Should I be concerned if my SSDI is subject to a continuing disability review?
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I am receiving Social Security Disability Insurance and am now subject to a continuing disability review. Should I be concerned?
Under current Social Security laws, the Social Security Administration (SSA) is authorized to conduct period reviews, referred to as continuing disability reviews (CDR), to evaluate whether claimants currently receiving Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) remain disabled and are entitled to continue receiving disability benefits.
Continuing disability reviews (CDR) are normally scheduled every three years for any claimant who does not have a permanent disability. Permanent health conditions are reviewed at intervals decided by the Commissioner.
After the review, if the SSA decides that a claimant has had significant medical improvement and they are capable of working, they may lose their benefits.
Continuing Disability Review Process
If you are notified that the SSA has scheduled a continuing disability review (CDR), there is no reason to panic. The CDR is part of the required disability process, and you have not been singled out by the SSA. It is, however, very important to cooperate with the SSA and make sure you understand the review process.
What do I do after receiving the CDR notification?
After receiving the notification for the CDR, it is important to follow every step carefully and provide all requested information. At the very least, you will need to complete Form SSA-455: Disability Update Form or Form SSA-454 Report of Continuing Disability Interview (if that form is initially sent to you). In some cases, you will also need to submit additional medical evidence for the SSA to consider during their review.
If you do not respond to the SSA, they will make several attempts to contact you. If they cannot reach you, however, they have the legal right to eventually terminate your disability benefits.
After the SSA receives the completed Disability Update Report (Form SSA-455), they will determine whether a full medical review of your case is necessary or whether your benefits can simply continue (if they initially sent you Form SSA-454, then they have already determined thata full medical review is required).
If they contact you and notify you that they will complete a full medical review of your case, it’s important to provide all requested information.
What if a full medical review is required?
If the SSA requires a full medical review of your medical condition, they will send you another form to complete (SSA-454: Report of Continuing Disability Review). It is important to contact someone at the SSA or contact a disability lawyer if you do not understand how to accurately complete this form.
Full continuing disability reviews are completed by a team at the Disability Determinations Office. The team consists of a doctor and a disability examiner.
Their evaluation will include a medical continuing disability review, which allows the team to request medical information and review all of your current medical data, including medical reports, medical tests and medical treatments.
If the team determines they do not have sufficient medical evidence to make a continuing disability determination, they will request that have a consultative examination. This exam will be paid for by the Social Security Administration.
In addition to evaluating your medical health condition, the team will also conduct a work continuing disability review. This review will evaluate whether your overall health, including any conditions you have developed since your initial disability decision, affects your ability to work any relevant job in the past or retrain for new work.
The process to evaluate whether or not your disability benefits should continue at this point can be a bit complicated. Discuss this issue with the SSA if you have additional questions.
What can disqualify me from receiving benefits?
You lose your benefits after a continuing disability review if the SSA can show that your condition has improved so much that you can work. You can also lose benefits for a variety of other reasons.
For example, SSDI benefits can be terminated if the SSA cannot contact you; if you fail to provide the necessary information to the SSA for them to complete their review; if you fail to follow the prescribed treatment plan of a doctor and the SSA determines that this treatment could restore your ability to work; or if you committed fraud to get benefits.
Appealing the CDR Decision
After the SSA completes the CDR, you will receive notification that your disability benefits will continue or that they have been terminated. If they are terminated and you fail to appeal the decision, benefits will stop after three months.
There are several steps in the appeal process that may allow you to regain benefits, including a positive review by a staff member of the DDS office, a disability hearing officer, an administrative law judge or the Appeals Council.
Bottom line: There is no reason to panic when you receive a continuing disability review notice. This is a normal part of the disability process. It is important, however, that you complete the forms that are sent to you and that you understand what it is that you are trying to prove.
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