Everything You Need to Know About Your ‘Continuing Disability Review’
After you receive Social Security disability benefits, the Social Security Administration (“SSA”) will set your case for a Continuing Disability Review (“Review”). These reviews are scheduled for all beneficiaries on a regular basis to ensure that they still qualify for ongoing disability benefits.
Frequency of Continuing Disability Reviews
Most cases are set for review in either 3 or 7 years.
- If your condition is not expected to improve it will likely be set at 7 years.
- If improvement is possible, but cannot be predicted, SSA will set your Review at 3 years.
- In circumstances where improvement is expected an administrative law judge can request that your case be reviewed even earlier.
From my experience, the closer someone is to retirement age, the less likely they are to be scheduled for a Review. Relevant age categories in disability are age 50, 55 and 60. Reviews are seemingly less likely in each category.
There are a few instances in which a review is automatically triggered.
- Returning to Work When you return to work and are working at or above substantial gainful activity (“SGA”), a review will automatically be triggered. In 2021, you are earning SGA if your gross income is $1,310 a month or more. The definition of disability requires that one be unable to work so it makes sense that actually working should result in a termination of benefits.
- Self-Reported Improvement An automatic review can also be triggered if you call the SSA and inform them that you have improved.
Third-Party Notification I am also aware of an automatic review occurring when a 3rd party calls the SSA and informs them that a review should take place. Essentially that 3rd party would be reporting what they perceived to be as a fraud on the program.
Process for Continuing Disability Reviews
If/when your case comes up for review, it will be assigned to a disability examiner from your state’s Disability Determination Services (“DDS”). Much like the initial time you were approved for benefits, the examiner is tasked with determining whether or not a beneficiary still qualifies for benefits.
Your examiner will first send you either a short-form or a long-form disability report.
- The short-form is only two pages and is generally sent to beneficiaries who are not expected to improve.
- The long-form is more likely to be sent to individuals who could improve or are expected to improve.
After receiving the disability report, the examiner will request medical records from your medical providers. If you have any evidence that supports your ongoing disability you should send it to your examiner at this stage of the process. Upon receipt of those records, the examiner will then review the medical record to determine whether or not your condition has improved. If there is not enough evidence in your record to make that determination, DDS may request that you attend a medical examination conducted by an independent physician.
Potential Review Outcomes
- If it is found that your medical condition has not improved to a point where you can engage in SGA, you will continue to receive disability benefits.
- If your condition has improved and it is found that you are able to work, DDS will schedule a date that your benefits will stop.
- You do have the right to appeal a cessation of benefits decision. If you need to appeal, it is likely that you will be required to present your case in front of an Administrative Law Judge.
Likelihood of Losing Your Benefits
Beneficiaries can and do lose their benefits as a result of a CDR. That being said, losing those benefits is unlikely.
I am not convinced that everyone undergoes a review, but when SSD recipients are reviewed, they maintain their benefits about 85% of the time. SSI recipients maintain their benefits about 83% of the time.
The most important thing that you can do in preparation for a CDR is to continue getting regular medical treatment for your conditions. If you are notified of a Review, ask your doctors to complete RFCs or write letters of support on your behalf. These additional pieces of evidence are extremely helpful in convincing an examiner to decide in your favor.