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People who receive Social Security disability benefits must undergo periodic medical reviews with the Social Security Administration to review the status of their health condition so the agency can determine if a person has recovered enough to return to work and no longer needs disability benefits.
Understanding Medical Reviews
When a person receives Social Security disability benefits from the Social Security Disability Insurance or Supplemental Security Income programs, the Social Security Administration may require that person to undergo periodic medical reviews, formally known as Continuing Disability Review (CDR). How often a person must undergo CDR will depend on the nature of their medical condition or disability and whether doctors expect the person’s condition to improve. When a person’s condition will likely improve, the SSA may require a CDR within six to 18 months after approval of the person’s application for SSD benefits; if the person’s condition might improve, reviews may occur every three years. When doctors do not expect a person’s condition to improve, the SSA may require CDRs approximately every seven years.
The Process of a Medical Review
During a CDR, an SSD benefits recipient will meet with representatives of the Social Security Administration to discuss how the recipient’s medical condition continues to affect their daily life and whether they have experienced any improvement in their condition. A recipient must provide the SSA with medical information such as:
- The names and contact information of their treating physicians
- Any patient record numbers for any healthcare facilities that have treated the recipient since the approval of benefits or their last CDR
- Any dates that the recipient has worked since the approval of benefits or their last CDR, the pay they received, and the type(s) of work they did
The SSA will send medical and work information to the Disability Determination Services office in the recipient’s state, which makes disability determinations for the Social Security Administration. DDS will contact the recipient’s healthcare providers for copies of the recipient’s medical records since the initial review of their application or their last CDR and to provide written opinions regarding how the recipient’s medical condition limits their activities, what treatments the recipient has received for their condition(s), and the results of any medical tests. Sometimes, the SSA will require a recipient to attend an independent medical examination or diagnostic test paid for by the SSA to provide updated medical information.
After gathering all available medical information, the SSA will compare the recipient’s present condition with their condition when the agency last reviewed the recipient’s case and identify any new health issues. When the SSA determines that a recipient’s condition has improved, it will evaluate whether it has improved enough to allow the recipient to return to work and what accommodations or restrictions the recipient might need to return to work.
Purposes of a Medical Review
Because the Social Security disability benefits programs have limited resources, the Social Security Administration periodically reviews benefits recipients’ medical conditions to ensure that recipients remain unable to work. Any recipient whose condition has improved enough to enable them to return to the workforce, given their education, training, skills, work experience, and capacity for retraining, may have their SSD benefits terminated.
What Happens After a Medical Review?
If the Social Security Administration determines that you can return to work after a medical review, it may terminate your disability benefits. However, a recipient who has their benefits terminated after a medical review can appeal the SSA’s decision through the agency’s administrative appeals process, which involves reconsideration of the decision, a hearing before an administrative law judge, and finally, an appeal of the ALJ’s decision to the SSA’s Appeals Council. A recipient who wishes to appeal the Appeals Council’s decision must file a civil action in federal court.
Contact a Social Security Disability Attorney Today
When the Social Security Administration notifies you of a pending medical review of your disability benefits, you need experienced legal representation to guide you through the process and protect your rights and interests. Contact Disability Advocates Group today for a free, no-obligation consultation to learn more about SSD medical reviews and your legal rights and options.
