By law, the Social Security Administration has to occasionally review the case of every person receiving Social Security Disability Insurance and/ or Supplemental Security Income disability benefits. The process by which this happens is what is called a “continuing disability review.” The intention is to figure out who might no longer qualify as disabled, and therefore who no longer needs benefits.
In general, it’s a lot harder to get benefits in the first place than it is to pass the process of a continuing disability review. That said, it’s wise to consult with an experienced Boston SSDI lawyer because there are a number of pitfalls that can arise throughout this process, and you don’t’ want to suddenly find yourself without much-needed benefits.
Continuing disability reviews are performed at various intervals depending on the underlying condition of the recipient, as well as his or her age.
For adults, the majority of cases are reviewed by representatives with the SSA every three to seven years, with more frequent reviews occurring in cases where there is a likelihood one’s condition is going to improve. This could be a condition like severe depression or disability due to multiple knee surgeries.
There are generally two categories here: Medical Improvement Possible and Medical Improvement Expected. Cases that are medically expected to improve could reviewed as frequently as every six to 18 months after claimant was first approved. However, in cases wherein there is only the possibility – but not the expectation – of improvement, reviews could occur anytime from three years to every seven years.
On the other hand, there are those who are disabled due to conditions that are permanent – and won’t get better. For example, if a disability is due to a loss of limb, blindness, Down syndrome, autism or a fatal disease – these type of chronic or terminal conditions aren’t likely to get frequent reviews. However, even permanent conditions are subject to a continuing disability review. This is especially true if the individual is under the age of 50 and receiving SSDI benefits.
For children (who are only eligible for SSI), cases can be reviewed when they turn 18, no matter what their condition. Newborn babies who receive SSI as a result of having low birth weight will have a continuing disability review before they turn 1.
There are also some situations in which the SSA could initiate a continuing disability review based on new information. Some events that could trigger a review might include:
- Recipient goes back to work.
- Recipient informs the SSA his or her condition has gotten better.
- Medical evidence has surfaced to indicate recipient’s condition has gotten better.
- A third party informs the agency that recipient isn’t following protocol.
- A new treatment for your disabling condition has been recently made available.
So how will you know if your claim is up for a review? You will get a notice in the mail. The agency will send you either a short form or a long form announcing he review (with the short form typically going to those whose conditions aren’t expected to improve and the longer form going to those who are expected to eventually get better). At that point, the agency will encourage you to send certain medical evidence, usually pertaining to the last year.
It’s at this juncture you should seek the advice of a lawyer who can help you determine the best way to present that evidence to improve your chances of hanging on to your benefits. Given how difficult those benefits are to get in the first place, it’s not worth the risk of possibly losing them by leaving it to chance.
If you or a loved one is seeking Social Security Disability Insurance in Boston, call for a free and confidential appointment at (617) 777-7777.
CONTINUING DISABILITY REVIEWS, Social Security Administration
More Blog Entries:
Over 1 Million Wait for Social Security Disability Benefits, Feb. 9, 2017, Boston SSDI Lawyer Blog