If you are receiving SS disability benefits you will be the subject of a Continuing Disability Review.
You need to understand what it is and how to prepare for it.
A Continuing Disability Review or CDR is a routine review conducted by the Social Security Administration to make sure that people receiving Social Security Disability (SSD) and Supplemental Security Income (SSI) benefits are still qualified as disabled and entitled to receive those benefits.
The Social Security Administration does not assume that you will be permanently disabled when you are initially granted Social Security Disability or Supplemental Security Income.
If you are no longer disabled or blind, the SSA will end your benefits. If you have returned to work or your condition has improved enough that you can return to work, the SSA may end your benefits. The law requires the Social Security Administration to perform a medical CDR approximately every 3 years unless the SSA determines that you have a condition that may improve sooner. If your condition is not expected to improve, SSA will still conduct a CDR, but not as often as every 3 years.
If the case involves a disabled child the SSA follows a slightly different procedure.
The SSA will perform a CDR approximately every 3 years if the SSA expects a child’s condition to improve, but may also conduct a CDR if they do not expect the child’s condition to improve. If the child’s disability was determined based on low birth weight, the SSA will usually do a CDR by the time the child reaches age 1. If the SSA decides that improvement is unlikely by age 1, it will conduct the CDR after age 1. At the time of the review, the SSA may ask the child’s representative payee to produce evidence that the child has been receiving treatment that is medically necessary and available for the child’s condition. A representative payee is a person, agency, organization or institution selected by the Social Security Administration to manage a person’s benefits when it is determined they are unable to do so. If the child’s representative payee refuses to show evidence without good cause, SSA will find another representative payee, or pay the child directly if he or she is old enough.
A continuing disability review may also be conducted in any of the following situations:
- You return to work.
- You inform the SSA that your condition has improved.
- Your medical evidence indicates that your condition has improved.
- A third-party informs the SSA that you are not following your treatment protocol.
- A new treatment for your disabling condition has recently been introduced.
The Social Security Administration will notify you by mail if your claim is up for review and will send you either a copy of the short form, Disability Update Report (SSA-455-OCR-SM), or the long form, Continuing Disability Review Report (SSA-455-BK).
The short form is two pages and is generally for those whose condition is not expected to improve. The SSA will send you the long form if your condition could improve, or if your answers on the short form alert the SSA to some potential issue.
The long form is similar to the initial disability application.
It contains questions which ask if you have seen a doctor or been hospitalized in the past year, or had any tests such as blood tests or x-rays. It also asks if you have been working.
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.
There are some steps you can take to prepare for a CDR review:
- Respond to SSA’s requests for information on time. If you need more time to respond, contact the SSA and request an extension.
- Request help if you need assistance in gathering information.
- Submit any updated medical information to the SSA.
- Keep copies of all documents you submit to the SSA.
- Maintain good relationships with your medical providers and keep them informed about your condition. Let them know that the SSA will review your case and may contact them.
- Keep a list of all medical tests and treatments and know where to obtain copies of records.
- Inform the SSA of any change in address.
The agency typically reviews your condition during the 12-month period prior to receiving the CDR notice, but may look at any evidence following the date you were originally granted benefits.
If you haven’t returned to work, the SSA will determine if there has been any improvement in your medical condition. If not, the review process is complete and your benefits will continue. If there has been improvement in your medical condition, the SSA will decide if the improvement affects your ability or inability to work. If it does not, your benefits will continue. If the SSA determines that your medical condition has improved to the extent that you are able to return to work, you will be notified that your benefit payments will be terminated and given an opportunity to appeal the decision. If the SSA determines there is insufficient evidence to reach a decision, or the agency finds discrepancies or inconsistencies between medical evidence and information you report, you may be sent for a consultative examination which is an exam performed by a doctor that is paid for by the SSA. Drug or alcohol abuse, or unexcused failure to follow prescribed medical treatment, can also result in denials, especially when they contribute significantly to the person’s disability.
If the SSA concludes you are no longer disabled and terminates your benefits, you may appeal the CDR decision by submitting a Request for Reconsideration.
If you want your benefits to continue during the time your case is appealed, the Request for Reconsideration must be submitted within 10 days of receiving the denial. If you elect to receive benefits, but your appeal is unsuccessful, Social Security will assess an overpayment and you will be required to pay back those benefits. The appeal process is lengthy, but it is worthwhile if you have a legitimate case.