How Can I Prepare for a Social Security Disability Review?
Knowing what to expect and filling out the forms properly are the only way you can prepare.
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Every few years, depending on the severity of your disability and the likelihood that your medical condition will improve, the Social Security Administration (SSA) will notify you that it's time for your continuing disability review for your SSDI or SSI benefits.
It would be difficult to actually prepare in advance for a continuing disability review (CDR). This is simply because the cessation or continuance of your benefits is based entirely on your medical records (unless a cessation occurs following a SSI redeterminaton, for non-medical reasons such as too much income or assets).
You simply fill out the form the SSA sends you, and if the agency needs more information, it will request medical records from your doctor. In some cases, the SSA may send you for a consultative medical exam or test.
Filling Out the Forms Properly
The best thing you can do to make your review go well if to fill out the Social Security form completely and send it back promptly.
How to Fill Out Form SSA-455
If the SSA send you the short form, SSA-455-OCR-SM (Disability Update Report), it is not expecting that you've had any medical improvement, and the form's purpose is to catch any changes in your circumstances. If the answers to the questions on the form (which are optically scanned by the SSA) raise any red flags, the agency will then do a full medical review. Red flags might be:
- entering earnings above $1,070 per month (the SGA amount)
- checking the box "my doctor told me I can work"
- checking the box saying your health is "better" than it was at your last review or approval, or
- saying you haven't visited a doctor since your last review or approval.
How to Fill Out Form SSA-454
If the SSA sent you the long form, SSA-454-BK (Continuing Disability Review Report), the agency is doing a full medical review because it anticipates that your condition may have improved. One purpose of this form is to discover if you have visited a doctor, been hospitalized, or had any medical tests in the past 12 months. If you have, the SSA will request medical records from the doctors and institutions you include on the form. You are encouraged to submit any updated medical evidence to the SSA even though the SSA may also obtain this on its own (only if you were sent the long form, SSA-454. In general, the SSA will be reviewing the period of 12 months prior to the notice, although the agency can look at evidence from any time after you were initially granted benefits.
Form SSA-454 also asks whether:
- you are currently taking the medicine you were prescribed (the SSA wants to know if you are complying with the treatment prescribed by your doctor)
- you are working, and
- you are able to perform various daily activities, such as driving, walking, shopping, dressing, bathing, or getting along with people.
The SSA will compare your latest medical records and your answers on your daily activities to your case file, which contains your old medical records and your RFC assessment, showing what you could do when you were approved for benefits or at your last disability review. If your medical records or answers show some medical improvement related to your ability to work, you could be denied benefits. It's usually difficult for the Social Security Administration to cease and discontinue a person's benefits if his or her medical records don't indicate the existence of medical improvement.
Maintaining Your Relationship With Your Doctor
To feel more secure about upcoming disability reviews, keep in mind that the relationship you have with your treating physician may be relevant to whether or not your disability benefits are continued. For example, if a doctor at some point concludes that a recipient no longer has trouble walking effectively, this position may begin to appear in the recipient's medical records. For this reason, disability recipients may wish to stay attuned to the relationship they have with their treating physician and be careful regarding what they say to their doctor. For example, a patient who has been awarded disability benefits based on degenerative disc disease may not wish to comment that they "felt well enough to mow their entire backyard" even though the mowing was followed by several days of unrelenting pain, fatigue, and discomfort. Your comments may be taken out of context, and the part about your pain or fatigue may be left out.
Worse, if you haven't been to the doctor in the last year, the SSA may doubt your continued disability and may send you to a consultative exam, where a doctor who is paid for by Social Security and who has no knowledge of your long-term medical history may spend 10 minutes examining you. It's much better to have your own doctor's records document your ongoing symptoms and limitations.
For more information on when the SSA can deny your benefits as the result of a CDR, see our article on your chances of being denied benefits after your disability review.
Learn more about continuing disability reviews.