Will my disability case be reviewed after I have been approved for disability benefits?

Yes, your disability case will be periodically reviewed to ascertain if there has been medical improvement. A review is known as a CDR, which stands for continuing disability review.

Sometimes, a CDR will be triggered by work activity that the claimant is engaging in (note: individuals are allowed to file for disability benefits and even to receive disability benefits if they are working as long as their gross monthly earnings do not reach the level of SGA, or substantial gainful activity). However, usually a CDR will be conducted simply because it has been scheduled to occur.

When a disability benefit recipient's case comes up for its scheduled review, it will be sent by the CR (claims representative, the individual at the social security office who has control of the case) to the state disability agency--DDS, otherise referrred to as disability determination services--where the continuing disability review will be performed by a disability examiner, the same type of specialist who makes decisions on disability applications and decisions on reconsideration appeals.

Most individuals have a continuing medical review every three years or so. Although, there are some disability claims that will be reviewed more often because medical improvement was thought to be likely (at the time the disability case was approved).

Some individuals will have medical reviews every seven years or so, because medical improvement was considered by a disability examiner or disability judge to be very unlikely.

Medical reviews are a fact of the Social Security Disability, SSI system; therefore you should not be upset when the time comes for your disability case to be reviewed. Nor should you worry too much about the outcome. The fact of the matter is, the majority of all Social Security Disability and SSI disability cases that are reviewed are continued---in other words, the benefits are continued.

Why are disability benefits usually continued following a review?

Because for a disability examiner to discontinue, or cease, a person's benefits, they must obtain recent medical evidence that indicates that the claimant's condition has improved. In other words, the records must show that the same level of physical or mental limitations that were in place at the time benefits were granted no longer exist, at least not to the extent that they would prohibit the individual's ability to engage in substantial and gainful work activity.

Proving this (medical improvement), however, tends to be fairly difficult, even more difficult than proving that the person was disabled in the first place. Why? Because medical records tend to say little about functionality.

To summarize, in actuality, a review of your case is much the same as when you first applied. Continuing medical reviews involve updating your medical sources, investigating any work activity, and a medical review decision from the state medical disability agency (DDS). The vast majority of continuing medical reviews, of course, are favorable to the individual.

However, should you have a negative decision, you have appeal rights and you may choose to find representation to assist you. In fact, in the unlikely event that your benefits are cut off, you should proceed with the help of representation since you will be headed to a subsequent hearing before an administrative law judge.

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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