 SSDRC What is the Application Process for Social Security Disability and SSI? How do you Win Benefits under Social Security Disability or SSI? If I am determined disabled, how far back will Social Security pay benefits? How do you prove your disability case if you have a mental condition? What Can I Do to Improve My Chances of Winning Disability Benefits Common Mistakes after Receiving a Denial of Social Security Disability or SSI Benefits How to File for Disability - Tips for Filing If You Get Approved For SSDI Will You Also Get Medicare? How much does a Social Security disability attorney get paid? Social Security Disability SSI Criteria and the Evaluation Process How long does it take to be approved for SSI or Social Security disability? What do you Need to Prove to Qualify for Disability Benefits? Social Security Disability SSI and Fibromyalgia Social Security Disability SSI and Degenerative Disc Disease Can I Qualify For Disability and Receive Benefits based on Depression? Answers to questions about SSD and SSI disability What Disabilities Qualify for SSI and Social Security Disability Benefits? Social Security Disability Status Social Security Disability Tips — how a claim gets worked on Social Security Disability, SSI Disability - Terms, Definitions, Concepts |
What will trigger a review of a social security disability claim?How to prove you are disabled and win disability benefits The two most common triggers of a review of an individual’s Social Security disability claim or Supplemental Security Income claim (SSI claim) are A) work activity and B) medical review diary dates. Social Security performs two types of continuing disability reviews (CDRs), either separately or simultaneously: the work continuing disability review and the medical continuing disability review. These reviews are performed simultaneously when a disability claim comes up for medical review and the disability beneficiary has worked. When a disability claim is medically reviewed, all work activity must be addressed prior to sending the continuing disability review to DDS, or disability determination services (where claims are processed for the social security administration) for a decision. Work activity may indicate medical improvement, thus it must be reviewed along with medical information. However, as I said earlier, Social Security may perform medical reviews and work reviews singularly as well. When disability claims are approved, a medical review diary date is established for a date in the future that is usually either three or seven years into the future. Medical diary date length depends upon the likelihood that an individual’s impairment will medically improve. Most disability cases have three-year medical review diary dates because there is thought to be a chance of medical improvement. If an individual has an impairment that is unlikely to have medical improvement, they may have a seven-year medical review diary. Some disability beneficiaries have medical conditions that are likely to have medical improvement so their disability claims may have medical review diary dates that are less than the standard three year medical review diary. All disability claims have medical review dates and individuals who receive disability benefits will most likely have more than one review in their lifetime. Most disability reviews result in a continuation of benefits for the disability beneficiary, so there is no reason to fear continuing disability reviews. The only way an individual could lose their disability benefits is if their work activity or medical records indicate that they have had medical improvement. The second type of review is a continuing disability review based upon work activity only. Work continuing reviews are most often triggered when an individual reports that they have gone back to work. Disability beneficiaries are required to report all work activity so that their disability file can be updated. Work reviews may not cause any change in benefits for a disability beneficiary, or they may cause an individual’s benefits to be suspended or even terminated. Although most work reviews are triggered by Social Security beneficiary work reports, a work review may be triggered A) if Social Security finds that work activity is being reported for a beneficiary to the IRS by their employer (W2 form) or B) even by a beneficiary filing self-employment earnings on their tax return. Generally, Social Security catches up with work activity sooner or later, so it is best to report it. Under current Social Security guidelines, individuals who do not report their work activity may be sanctioned or even charged with fraud for not reporting their work activity. 
Return to: SSDRC, or the Questions, Answers, Tips, and Advice page Individual Questions and Answers SSD and SSI are Federal Programs The title II Social Security Disability and title 16 SSI Disability programs operate under federal guidelines and, therefore, the program requirements--medical and non-medical--apply to all states: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming Recent approval and denial statistics for various states can be viewed here: Social Security Disability, SSI Approval and Denial Statistics by state Special Section: Disability Lawyers and unnecessary claim denials |