What will trigger a review of a Social Security Disability claim?

The two most common triggers of a review of an individual's

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.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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