Social Security Proposes Changes to Continuing Disability Reviews

How is the Social Security Administration changing the way they handle Continuing Disability Reviews?

Author Attorney Lloyd Bemis:

On November 18, 2019, the Social Security Administration announced proposed changes to how it conducts continuing disability reviews.

---

Under the new rule, Social Security proposes adding a new category, Medical Improvement Likely (MIL) under which cases would be reviewed every two years.

“We propose to revise our regulations regarding when and how often we conduct continuing disability reviews (CDR), which are periodic reviews of eligibility required for benefit continuation. The proposed rules would add a category to the existing medical diary categories that we use to schedule CDRs and revise the criteria for assigning each of the medical diary categories to cases. The proposed rules would also change the frequency with which we perform a CDR for claims with the medical diary category for permanent impairments. The revised changes would ensure that we continue to maintain appropriate stewardship of the disability program and identify medical improvement (MI) at its earliest point. “
https://www.ssa.gov/regulations/recentregulatory.html

During a continuing disability review or CDR, Social Security reviews a beneficiary’s medical impairment(s) to determine if they still have a disabling condition.

If Social Security decides a person is no longer disabled or blind, their Social Security disability benefits will stop. At the same time, Social Security will also review the beneficiary’s income, resources, and living arrangements to confirm they meet the program’s non-medical requirements. How often a case is reviewed depends on whether the beneficiary’s condition is expected to improve.

Currently, Social Security divides continuing disability reviews into three categories:

•    If a medical condition is “Expected” to improve, the case will be reviewed every six to 18 months after benefits have started.
•   If it is “Possible” a medical condition will improve, the case will be reviewed every three years.
•   If a case is “Not expected” to improve, it will normally be reviewed every seven years.

If you have been denied disability don’t give up! Contact a Disability lawyer at 512-454-4000 for a free consultation and get the benefits you deserve.

Under the new rule, Social Security proposes adding a new category, Medical Improvement Likely (MIL) under which cases would be reviewed every two years.

Social Security explains its reasoning, stating, in the agency’s experience, medical improvement rates were similar in the Medical Improvement Expected (MIE) and Medical Improvement Possible (MIP) categories and that adding “a fourth category between MIE and MIP that would allow us to align our CDRs more directly to when certain conditions are more likely to medically improve.”

Social Security is also proposing to change the criteria for existing medical improvement categories and provides a description of how it will evaluate the new proposed category of Medical Improvement Likely:

“We propose to use the MIL diary category, instead of the MIE or MIP diary categories, to conduct reviews for specific impairments that typically do not result in permanent, irreversible structural damage and are amenable to improving with treatment. This category will apply to impairments in both adults and children, and will include some claims that currently fall into the MIE and MIP diary categories. Some examples of claims that we expect to include in this category are favorable determinations and decisions for both adults and children based on cancer listings that include a specified minimum period of disability (for example, leukemia, lymphoma), anxiety disorders, speech impairments, and malignant solid tumors in children. This category will also include cases in which we make a favorable determination or decision based on the inability to adjust to other work (i.e., allowances at step 5 of the sequential evaluation process). “

Social Security claims these changes will allow the agency to administer the program more efficiently and reduce costs; however, attorneys and advocates for people who are disabled, as well as some members of Congress, have already questioned the new rule’s consequences, citing a host of problems.

It is already very difficult to qualify for Social Security Disability benefits and it can take years for a claim to be approved. Continuing disability reviews are burdensome and stressful for people with physical or mental impairments, and it is feared that many will lose their disability benefits even though they are unable to work because of their medical condition. Older adults who are nearing retirement, children ages 6-12 living below poverty level, and children and adults suffering from cancer or a serious mental disorder are at particular risk. While Social Security estimates it will save $2.6 billion by reducing disability payments, the administrative costs of the changes – approximately $1.8 billion – are another cause for concern. Is it worth the risk of denying support to people who need it?

The rule is long and complex and Democrats overseeing Social Security policy in the House of Representatives and Senate have urged the Social Security Administration to extend the comment period:

“Under the proposed rule, SSA will increase the number and frequency of reviews of people who have previously been approved for SSDI and SSI, to see if the person’s medical impairment has improved. This process, known as a continuing disability review (CDR), can be extremely complex for beneficiaries to navigate. We are concerned that under the proposed rule, some individuals subject to review will be simply unable to navigate the process and, as a result, lose their benefits even though there is no medical improvement. In addition, the process can create severe and unnecessary stress as beneficiaries fear they will lose their main source of income even though they are still unable to support themselves through work due to their medical impairment. “

The original deadline for commenting on the proposed rule, January 17, 2020, has been extended to January 31, 2020. Read the complete rule at: Rules Regarding Continuing Disability Reviews