Understanding Continuing Disability Reviews
Determining whether you are disabled does not end when your Social Security Disability application for benefits is approved. Even after you are approved, you may be contacted about a Continuing Disability Review (CDR).
There are two types of CDRs and there are several things you need to know about them so that you will be better prepared for them and can avoid any actions that could jeopardize you continuing to receive disability compensation.
If you have questions about continued eligibility to receive disability benefits, it is important to consult with an experienced Phoenix Social Security Disability lawyer for assistance. Our lawyers can explain what the review is, when you can expect a review, and how you should respond.
Types of CDRs
When an individual receives Social Security Disability Insurance or SSDI benefits, he or she may acquire a letter and questionnaire sent by the Social Security Administration (SSA). The SSA explains that a review of the person’s medical condition will occur and when it will happen. There are two types of these CDRs:
The Work Review
With the work review, the SSA assesses current and past earnings under SSDI to determine if this person grosses more than the substantial gainful activity or SGA of $1,220 each month. If the determination does expose this, benefits cease. However, the work activity or the income earned can also trigger a medical review.
The Medical Review
When the SSA conducts a medical review, it is to determine if the person meets medical requirements to continue collecting SSDI benefits. The reviewer of the case cannot substitute his or her own judgment for the original adjudicator for disability benefits. Because of these limitations, the SSA has serious restrictions from terminating eligibility.
When to Expect a Review
After the applicant is approved for disability benefits, a representative who handled the claim will set the dates for the CDR. The Certificate of Award should also come with a date of the first review. Normal reviews should occur every three or seven years, depending on the disability. The case should involve one of three possible assessments before the review. These are medical improvement possible, medical improvement expected and no medical improvement expected.
Medical Improvement Possible
With MIP or medical improvement possible, a CDR occurs every three years or longer. The SSA expects doctors to find that the disabled person can eventually improve and no longer needs SSDI.
Medical Improvement Expected
With a medical improvement expected or MIE, the SSA may review the case six to eighteen months after the applicant receives disability benefits. This type of case usually occurs when the person is temporarily disabled for injuries, illnesses and other conditions that are short-term such as work-related injuries or surgery. Someone over 55 rarely will have a MEI case.
Medical Improvement Not Expected
For those who have a medical improvement not expected or MINE case, a CDR usually occurs every seven years. These conditions generally include the following:
- Certain cancers
- Blindness that is permanent
- Deafness that is not temporary
- Down syndrome
- Chronic conditions
Those over 55 often have the seven-year CDRs because of the unlikeliness of improvement in the condition. However, even permanent conditions require a CDR.
You Should Always Respond to a CDR Notice
The SSA expects prompt communication. Any lack of response to the CDR notice can lead to complications in receiving benefits. The person receiving SSDI may also need to remain in constant contact to address any changes in the claim. This includes personal details such as a change of address and if the condition improves. It is especially important to contact the SSA if the unexpected case does improve.
When Can a CDR Lead to Termination of Benefits?
Termination of benefits can occur in the following ways:
- Medical improvement to the point benefits are no longer necessary
- Fraudulent claims
- The person is no longer disabled
- Inconsistencies in reports and the medical evaluation
The CDR representative who performs the review will check documentation, reports and any updates that can affect the case.
Contact a Disability Lawyer
When you need support and the legal services of a disability lawyer, you can count on the help of Dayes Law Firm. Our lawyers can explain each step of the review process and what the agency will request. Certain documentation is vital to these cases, and the person undergoing the CDR will need to gather it prior to the medical review. The severity of your condition normally determines when the review will occur. If this process is unclear and you need a better understanding of what requirements are necessary, we can support you through this process.
Contact us for a free case review either over the phone or online.