If you are receiving Supplemental Security Income (SSI) through the Social Security Administration (SSA) Disability Benefits program, you likely know that the SSA will periodically conduct a continuing disability review of your case to see if you still qualify for benefits. Questions often arise about what triggers the review, how long does social security disability review take, and what you can do if your social security benefits are terminated.
What Is a Continuing Disability Review (CDR)?
The SSA conducts a periodic review of your case to determine if you still have the disabling condition that initially qualified you for benefits. It is called a continuing disability review (CDR) and includes a review of:
- Your current medical condition.
- Your income.
- Resources available to you.
- Your living arrangements.
If the SSA determines you still have the disabling condition, and that disabling condition prevents you from working, you will continue to receive benefits.
What Triggers a CDR?
When the SSA initially approves your application for social security benefits, it establishes a review schedule depending on the nature of your disability. It bases the timing of the review on the nature of your disabling condition.
- If you are expected to experience medical improvement, a review will be within six to 18 months of the decision to award you benefits.
- If improvement is possible, but might not occur, then the CDR will occur about every three years.
- If your disabling condition is such that no improvement is expected, a review will occur about every seven years.
What is the Standard for Evaluating Medical Improvement?
The SSA will send you a letter telling you that it is conducting a medical review to determine if you still qualify for social security disability. Soon after you receive the notice, someone from the SS office near you will contact you to explain to you what is involved in the process.
The SS representative will explain to you your rights and ask you to provide information about your medical treatment and current medical condition within 30 days of the notice so the SSA can evaluate your medical condition. You will also be asked about any work you may have done since you first started receiving benefits.
You will be given the opportunity to explain in your own words how you are feeling in general and if you feel like you are still disabled. You can explain how your condition affects your ability to work.
You need to inform the SSA about all doctors you have seen and all medical treatment you have received. Your doctors will be asked to provide your records to the SSA for review. It is not enough for your doctors to say you are disabled. They must explain what your disability is and how that disability affects your ability to work.
A team consisting of a doctor and disability examiner at your state’s Disability Determination Office will review your medical records. You may be asked to submit to an independent medical exam (IME) by a doctor hired by the SSA. The SSA will pay for the exam and also pay for your transportation to the location.
The team will decide if you still have a disabling condition and if so, how does that affect your ability to do the work you did in the past, and whether there is any job you might be able to work at according to the findings of the review. They will also consider whether you have followed a recommended treatment plan and have complied with the recommendations of your treating physicians.
After reviewing your medical records, and the results of the IME if one was required, the SSA will make a decision. If it deems you are still disabled, your benefits will continue. If it decides you are no longer disabled, your benefits will be terminated three months after the SSA decides your disability ended.
How Long Does Social Security Disability Review Take?
How long it takes the SSA to process a CDR depends on whether your case is selected for a full medical review which requires a review of your records by a team. If you are required to submit to an IME, that will take longer.
If your benefits are terminated, and you request a hearing in front of an administrative law judge, the SSA must give you 75-days’ notice of the hearing date.
You can speed up the process by promptly returning any forms you are sent and by waiving the 75-days notice requirement.
If the result of the CDR is the termination of your benefits, you have the right to appeal, which may according to the SSA may be a “lengthy” process.
You Have the Right to Appeal if the SSA Terminates Your Benefits
If the SSA informs you that your benefits are denied, you have the right to appeal within 60 days of the day you get notice your benefits have been terminated. There are four levels of appeal, and you have 60 days to appeal to the next level after each denial. The levels are:
- Reconsideration. This means you simply ask for a reconsideration. This means a different team will review your case. The original team will have no part in this second review. A hearing officer may be designated to hold a disability hearing where you can appear in person and argue your case.
- Administrative Hearing. If you are again denied, you can request a hearing before an administrative law judge. At the hearing, you may present witnesses to support your case. In turn, the judge may call witnesses, such as a vocational counselor, treating physician, or independent medical examiner to ask questions. If the judge denies you benefits, you can appeal your case to the Appeals Council.
- Appeals Council. The Appeals Council will do another independent review of your case and of the decision issued by the administrative law judge. If the Council agrees with the judge that your benefits should be terminated, your last recourse is to file a civil lawsuit in federal court.
- File a civil lawsuit in federal court. If the Appeals Council denies you benefits, your only recourse is to then file a lawsuit in federal court.
What Happens If I Don’t Reply to the CDR Notice?
The CDR notice gives you 30 days to respond. The SSA sends a follow-up notice within 15 days to remind you that you need to respond. If you do not respond to that notice or phone calls, the SSA must try to locate you.
This includes checking with third parties, your financial institution, the post office, or your employer. If the SSA cannot locate you or communicate with you, and they do not hear from you, your benefits will be suspended 45 days after the day the SSA notifies you it is conducting a CDR.
What Must I Report to the SSA While I am Receiving Disability Benefits?
To keep in good standing with the SSA and keep your benefits coming, there are requirements you must meet. You must report, by phone, mail, or in person, the following to the SSA:
- If you work while receiving benefits. This requires reporting no matter how little money you earn. You are to report how many hours you work, when you start, and when you stop. You are given a trial work period and can still receive benefits for up to nine months. Tell the SSA if you have expenses associated with work, such as a wheelchair or prescription drugs.
- If you receive other disability benefits. This means any benefits you receive from any other source based on your disability, whether government or private, or proceeds from a lawsuit. Also, report if you stop receiving any other benefit.
- If you are working under the Ticket to Work program. This is a voluntary program, but if you take advantage of it, report it to the SSA.
- If you move. The SSA needs your new address and phone number and any other contact information you can provide. This is true even if you have direct deposit of your benefits. If the SSA tries to contact you, and your phone number and address are not accurate, your benefits will be terminated.
- If you open a different bank account for direct deposit. You can do this online or with a telephone call.
- You cannot manage your benefits. If you admit you are unable to manage your money, you can name a personal representative who you can ask to do this for you, and SSA will evaluate that person and determine if they are suitable. If so, your benefit check will be sent to your designee.
- If you get a pension from a job that did not pay into SS. Civil service jobs and jobs with state governments do not pay into SS. Receiving this pension may result in a reduction of your SS disability benefits.
- If you get married or divorced. Your marital status may affect your disability benefits.
- If you change your name.
- If you have a warrant for your arrest.
- If you are convicted of a crime.
- If you move out of the country. You can still receive your disability benefits, but there are some countries where SSI checks cannot be sent.
If you fail to inform the SSA about any of the changes for which it requires notice, your benefits will be terrminated.
