Facing a continuing disability review (CDR)? This can be an unsettling situation to be in. You might feel anxious about the process, and it’s understandable to have questions. This post aims to clear up the confusion surrounding CDRs and provide you with the knowledge to approach it with confidence.
We’ll break down exactly what a CDR is. We’ll also explore why it happens, what to expect during the evaluation process, and how to respond effectively. This will cover both Title II Disability Insurance and Title XVI Supplemental Security Income for those no longer disabled.
What is a Continuing Disability Review (CDR)?
A continuing disability review is how the Social Security Administration (SSA) checks if you still meet the requirements for disability benefits. This process ensures that Social Security disability benefits go to those who truly need them based on their medical conditions and functional limitations. The law requires these periodic reviews to maintain the integrity of the Social Security Disability Insurance and Supplemental Security Income programs.
The SSA periodically reviews cases to see if beneficiaries receiving Social Security Disability or SSI are still disabled based on the SSA definition. The SSA conducts CDRs according to Section 225 of the Social Security Act, further refined by the 1980 and 1984 amendments (20 CFR §404.1594, 20 CFR §416.994).
Why Does a CDR Happen?
The SSA conducts CDRs to confirm your medical condition still prevents substantial gainful activity. These reviews help the SSA maintain the integrity of disability programs. CDRs ensure benefits reach individuals who continue to meet the eligibility criteria and haven’t experienced medical improvement.
Sometimes, information received by the SSA can trigger a review. For instance, a report of improved health or work activity can prompt the SSA to review your case. Additionally, certain medical conditions have an expected improvement period and are subject to more frequent reviews (DI 28001.001). These short-form reviews don’t usually request updated medical documentation.
What To Do If You Receive a CDR Notice
Receiving a CDR notice might feel overwhelming, but knowing the steps involved can ease anxiety. Take your time to process the information, then start gathering your medical documents and records that were requested.
1. Understand the Notice
Carefully review the notice. Look for key details like deadlines, required forms, and the specific information the SSA requests. Some forms you might encounter are Form SSA-454-BK (Disability Update Report), the shorter Form SSA-455 (short form), or Form SSA-827 (Authorization to Disclose Information to the Social Security Administration).
2. Gather Medical Evidence
Compile all relevant medical records. This includes doctor’s reports, test results, treatment summaries, and other documentation supporting your disability claim. This comprehensive record helps the SSA fully assess your current condition.
3. Complete Required Forms
Fill out all necessary forms accurately and thoroughly. Provide clear, concise, and honest answers. If you have questions or need help with the forms, seek assistance from resources like the SSA or organizations specializing in Social Security disability benefits.
4. Consider Professional Guidance
Navigating the CDR process can be challenging. Consider contacting an attorney or advocate specializing in Social Security disability. They can provide guidance and represent you during the review process. These professionals are especially valuable for long form CDRs or complex cases.
5. Attend Consultative Examinations
The SSA might schedule a consultative examination (CE) with an SSA-approved doctor. These exams happen if the SSA needs additional information about your condition. Attend these exams prepared with your medical history, medication lists, and updated medical documents.
6. Submit Everything on Time
Send in your completed forms and supporting documents by the deadline in your notice. Submitting everything on time keeps your review process moving forward and avoids potential delays.
Timeline and Expectations
A CDR can take several weeks or months. The review length depends on several factors. One key factor is the amount of evidence the SSA needs to review. Your initial award notice should have provided information about the timeline for your first CDR. Cases that require a medical continuing disability review, especially, are conducted no later than every three years based on likelihood of medical improvement being expected. It’s a good idea to check this notice so you know what to expect.
Frequency of Reviews
How often you undergo a CDR varies depending on the nature and severity of your condition. Conditions expected to improve will have a CDR more frequently. The SSA usually reviews these cases every 6 to 18 months. Conditions not expected to improve have less frequent reviews. The frequency may be around every seven years for these more stable conditions.
Understanding Medical Improvement
For a CDR to cease your benefits, the SSA must find that you’ve experienced medical improvement. This medical improvement must be significant enough to allow you to return to substantial gainful activity. Medical improvement is decided based on current medical condition, medical history, birth weight, etc. The SSA evaluates medical improvement and makes favorable determinations.
FAQs about continuing disability review
What does continuing disability review mean?
A continuing disability review is the process where Social Security checks in with you to see if you still have a qualifying disability. This is used as an opportunity to check if your condition has improved enough to allow you to return to work.
What are the chances of passing a continuing disability review?
Many people retain their benefits after a CDR. However, some cases may end in terminated benefits due to medical improvements or work activity. Favorable determination is the decision you would like to receive as part of the SSA continuing disability review process. A successful outcome maintains eligibility for the cash benefits of the program based on current medical conditions. It is possible benefits could stop or change as part of this process based on individual factors, such as changes in a beneficiary’s ability to engage in substantial gainful activity.
Is it hard to pass a disability review?
It’s natural to feel concerned about a CDR. It is advisable to take certain steps such as submitting all medical records during the CDR process to help increase your chances of success and show that your current medical conditions would preclude gainful activity. Working with experienced professionals can make the review process smoother. They can assist with completing required paperwork, gathering evidence and documents regarding the claimant’s medical treatment, representing clients during continuing reviews or hearings, etc.
At what age do continuing disability reviews stop?
The frequency of CDRs may decrease with age. While cases with a greater chance of improvement will be reviewed as often as every six months, other conditions might only undergo continuing disability review every three years (DI 28001.001). After age 55 or 60, reviews may shift from every 3 years to every 5-7 years. Additionally, if you are over age 64 the SSA may stop conducting continuing reviews due to special rules for cases close to retirement age.
For those on SSDI, once these disability insurance benefits convert to retirement benefits, your medical condition is no longer a factor for eligibility. Those receiving SSI disability benefits might have continuing financial eligibility reviews beyond retirement age since the program involves both income limits and medical criteria to determine benefits.
Conclusion
A continuing disability review might seem stressful. By understanding what goes into the CDR process and preparing for it thoroughly, you can effectively and confidently navigate the review. From understanding why the SSA conducts CDRs to gathering your medical evidence and attending consultative examinations, being proactive is important. There are available resources that may provide additional help or a CDR overview.
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The information provided in this blog article is intended to be general in nature and should not be construed as legal advice. Social Security laws and regulations are subject to, and often change. Please consult the official Social Security Administration (SSA) website or contact SSLG for advice regarding your specific legal matters.