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Continuing Disability Reviews

On Behalf of | Mar 9, 2021 | Social Security Disability Benefits |

The Social Security Administration provides disability income to qualifying individuals and their families. The Social Security Administration is required to periodically review the case of every person who is receiving Social Security Disability Insurance or Supplemental Security Income disability benefits. If you are receiving these benefits, the SSA might choose to conduct a Social Security Continuing Disability Review (CDR) to closely examine your situation. A CDR is intended to identify recipients who might no longer qualify as disabled. If, during a CDR, Social Security finds that your medical condition has improved enough so that you can work, your Social Security benefits will end.

Continuing disability reviews are performed at different frequencies for different recipients, depending on their age and medical condition. In general, it is much easier to pass a continuing disability review (CDR) than it is to be granted benefits in the first place.

CDRs for Adults

The Social Security Administration will periodically review a person’s medical impairment to see whether they are still considered disabled. If the SSA determines that someone is no longer disabled, their benefits will stop. Most cases are set for review every three or seven years, depending on the likelihood that your condition will improve. A CDR is required by law at least once every three years. However, if a medical condition is expected to improve sooner, CDRs will be conducted more frequently. If the medical condition is not expected to improve, the case will be reviewed once every five to seven years. If a claimant has a condition that is expected to medically improve, a CDR may be conducted even sooner than three years. On the other end of the range, Social Security beneficiaries whose condition is not expected to improve or are disabled due to a permanent condition (such as a lost limb or impaired intellectual functioning) may have their claim reviewed even less than every seven years. But even those with permanent disability conditions are subject to CDRs. In addition, CDRs are also more frequently conducted for beneficiaries who are under the age of 50.

Continuing Disability Reviews for Children

The CDR process is slightly different for minors. The SSA will conduct a CDR at least once every three years, regardless of whether they expect the condition to improve. If the child was considered disabled due to a birth defect, a CDR would typically be started by their first birthday. Newborns who receive SSI due to a low-birth weight will have their claim reviewed prior to the one-year mark. However, if improvement is unlikely to occur by age one, then a CDR will not be scheduled until after their first birthday. Children who are receiving SSI disability benefits will automatically have their claims reviewed when they turn 18. The standards that must be met for an adult to be considered disabled are different than those for a child, so at age 18, the child will be evaluated under the adult standards.

Other situations can also trigger a CDR such as:

The recipient of benefits returns to work;
The recipient informs the SSA that their condition improved;
Medical evidence indicates an improved condition;
The SSA is informed that the individual is not following proper treatment protocol; or
A new treatment for the disabling condition has been introduced.
Any of these scenarios could cause someone to become ineligible to continue receiving benefits.

If your Social Security claim is up for review, the SSA will notify you by mail. You are encouraged to submit any updated medical evidence to the SSA, although the SSA may also obtain this on their own. In general, the SSA will be reviewing the period of 12 months prior to the notice, although the agency can look at evidence from any time after you were initially granted benefits.

A CDR examines a person’s income, resources, and living arrangements to determine whether they are meeting all the non-medical requirements for disability benefits. If a CDR shows that an individual is no longer disabled, they will stop receiving disability benefits from the SSA.

Assuming you haven’t returned to work, Social Security will first determine if there has been medical improvement in your condition. If the answer is no, the continuing disability review process is complete, and your benefits will not be affected.

If the answer is yes, the SSA will then decide if the medical improvement affects your ability (or inability) to work. If it does not, you will continue to receive benefits. But if the SSA comes to the conclusion that your condition has improved to the point where you can return to work, you will be notified that your benefit payments will stop and will be given the chance to appeal the decision. If the SSA feels that the evidence is insufficient to make a decision, or if there are inconsistencies between what you report and your medical evidence, you could be sent for a “consultative examination,” which is an examination by a doctor that is paid for by the SSA. If Social Security decides to terminate your benefits because you are no longer disabled and are able to work, you can appeal the CDR decision.