Although rare, a continuing disability review (CDR) sometimes results in a cessation (termination) of Social Security disability benefits. If this happens to you, you have the right to appeal the decision and request that a hearing be held to reconsider your claim.
Continuing Disability Review Appeals Process
How do you appeal a termination of benefits following a CDR? The first step in appealing a cessation of benefits is to request a review by the state disability determination agency's hearing office. (This state agency is usually called Disability Determination Services (DDS) or something similar.)
A staff member at the DDS hearing office will review your file. It is possible at this point that the staff member will reverse the cessation of benefits. If not, you will have a hearing with a DDS hearing officer (called a disability hearing officer, or DHO). A DHO is specially trained to review the medical-legal issues posed by a CDR.
If the DHO upholds the cessation, you can request a hearing in front of an administrative law judge (ALJ). If you receive an unfavorable decision from the ALJ (meaning the cessation of benefit is not reversed), you can appeal to the Appeals Council and then to federal district court, just as you would appeal an initial claim. For more information, see our section on appealing a disability denial.
The Social Security Administration's (SSA's) purpose in requiring that CDR appeals be heard by a DHO before getting sent to an ALJ is an effort to reduce the caseload managed by the ALJs at the Office of Disability Adjudication and Review (ODAR), to streamline the CDR appeals process.
What Forms Do I Need to Appeal My CDR Denial?
You need to file two forms to appeal a CDR denial: the Request for Reconsideration (and possibly a written request to continue benefits) and the Disability Report.
Form SSA-789-U4, Request for Reconsideration—Disability Cessation Right to Appear
The first step in appealing a cessation of benefits is to file a form SSA-789-U4.This is a simple one-page form that asks for your basic information (name, address, and Social Security number) and allows you to state why you disagree with the CDR decision to stop your benefits. You must file this form within 60 days of receiving your denial.
However, if you want your disability benefits to continue during the decision period, you must file the form within ten days of the denial (but if you lose your appeal you will probably have to repay these benefits). To request that your disability benefits be continued, you must submit a written signed statement to the SSA when you submit the Request for Reconsideration. For more information, see our article on continuing disability benefits during a CDR appeal.
The Request for Reconsideration form provides a space for submitting additional medical information. Here, you need to provide the SSA with the names of your treating physicians and, if you have additional and new medical evidence to support your claim, you need to explain it.
You must also check the appropriate box that states whether you wish to be present (with or without an attorney) at your disability hearing. You can waive your right to appear personally at the hearing, but you shouldn't; it's important that you be there. If you do choose not to appear in person, you will need to complete form SSA-773-U4 so that the SSA is satisfied that you understand the rights you are giving up by not appearing.
If you need help completing this form, a representative at your local SSA field office can assist you. You can go to the SSA's website to find the location of your Social Security field office. Here's a sample of a completed Request for Reconsideration After Disability Cessation.
Form SSA-3441-BK, Disability Report—Appeal
Form SSA-3441 is used to update medical and contact information with the SSA while your request for reconsideration of your CDR cessation is pending. Even if you have completed this form before, you will need to fill it out again; however, you only need to include any changes that have occurred since the last report. If you aren’t sure what has changed since the last time you filled out the form, be as detailed as possible when you complete it, because it is better to provide too much information than too little. If for some reason this is the first time you have done a Form SSA-3441-BK, complete it in its entirety. You can use this form to provide new information about the following:
- changes in personal information (name, address)
- new information about your condition
- additional information about your medical records
- changes in your medications
- results from new medical tests
- whether you are working or tried to work
- how your impairment impacts your activities of daily living, and
- new information about any educational, vocational, employment or any similar services or training you have received.
There is also additional space at the end of the form where you can provide further information that you think is helpful. Be sure to attach any relevant medical records and provide the SSA with the proper contact information for doctors, hospitals, or other medical facilities where you received treatment since your CDR.
Preparing for Your Hearing
When your DHO hearing is first scheduled, you will be sent a letter letting you know the time and location of the hearing. The letter will also ask you to notify the disability hearing officer (DHO) about whether you will bring any witnesses to testify about your impairment and whether a lawyer will be present.
Once your hearing is scheduled, you should go to your local DDS field office and look at your file to make sure that it is accurate and that nothing is missing. Specifically, you should review the following:
- your reported work record
- your medical records
- your residual functional capacity (RFC) forms, and
- the SSA’s technical rationale forms (this explains why the SSA decided to stop your benefits).
