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.
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 a review to determine if you should continue to receive Social Security disability insurance (SSDI) or Supplemental Security Income (SSI) benefits.
It's difficult to actually prepare in advance for a continuing disability review (CDR). This is simply because the decision as to whether your disability benefits should be continued or stopped will be based entirely on your medical records. (There is another type of review, called an SSI redetermination, where the SSA will look for non-medical reasons to discontinue your benefits, such as having too much income or assets.)
For a CDR, the best thing you can do to make your review go well is to continue to see your doctor regularly and to fill out the Social Security review form properly.
Maintaining Your Relationship With Your Doctor
If you haven't been to the doctor in the last year, the SSA may doubt that your disability is ongoing and could send you to a consultative exam, where a doctor who is paid 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.
To feel more secure about your upcoming disability review, 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 you no longer have trouble walking effectively, this may begin to appear in your medical records. For this reason, stay attuned to the relationship you have with your treating physician and be aware of what you say to your doctor. For example, a patient who has been awarded disability benefits based on degenerative disc disease may not wish to comment that he or she "felt well enough to mow the entire backyard" even though the mowing was followed by several days of unrelenting pain, fatigue, and discomfort. Remember that your comments may be taken out of context, and the part about your pain or fatigue may be left out.
Filling Out the Forms Properly
Fill out the form the SSA sends you (either Form SSA-455 or Form SSA-454), 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. The best thing you can do to make your review go well is to fill out the Social Security form completely and send it back promptly.
How to Fill Out Form SSA-455
If the SSA sends 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 just to catch any changes in your circumstances. If your 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 (using Form SSA-454). Red flags might be:
- entering earnings above $1,130 per month (the SGA amount in 2016)
- 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.
There is no need to send in medical records when you receive the Form SSA-455.
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 may want to submit any updated medical evidence to the SSA even though the SSA may also obtain this on its own. In general, the SSA will be reviewing the period from 12 months prior to the notice to the present, 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, your application, and your RFC assessment. These documents show what you could do when you were approved for benefits or at your last disability review.
If your medical records or answers show that there has been some medical improvement related to your ability to work, you could be denied benefits. But it's 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.
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, or learn more about continuing disability reviews in general.