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How often will social security review my disability claim in California?
Trying to get approved for social security disability or SSI disability benefits in California can be daunting, due to these aspects (this is by no means a complete list):
1. How long the process takes (which can cause considerable financial repercussions),
2. The poor job the social security administration does with regard to explaining "how things work",
3. The fact that while your case is being processed, your claim will seem to be in limbo (SSA does not provide status updates, just decisional notices).
In fact, the process can be so draining and exhaustive that many claimants, after they've finally won their benefits, will simply want to get the experience behind them and give little thought to how their later actions might affect their benefit eligibility. This, of course, can pose risks. One of those risks has to do with work and how work may affect a recipient's eligibility to receive benefits (On the day I wrote this, I learned of an individual who has a $51,000 overpayment which is owed to SSA as a result of unreported earnings).
However, another risk in this area (in the opinion of some disability representatives) has to do with continuing disability reviews, or CDRs.
What is a CDR? Well, after a social security disability or SSI disability claimant is approved and put on benefit receipt, their case is also set for review. Depending on the severity of their condition(s) and the evidence that was available at the time their claim was decided, their claim will typically be reviewed every one, three, or seven years.
To illustrate the differences, a claimant whose case is approved but is "somewhat on the line" may be given a one-year diary date for a review of their disability claim, whereas a person whose condition is such that medical improvement is not expected may be given a seven-year diary date for a review of their disability claim.
When a continuing disability review is conducted, a disability examiner (disability examiners make decisions on disability claims for the social security administration) essentially looks to see whether or not medical improvement has taken place. If the individual's condition has improved, they face the prospect of having their SSD or SSI diability benefits discontinued. If their condition has worsened, or simply stayed the same, their benefits will be continued. The keystone variable, of course, is medical improvement.
The thing is, though, a certain percentage of claimants will stop going to the doctor after they have been awarded benefits, meaning that, by the time their claim is reviewed, there is no preferred means of determining whether or not medical improvement has taken place ("preferred means" equates with records obtained from an individual's treating physician). In other words, how can you gauge an individual's medical eligibility to receive benefits if medical eligibility is based on a review of records...and there are no records?
Can a lack of records at the time of review harm a recipient's chances of having their benefits continued? That's debatable, at best, though I've encountered at least one representative who seemed to think so. However, the answer to the question of whether or not a benefit recipient should keep going to the doctor for the sake of a future review may have at least a little to do with whether or not the individual's condition is mental or physical.
Regarding physical impairments, for those who have reached MMI (maxiumum medical improvement), there may be very little reason to keep going to the doctor on a routine basis. And for someone who has been released by their doctor after the doctor has concluded that MMI has been reached, to continue making office visits would seem to be a non-productive use of time (particularly by the doctor).
With mental impairments, the situation may be completely different. If a benefit recipient has schizophrenia, bipolar disorder, anxiety disorder, or any one of a number of other mental conditions, it's not likely that the need for treatment will dissipate after a claim has been won. And most examiners conducting a review of an individual's disability claim would probably find it unusual if treatment had not been obtained for quite some time and records were not available as a result.
Should you keep going to the doctor after you've won your benefits for the sake of future reviews of your claim? Answer: if you need to be seen by a doctor then go, and if you don't need to be seen...then don't go. But treatment should probably not be sought simply for the sake of a continuing disability review (please bear in mind, though, that if you are trying to initially win your benefits, you should be seen regularly so you or your representative can present medical documentation with which to win your claim).
What happens if your claim is reviewed and you do not have current medical records? You will most likely be sent to a consultative exam. However, the findings of CE exams are "very thin", that is to say generally useless. In most cases, other than allowing SSA to fulfill their "recency of medical evidence" requirement, their effect is generally meager.
As an anecdotal contribution to this post, I should mention that many disability examiners have actually remarked that it is difficult to stop someone's benefits if they have not had continued medical treatment simply because without such documentation it is difficult to show that medical improvement has actually taken place. And without medical improvement being demonstrated, a social security disability or SSI recipient cannot have their benefits stopped on the basis of a medical rationale.
Return to: Social Security Disability Resource Center, or read answers to Questions
Filing for disability in California
How do I Apply for Disability Benefits in California
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SSD and SSI applications in California
What do you do if your California disability claim is denied?
Do you file for your children when you apply for disability in California?
Should you apply for disability in California after a denial?
How long does a disability case take in California
After you file for disability in California
Filing for disability in California and your condition
Filing a disability claim in California, long filing process
The California disability process
Do I need to be disabled a year in California to get disability?
The Social Security Disability process in California
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How much can you make in California and still apply for disability?
California Social Security Back Pay
Can Disability benefits be garnished in California?
Disability two year medicare waiting period in California
California review of Social Security Disability claim
California Social Security Disability status
VA disability and California Social Security Disability
Can a Congressman in California help on a disability case
How do examiners make disability decisions in California?
Applying for disability benefits in California
How long does disability take in California?
How long does it take to get a decision on a disability case in California?
Why do disability claims take so long in California?
How Long Will It Take To Get My Disability Decision If I Appeal in California?
Disability claims in California with certain conditions
Applying For Disability On the Basis of Back Pain in California
Filing for Disability with Fibromyalgia in California
Social Security Disability For Mental Illness in California
Winning California disability
Will a lawyer improve the chance to win disability in California?
Getting approved for disability in California
Winning disability in California
California Disability Lawyers and Representation
Getting a disability attorney in California
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How to apply for SSI Disability in California
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Qualifying for disability in California
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Disability lawyers in California
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Cost of a California disability attorney
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Should you get a disability lawyer before you get denied in California?
Lawyer for a disability hearing in California
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