What to Expect at Your DHO Hearing
Your hearing with the DHO will be informal; the hearing is not held in a courtroom but usually in a private conference room-like setting
At the beginning of the hearing, the DHO will usually explain how the hearing will be conducted so that you know what to expect. The DHO will likely discuss your work history, medical impairments, and treatments, and will ask you why you think your disability benefits should continue.
At this point, you should ask the DHO what significant medical improvement the SSA believes you have undergone that enables you to now work, and what kind of work it thinks you can do. (To terminate someone's disability benefits following a CDR, the SSA must prove that medical improvement occurred that allowed you to go back to work. See our article on the medical improvement standard.) You can try to prove how your medical evidence shows that your condition has not improved and that you can't do the kind of work that SSA thinks you can do.
You should also point out any errors in the DDS documents and any evidence that wasn’t properly considered. You can also direct the DHO’s attention to any supporting statements made by your physicians.
Can I Get My Benefits Reinstated Without a DDS Hearing?
There are some occasions where it may be possible to have the cessation decision reversed without the necessity of a DDS hearing -- in other words, before your CDR appeal gets to a DHO. These options require you to show that the DDS did not review the cessation denial properly, which in turn requires a visit to your DDS office.
A Doctor Never Looked at My File
The DDS staff member who reviewed your CDR denial may have done so without considering the opinion of a medical professional (a medical consultant who works for DDS). To determine whether your appeal was denied without the assistance of a medical consult, you should review your disability case file at the DDS. (You can go to your local DDS office and request to review your file. If you discover that a doctor was not involved in the pre-DHO hearing review, insist that a DDS medical consultant review your file in conjunction with a DDS staff member. Occasionally, a cessation decision is reversed by the DDS staff member once a doctor has properly reviewed the evidence.
DDS Didn’t Consider My New Medical Records
If you provided the SSA/DDS with new medical evidence to support your claim for disability following the cessation of your benefits, make sure it was taken into account. Some review teams (the DDS staff member and a medical consultant) will disregard new medical evidence and merely rubber stamp the CDR decision. You can go to your local DDS office and request to review your file. If it appears that the new evidence wasn't considered, write a letter to the DDS director or make a phone call and ask that your file be reopened so that the new evidence can be considered.
After Your DHO Hearing
Within a few weeks after your hearing, a written opinion will be sent to you that states the DHO’s decision and the basis for the decision. If the DHO does not reinstate your disability benefits, you can appeal the denial to an administrative law judge (ALJ).
How Do I Get a CDR Hearing In Front of an ALJ?
If your appeal was denied by the DHO, you have 60 days to appeal the decision to an ALJ. But, if you still want your benefits to continue, you need to file your request for a hearing within ten days.
To request a hearing in front of an ALJ, you must first file the following forms:
- HA-501-U5, Request for Hearing by Administrative Law Judge
- SA-344I-BK, Disability Report—Appeal, and
- SSA-827, Authorization for Source to Release Information to the SSA.
Form HA-501-U5. This form is straightforward and similar to SSA-789-U4 discussed above. You will need to provide your basic personal information (name, address, Social Security number), a statement about why you believe the CDR decision was wrong, information about any new evidence (including copies medical records), and whether you intend on appearing in person at the hearing.
Form SA-3441-BK. This is the same form that is discussed above, the Disability Report. When you complete the form this time, just update any new information that was not discussed in your most recent Disability Report.
Form SSA-827. This is simply a medical release form that allows the SSA to request and receive your personal medical information.
Once you have completed and returned the forms to the SSA, an ALJ hearing will be scheduled. However, wait times for hearing dates can be long, depending on your ODAR region’s caseload. To learn more about the disability hearing process, see our articles on administrative law judge disability hearings.
Do I Need An Attorney?
The law does not require you to hire an attorney to represent you through the CDR process but because the procedure can be complicated, and a lot is at stake, it's a good idea to consult an attorney who specializes in Social Security disability law. Attorneys' fees are paid directly to the attorney from the SSA out of any back benefits you are paid. For this reason, however, it may be difficult to find an attorney to represent you if you continue receiving benefits during the appeal, because there would be no funds available with which to pay the attorney. In these cases, an attorney can petition the SSA for a reasonable fee. You can use our disability attorney locator to find a local lawyer to help you appeal a CDR denial.