Surviving a Continuing Disability Review
If you collect Social Security Disability [“SSD”] benefits, the Social Security Administration [“SSA”] will review your medical condition from time to time to make sure you
continue to be disabled. If your medical condition has improved AND that you can work on a regular basis, SSA will stop your benefits. For more information about the medical
improvement standard, check out https://secure.ssa.gov/poms.nsf/lnx/0428010000
This review is called a Continuing Disability Review [“CDR”]. We usually DO NOT represent someone going through a CDR. The law requires SSA to perform a CDR about every 3 years, unless you have a condition that is expected to improve sooner. If you have a condition that is considered permanent, SSA still may review your case (but probably not every 3 years).
If your health has not improved, or if your disability still keeps you from working, you should continue to collect SSD benefits. The CDR process is designed to give you every opportunity to show that you are still disabled. All evidence about your condition will be evaluated completely. If you have more than one disabling condition, SSA will consider the combined effect of all your impairments on your ability to work.
WHAT YOU CAN DO
If SSA decides that a full medical review is needed, they will send you a letter asking to meet with you at one of its offices. You should bring to that meeting the names
and addresses of the doctors who have treated you since you were approved for SSD.
If you have worked since you applied for SSD or since your last CDR, SSA will need information about the dates you worked, the pay you received and the kind of work you did.
At the meeting, SSA will ask how your medical condition affects you and whether it has improved. We recommend that you:
- THINK “HEAD TO TOE” WHEN DESCRIBING YOUR PROBLEMS. You probably will be nervous. This is natural. One way to be sure that you tell SSA about all your problems is to describe them from “head to toe,” that is, start at your head and describe your difficulties going down your body.
- BE PREPARED TO GIVE ESTIMATES ABOUT YOUR ABILITIES/LIMITATIONS. You probably will be asked to give estimates about your abilities and limitations. For example, you may be asked how far can you walk and how long you can you stand. SSA is looking for an average. We know that every day is different and that your abilities and limitations may vary on a given day.
HOW SSA DEVELOPS THE EVIDENCE
SSA will send your case to the New York State Office of Temporary and Disability Assistance [“OTDA”]. An experienced disability examiner will request medical reports from your
doctors and from other places you go for treatment. The examiner and a medical consultant, who work together as a team, will carefully review all the information received for
your case and then make a decision.
In most cases, the decision will be based on the information from your doctors, hospitals or other medical sources. But, if the medical evidence is not complete or current, you may be asked to have a special examination at no cost to you. You will be notified in writing of the date, time and place.
Generally, your SSD benefits are stopped ONLY if the evidence shows that your medical condition has improved AND that you can work on a regular basis. As long as your condition has not improved and you are not able to work, your cash benefits will continue.
HOW CAN YOU CHALLENGE A DECISION THAT YOU ARE NO LONGER DISABLED?
If SSA decides that you are no longer disabled or blind, you can appeal that decision. This means you can ask SSA to look at your case again to see if their decision was
There are four levels of appeal. Generally, you have 60 days to appeal from one level to the next. However, you (and your minor child[ren]) may need to file the initial appeal within TEN DAYS of the Notice of Cessation to keep the monthly benefit and Medicare coverage in place while the appeal is pending. Thus, it is extremely important to read the Notice of Cessation carefully to insure you appeal timely.
The four levels are:
- Reconsideration–Your case is independently reviewed by people who had no part in the original decision. You may appear before a disability hearing officer [“DHO”] who will decide your appeal. The DHO is NOT a judge and your meeting with him is NOT a hearing.
- Hearing–If you disagree with the reconsideration decision, you may request a hearing before an Administrative Law Judge [“ALJ”].
- Appeals Council–If you disagree with the ALJ’s decision, you may ask for a review of the decision by the Appeals Council (“AC”).
- Federal Court–If you disagree with the AC’s decision, or if the AC decides not to review your case, you may bring a civil action in a Federal Court.