If you’re approved for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), you’ve successfully completed the hardest part of the process. However, that doesn’t mean the process is over forever. The Social Security Administration (SSA) periodically conducts a continuing disability review to ensure you are still eligible for benefits. The timeframe for these reviews depends on how likely the SSA believes your condition is to improve.
What Is a Continuing Disability Review?
A continuing disability review (CDR) is a periodic review conducted by the SSA to determine if someone receiving disability benefits is still disabled and unable to work. There are two kinds of CDRs: work CDRs and medical CDRs.
- Work CDRs: The SSA looks at your earnings to see if you are earning more than the substantial gainful activity (SGA) threshold. If your earnings exceed SGA, your benefits may be terminated.
- Medical CDRs: The SSA determines if you continue to meet the medical criteria for disability benefits.
The frequency with which medical CDRs are conducted is based on the severity of your condition and the likelihood it will improve. There are currently three categories of potential improvement.
- If your condition is expected to improve, a CDR will be conducted within the first six to 18 months.
- If there is a possibility that your condition will improve, CDRs will be conducted every three years.
- If your condition is not expected to improve, CDRs will be conducted every five to seven years.
What Is a Continuing Disability Review Form?
The CDR report is a ten-page questionnaire that you complete regarding the state of your health. It asks you multiple questions regarding whether you have seen your doctors, have been hospitalized in the last year, have undergone any medical tests, or have started working again. The CDR generally reviews your condition over the previous year, but the SSA can go back to the moment you were first awarded benefits.
What Triggers a Continuing Disability Review?
If you report your condition has improved or you are engaged in work activity, you may trigger a full review. You can also trigger a full review if you fail to complete the questionnaire. If you do not report any work changes or improved health status, and the SSA does not have any other reason to believe that your condition has improved, the SSA will defer a full review.
If the SSA has decided to review your case, you will likely receive a written notice with forms to fill out and return. Make sure you respond to the SSA’s requests on time. And if there is anything that you do not understand, get help.
Key Considerations During Your Continuing Disability Review
When completing the questionnaire or undergoing the full review, please note a few important aspects of CDRs. First, SSA cannot stop your benefits if the medical criteria for your condition to be considered disabling changed between the time you were awarded benefits and now. Additionally, reviewers are barred from substituting their judgment for that of the adjudicator who originally approved you for benefits.
Your benefits also cannot be terminated unless the SSA finds substantial evidence your medical condition has improved to the point you can engage in SGA and are, by definition, no longer disabled. The SSA can terminate your benefits if it determines that you:
- Obtained benefits fraudulently in the first place
- Cannot be located
- Did not provide good cause for your failure to cooperate with a CDR
- Do not follow your prescribed medical treatment anymore which may have allowed you to work again
Remember, you do not have to prove your disability to the SSA all over again. The SSA has to prove there has been medical improvement to the point that your condition has lessened in severity and you can work again. If your condition has not improved to the point that you can resume work, the SSA cannot terminate your benefits. Once the agency has determined you are still unable to work because of your disability, the CDR is over.
Protecting Your Social Security Disability Review Status
The easiest way to lose your disability benefits is to fail to respond to the SSA’s requests or otherwise refuse to cooperate. They can also terminate your benefits if they find you have obtained substantial gainful activity or your prior disability award was fraudulent. Your benefits will also be jeopardized if the SSA finds you aren’t following prescribed medical treatment that could restore your ability to work.
Although it sounds like an intimidating process, the SSA is not looking to take away your benefits, and there are simple things that you can do to prepare. First, be sure to notify the SSA of any changes to your mailing address. Continue to see your doctors and follow their treatment plans. Continuing treatment shows the SSA you are doing what you can to improve your condition. If you stop seeing your doctors or fail to follow their advice, the SSA will schedule a CDR. Keep copies of all documents you send to the SSA and create lists of medical tests and treatments you’ve undergone. Learn as much as you can about your condition because the SSA will ask you a lot of questions and cross-reference the information in your medical records. If what you tell the SSA does not match what your treating or examining physician listed, the SSA will conduct a further investigation that could result in you losing benefits.
It takes one to three months to hear back from the SSA following your review. If the agency determines you are no longer disabled, your benefits will stop. However, you can appeal this decision and request provisional benefits to continue for up to six months. Having legal counsel during this time can help you maintain your benefits while you fight for your disability status.