is good 
cause for not following the prescribed treatment. We will find the 
child is disabled if we determine that he or she has good cause for not 
following the prescribed treatment. If we determine that there is not 
good cause for failing to following the prescribed treatment, we will 
find the child is not disabled.
    There are two instances when we will not make a failure to follow 
prescribed treatment determination at step 3 of sequential evaluation 
process even if there is evidence that a child did not follow 
prescribed treatment. First, we will not make a failure to follow 
prescribed treatment determination when we find the child is disabled 
based on a listing that requires only the presence of laboratory 
findings. In these claims, treatment would have no impact on the 
disability determination or decision. Second, we will not make a 
failure to follow prescribed treatment determination when we find the 
child is disabled based on a listed impairment(s) which requires us to 
consider whether the child was following that specific treatment as 
part of the required listing

[[Page 49620]]

analysis. If either of these exceptions apply, we will find the child 
is disabled without making a failure to follow prescribed treatment 
determination.

Adult Claims Finding Disability at Step 5

    If we find that an individual is disabled at step 5 of the 
sequential evaluation process and there is evidence the individual is 
not following treatment prescribed by his or her own medical source(s), 
before we find the individual is disabled, we will assess whether the 
individual would still be disabled if he or she were following the 
prescribed treatment.
    We will determine what the individual's residual functional 
capacity (RFC) would be had he or she followed the prescribed 
treatment. We will then use that RFC to reevaluate steps 4 and 5 of the 
sequential evaluation process to determine whether the individual could 
perform his or her past relevant work at step 4 or adjust to other work 
at step 5. We will find the individual is disabled if we determine that 
the individual would remain unable to engage in SGA, even if the 
individual had followed the prescribed treatment. We will also find the 
individual is disabled if we find the individual had good cause for not 
following the prescribed treatment. However, we will find the 
individual is not disabled if the individual does not have good cause 
for not following the prescribed treatment and we determine that, had 
the individual followed the prescribed treatment, he or she could 
perform past relevant work or engage in other SGA.

G. Reopening a Determination or Decision

    As permitted by our regulations, we may reopen a favorable 
determination or decision if we discover we did not apply the failure 
to follow prescribed treatment policy correctly.\7\ We may base our 
reopening on the evidence we had in the folder at the time we made our 
determination or decision or based on new evidence we receive. When we 
reopen a disability or blindness determination or decision and find 
that an individual does not have good cause for failing to follow 
prescribed treatment, we will issue a predetermination notice and offer 
the individual an opportunity to respond before we terminate benefits.
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    \7\ See 20 CFR 404.988, 404.989, 416.1488, and 416.1489.
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H. Continuing Disability Reviews (CDR)

    When we conduct a CDR, we will make a failure to follow prescribed 
treatment determination when the individual's own medical source(s) 
prescribed a new treatment for the disabling impairment(s) since the 
last favorable determination or decision and the individual did not 
follow the prescribed treatment.
    We will also make a failure to follow prescribed treatment 
determination during a CDR if we find that an individual would continue 
to be entitled to disability or blindness benefits based upon an 
impairment first alleged during the CDR and there is evidence that the 
individual has not followed his or her own medical source's prescribed 
treatment for that impairment.
    If we determine an individual does not have good cause for failing 
to follow the prescribed treatment that we have determined would 
restore the individual's ability engage in SGA, we will issue a 
predetermination notice and, because benefits may be terminated, offer 
the individual an opportunity to respond before terminating benefits. 
Individuals are entitled to benefits while we develop evidence to 
determine whether they failed to follow prescribed treatment. If we 
determine that an individual failed to follow prescribed treatment 
without good cause in either situation, we will cease benefits two 
months after the month of the determination or decision that the 
individual is no longer disabled or statutorily blind.

I. Duration in Disability and Title II Blindness Claims

    If an individual failed to follow the prescribed treatment without 
good cause within 12 months of onset of disability or blindness, we 
will find the individual is not disabled because the duration 
requirement is not met.\8\ However, if an individual failed to follow 
prescribed treatment without good cause more than 12 months after onset 
of disability or blindness and is otherwise disabled, we will find the 
individual is disabled with a closed period that ends when the 
individual failed to follow the prescribed treatment. In this 
situation, we will continue to pay benefits as usual through the second 
month after the month disability or blindness ends.
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    \8\ See 20 CFR 404.1509 and 416.909.
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J. Duration in Title XVI Blindness Claims

    Because title XVI blindness entitlement does not have a duration 
requirement, an individual meeting the title XVI blindness requirements 
may be entitled to benefits beginning the month after he or she applies 
for benefits.\9\ If we determine an individual failed to follow 
prescribed treatment without good cause any time before the first day 
of the month after filing, we will find the individual is not disabled. 
However, if we determine the individual failed to follow prescribed 
treatment without good cause any time after the first day of the month 
after filing, we will find the individual is disabled with a closed 
period from the date of entitlement until the date we determined the 
individual failed to follow the prescribed treatment without good 
cause. In this situation, we will continue to pay benefits as usual 
through the second month after the month blindness ends.
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    \9\ Section 216(i)(1)(B) of the Act.
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    If we need further development to determine whether a title XVI 
blind individual failed to follow prescribed treatment without good 
cause, the individual is entitled to benefits while we conduct the 
additional development. At the hearing and Appeals Council levels, we 
will refer the claim to the effectuating component to develop the 
evidence necessary to make a failure to follow prescribed treatment 
determination.

K. Claims Involving Both Drug Addiction and Alcoholism (DAA) and 
Failure To Follow Prescribed Treatment

    In a claim that may involve both DAA and failure to follow a 
prescribed treatment for an impairment other than DAA, we will first 
make the DAA determination.\10\ If we find that the individual is 
disabled considering all impairments including the DAA and that DAA is 
material to our determination of disability, we will deny the claim and 
not make a failure to follow prescribed treatment determination. If we 
find that the individual is disabled considering all impairments 
including the DAA, but the DAA is not material to our determination of 
disability, we will then make the failure to follow prescribed 
treatment determination for the impairment(s) other than DAA. Even if 
the prescribed treatment for the other impairment(s) may also have 
beneficial effect on the DAA, we do not reevaluate for DAA materiality 
a second time.
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    \10\ See SSR 13-2p: Titles II and XVI: Evaluating Cases 
Involving Drug Addiction and Alcoholism (DAA), 78 FR 11939 (Mar. 22, 
2013).
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    For example, we cannot find that an individual has failed to follow 
prescribed treatment for liver disease based on a failure to follow 
treatment prescribed for alcohol dependence. If the cessation of 
drinking alcohol would

[[Page 49621]]

be expected to improve the individual's functioning so that he or she 
is not disabled, we would find that DAA is material to the 
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determination of disability and deny the claim for that reason.

[FR Doc. 2018-21359 Filed 10-1-18; 8:45 am]
 BILLING CODE 4191-02-P