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A Look at the Review Period for Disability Benefits

As discussed in a recent news feature from ABC News, the United States Social Security Administration (SSA) will subject a claimant to review process at certain intervals following an award of disability benefits.  While in most cases it is just a scheduled or even random review, in some cases the agency does suspect fraud and will require a claimant to undergo a review.

deniedThe process by which the SSA will typically request a review is to send a letter to the claimant requesting that the claimant see a certain doctor and have an evaluation as to their condition that qualifies them for disability benefits. This doctor does not necessarily work directly for the SSA, but the doctor does get paid by SSA, so there is certainly some level of bias we see from time to time.

As our Boston disability benefits attorneys have seen in many cases, when the diagnosis has any room for discretion by the evaluating physician, such as with mental illness and the level of pain from which a claimant is suffering, there could be bias.  If the agency gets a report that you have made a significant medical improvement, it may determine you now have a residual functioning capacity that allows you to work, and will simply cut off your benefits without having a hearing or allowing you to submit any evidence.  On the other hand, you may be given hearing before an administrative law judge (ALJ), but normally you have to request this.

There are certain things you can to do prevent the agency from inappropriately reducing or cutting off your benefits; but, it is important to understand, the agency does this as a means to reduce your benefits and save money, so it helps to have an experienced attorney on your side fighting for your rights to Social Security Disability Insurance (SSDI) benefits and the continuation of benefits already imposed.

The most important thing you can do to prevent your benefits from being cut by the unilateral action of the SSA is to make sure you see your doctor regularly.  While this may seem strange, by going to the doctor or physical therapy and receiving routine treatment for your disabling condition, you are accomplishing two things.   First, you are making sure that you are getting all of the treatment and rehabilitation you medically need, and this is very important.  Second, you are creating a medical record.  This medical record can be used to support your argument at a review hearing that your condition has not changed to the point where you are no longer disabled.

When you go to the hearing, the ALJ will have the opinion of an evaluating physician who has only seen you one time and formed the opinion you are no longer disabled.  To counter this argument, you will have years of records for your doctors and therapists that show your condition has not improved to the point where you are not disabled.  Under the SSA guidelines, it is difficult overcome the opinion of a treating physician unless doing so would clearly be supported by the evidence.

The other thing to make sure you do is to keep in touch with your SSDI attorney in Boston. He or she can make sure that you are doing all you can to protect your benefits.

If you or a loved one is seeking Social Security Disability Insurance in Boston, call for a free and confidential appointment at 1-888-367-2900.

Additional Resources:

Oneida woman’s Social Security disability cut off, despite no change in condition, July 13, 2016, ABC News, By Don Dare

More Blog Entries:

Who is Getting the Most from Social Security Disability? July 2, 2016, Boston SSDI Lawyer Blog