Is Your Disability Status Under Review? (Don’t Panic)

What you need to know about Continuing Disability Reviews.

If you are receiving disability benefits, the Social Security Administration (SSA) is required by law to conduct periodic checks of your medical condition to determine if you still meet their disability standards. These evaluations of a person’s disability status are called Continuing Disability Reviews (CDRs), and are conducted at different times for different reasons, depending your age, medical condition, and other factors.

If you are an adult, your disability status will be set for review every six months to seven years, depending on the likelihood (in the government’s view) that you will get better.

• If your condition is expectedto improve, your case will likely be reviewed every 6 months to 2 years.
• If the SSA believes it is possible that your medical condition may improve, your case will likely be reviewed at least every 3 years
• If your medical condition is not expected to improve, then your case will likely be reviewed every 7 years.

We say likely to be reviewed, because the scheduling can be altered for many reasons. For example, due to a huge backlog in CDRs, the time between reviews has become longer in recent years. Also, Attorney Tom Nash points out that SSA Administrative Law Judges (ALJs) who decide on awarding disability benefits have a great deal of leeway in deciding when CDRs are scheduled. If an ALJ awards disability benefits but is not totally convinced about the merits of a case, they can add a “time bomb” to their decision by adding a recommendation that improvement is expected so that a disability review is scheduled within 6 to 12 months. Unfortunately, all too often this happens when a there is clearly no likelihood of improvement in a disability claimant’s medical condition. This adds an undue burden on individuals who have difficulty navigating the system and who get lost in the bureaucratic paper and evaluation shuffle.

In addition to a regularly scheduled CDR, the SSA may conduct what is known as a “triggered CDR.” This is a continuing disability review triggered by any of the following situations:

• You return to work.
• You inform the SSA that your condition has improved.
• Your medical evidence indicates that your condition has improved.
• A third-party informs the SSA that you are not following your treatment protocol.

“If you receive notice of a CDR, don’t panic,” advises Nash attorney Dan Rosen. “The notice will be accompanied by a form. Absolutely the best course of action is to fill out the form completely and send it back promptly. Be honest in your answers, focusing on how your medical conditions continue to affect even your ability to complete your daily activities independently, but also prevent you from working full-time, day in and day out.”

“It is important to remain in treatment and respond in time to the CDR correspondence,” Dan adds. “I’d say that of all the callers that we get with benefit cessation issues, the most common issue is failure to comply or respond to SSA’s CDR correspondence. Failure to respond often happens because the individual moved and didn’t update their address with SSA. The second most frequent issue with benefit interruptions is work and earnings. If you return to work, even a little bit, you need to keep track of your pay stubs and report your earnings to Social Security. Many callers will say that they provided SSA with a W2 or 1099, which is not specific enough; Social Security needs to see proof of month-to-month income.”

Remaining in treatment for the health problems that resulted in your disability award is also important. If a CDR is conducted and you have not seen the doctor for some time, SSA may believe that your condition improved. There will also be no evidence of your ongoing limitations. Understanding what medical impairments led to your original approval, and establishing ongoing care for them, can help if and when you are faced with a CDR.

If, as a result of the Continuing Disability Review process, SSA says you are no longer eligible for benefits, you can appeal the decision, but you must do so within 10 days in order to keep your benefits while your appeal is pending.