Only reopen an adverse determination (denial, closed period, or cessation) due to
failure to follow prescribed treatment if the determination was incorrect.
Examples of this situation include:
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The treating source did not actually prescribe the treatment; or
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The treatment could not have been expected to restore the claimant's capacity for
Substantial Gainful Activity (SGA); or
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Good cause for failure to follow prescribed treatment existed.
NOTE: After denying a case based on failure to follow prescribed treatment, the fact that
the individual may later agree to follow such treatment cannot be the sole basis for
revising the previous determination
See Details
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DI 27505.001 - Conditions for Reopening a Final Determination or Decision