In the last year, SSA, with direction and funding by Congress, has initiated a more aggressive campaign to review and potentially terminate disability status, benefits and Medicare to tens of thousands of people. At a meeting with Administrative Law Judges locally, it was estimated that as many as 35 to 40 percent of the cases being appealed in 2016 to area SSA hearing offices will be disability cessation appeals, rather than the typical “initial entitlement” cases. SSA characterizes the process of reviewing and ceasing disability status as “Continuing Disability Reviews.”
What is a Continuing Disability Review (CDR)?
If you are currently receiving Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits, your disability status will be periodically reviewed by Social Security. This review is called a “Continuing Disability Review (CDR).” The purpose of the CDR is to determine whether or not you still meet the medical and income standards to be eligible for Social Security disability benefits. If your medical condition is expected to improve, the first review generally will be approximately 6 to 18 months after the approval of disability. If improvement is possible but can’t be predicted, Social Security will conduct a CDR approximately every 3 years. If your condition is not expected to improve, Social Security may still conduct a CDR, but typically in 5 to 7 years. Certain other events may trigger a CDR, such as completion of a vocational rehabilitation program, the 18th birthday of a child receiving SSI benefits, and occasionally work-related income within 24 months of entitlement to SSDI benefits.
How Do I Respond to a CDR Notice?
Read the notice carefully, and meet all deadlines for responding to any requests for information. Complete the forms that SSA sends to you. It’s a good idea to keep a record of all medical tests and treatments, and to ask your treating physician how to get copies of pertinent medical records. If you need more time to respond, ask for an extension. Cooperate in every way possible with the review, but remember that, in most cases, Social Security simply wants to verify that your disability in ongoing and that you still meet the eligibility requirements for benefits.
What if My Benefits are Terminated after a CDR Initial Review?
If SSA determines after a CDR that you are no longer entitled to benefits, it will send a notice of denial. Your benefits will be cut-off after two months unless you submit a Request for Reconsideration-Disability Cessation within 10 days of receipt and you specifically request within 10 days that your benefits continue during the appeal. Otherwise, the Reconsideration form is due within 60 days of receiving your denial notice. You can request an in person meeting with a disability hearing officer at the SSA, and you can also file the Request for Reconsideration form at your local SSA office. Be sure to save a copy and proof of the date that your Request was filed. If you request that your benefits continue during the appeal, and it is later determined that you were ineligible to receive benefits, the SSA will assess an overpayment and may seek recovery of those benefits from you, although you have a right to then request that the recovery of the overpayment be waived.
What does SSA look for in a CDR?
Keep in mind that the standard of review is more favorable in a CDR matter than it was when you were first awarded disability. With limited exceptions, to justify terminating your disability status, SSA must demonstrate that your health has significantly improved, and that the medical improvement is such that you can now return to full-time, reliable work. Because most health conditions that caused the initial disability by their nature do not improve as the years go on, the great majority of people reviewed in a CDR are determined to be still eligible for disability by SSA. If you have been continuing to see the doctors(s) you saw at the time you were awarded disability, make sure that your doctor’s records are obtained and submitted to SSA. Also, ask whether your doctor can include within your records your doctor’s opinion about whether your health has improved, and whether the doctor believes you can now return to full-time work. Note also that SSA must consider new health problems which you did not have at the time you were placed on disability, but which would now restrict your work capacity.
What if I lose my first appeal with the hearing officer?
If you lose the initial appeal with the hearing officer, you can file a second appeal to request a hearing with an Administrative Law Judge. As before, you have 60 days to file a Request for Hearing, but can elect to have your disability benefits and Medicare continue as long as you file a written statement for benefit continuation with the SSA field office within 10 days of receipt of the hearing officer decision.
If you have any questions about CDR issues and appeals, please feel free to call us at the LaPorte Law Firm.