The Social Security Administration (SSA) is required by law to periodically review the case of every person who is receiving Social Security Disability (SSD) or Supplemental Security Income (SSI) disability benefits. This process is called a “continuing disability review” (CDR) and is intended to identify beneficiaries who may no longer qualify as disabled. If, during a CDR, the SSA finds that your medical condition has improved enough so that you can work, your Social Security benefits will end.
In general, it is much easier to pass a continuing disability review than it is to be granted benefits in the first place.
Frequency of Continuing Disability Reviews
The frequency at which CDRs are completed vary.
CDRs for Adults
Most claims are set for review every three or seven years, depending on the likelihood that your condition will improve. If a claimant has a condition that is expected to medically improve, even a CDR may be conducted even sooner than 3 years. On the other end of the range, Social Security beneficiaries whose condition is not expected to improve or are disabled due to a permanent condition (such as a lost limb or impaired intellectual functioning) may have their claim reviewed even less than every seven years. However, even those with permanent disability conditions are subject to CDRs. In addition, CDRs are also more frequently conducted for beneficiaries who are under the age of 50. For more information on the frequency of medical reviews for adults, see our article on how often disability reviews happen.
CDRs for Children
Children who are receiving SSI disability benefits will automatically have their claims reviewed when they turn 18. The standards that must be met for an adult to be considered disabled are different than those for a child, so at age 18, the child will be evaluated under the adult standards.
Newborns who receive SSI due to a low-birth weight will have their claim reviewed prior to the one-year mark.
In addition to the regularly scheduled CDRs, the SSA may conduct a continuing disability review in any of the following situations:
- You return to work.
- You inform the SSA that your condition has improved.
- Your medical evidence indicates that your condition has improved.
- A third-party informs the SSA that you are not following your treatment protocol, or
- A new treatment for your disabling condition has recently been introduced.
Continuing Disability Review Process
If your Social Security claim is up for review, the SSA will notify you by mail. The SSA will send you either a copy of the short form, Disability Update Report (SSA-455-OCR-SM) or the long form, Continuing Disability Review Report (SSA-454-BK) announcing a CDR. The short form is generally for those whose condition is not expected to improve, and is only two pages.
If your condition could improve, or if your answers on the short form send a red flag to the SSA, the agency will send you the long form, which is similar to the initial disability application and is ten pages long. On it the SSA asks whether you have seen a doctor or been hospitalized in the past year, whether you have had any recent tests in the past year, such as EKGs, blood tests, or x-rays, and whether you have been working, among other things.
You are encouraged to submit any updated medical evidence to the SSA, although the SSA may also obtain this on their own. 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.
Medical Improvement Review Standard
Assuming you haven’t returned to work, the SSA will first determine if there has been medical improvement in your condition. If the answer is no, the continuing disability review process is complete, and your benefits will not be affected. If the answer is yes, the SSA will then decide if the medical improvement affects your ability (or inability) to work. If it does not, you will continue to receive benefits. But if the SSA comes to the conclusion that your condition has improved to the point where you can return to work, you will be notified that your benefit payments will stop and will be given the chance to appeal the decision. How the SSA makes this decision is governed by guidelines that can be confusing; for more information on your chances that the SSA will find you have medically improved, see our article on the medical improvement review standard.
If the SSA feels that the evidence is insufficient to make a decision, or if there are inconsistencies between what you report and your medical evidence, you could be sent for a “consultative examination,” which is an examination by a doctor that is paid for by the SSA.
If the SSA finds that you are now able to work, see our article on continuing benefits while you appeal for information on when your disability benefit checks will stop.