For individuals to be approved for Social Security disability benefits (either Social Security Disability Insurance [SSDI] or Supplemental Security Income [SSI]), they must be determined to be disabled, but this determination of disability is not permanent.
The Social Security Administration (SSA) periodically reviews individuals' disabilities to insure that they still are disabled and unable to work. This periodic review is called a Continuing Disability Review (CDR). At a CDR, SSA will reassess your case and determine whether to continue or stop your benefits.
If your disability is expected to improve, you will likely have a CDR every six to 18 months. If you are not determined to have a permanent disability, but the timeframe of the improvement cannot be predicted, you will have a CDR at least every three years. If your disability is considered permanent (meaning it will not improve), you will have a CDR at least once every seven years, but no more frequently than every five years.
Despite these guidelines, CDRs can occur at any time if SSA feels there is a reason to review your case. There are a variety of situations that trigger a CDR to occur. Below is a list of situations that will prompt a Continuing Disability Review.
Your disability is expected to improve. There are certain disabilities that are expected to improve and therefore have shorter times between reviews. For example, those who receive stem cell transplants are considered disabled for only one year after their transplant and those disabled by fractures are considered to be likely to improve. Scheduled surgeries are also another factor that is considered in determining if your disability is expected to improve.
A current medical report is needed to show that you are still disabled. Situations were current medical reports are needed occur when there are improvements in the medical field that may affect your disability. For example, a new and very effective medication to treat Alzheimer's may allow an individual suffering from the condition to return to work.
You have returned to work successfully for a trial period. Since a key part of receiving disability benefits is the inability to work, you may no longer be eligible for benefits if you are able to successfully work.
Substantial earnings were reported. If you report earnings near the SGA limit, you can expect a review.
Vocation rehabilitation report. CDR will occur if your vocational services have been completed and Vocational Rehab reports you are working or able to work.
Report from someone who is in a position know the claimant. If SSA receives a report from an individual who knows you and the agency believe the reports to be true, it may trigger a CDR. Triggering reports include stating that you are no longer disabled, you have returned to work, or that you are violating SSA regulations.
Evidence received puts into question whether you are still disabled.
It is time for a vocational reexamination. Vocational reexaminations will generally occur after your vocational services are completed in order to assess your ability to work after receiving services.
In evaluating whether you are still disabled, SSA will look at whether you are currently involved in substantial gainful activity, whether you still meet or equal a listing, and whether there are any improvements in your impairment that may have increased your ability to work. It is important to note that SSA will also assess your compliance with SSA rules at this time; for example, if you refuse to follow prescribed treatment that could restore your ability to work, you may lose your benefits.
The evaluation process will begin with you receiving a form in the mail from SSA to fill out. Once you send the form back, SSA will review it and provide you with a decision. The wait time to hear a response from SSA can range from several weeks to several months, depending on the backlog that your state is experiencing with CDRs. The approval rate (meaning the continuation of benefits) for CDRs nationally is just under 75%.
If your benefits are stopped (called cessation), you have the right to appeal. In order to appeal, it is essential that you send a reply to SSA within the required time frame. All of the necessary information regarding how to appeal can be found in the letter stopping your benefits that you receive from SSA (your cessation notice).