What are the chances of being denied SSI after my review?

Continuing to see your doctor, and having your doctor agree you are still disabled, can help.

Question

I was awarded disability benefits on my first try (SSI). However, I received a letter from Social Security that my health is expected to improve and my case would be reviewed, even though I've only been on disability one year. I shouldn't be subject to review until August 2018. My oncologist and my psychiatrist both feel I will not be able to work anymore. What are the chances of Social Security denying me the continuance of my SSI after they complete my review? Even though my cancer is now in remission, I am still extremely depressed and in constant pain; therefore I am on various different medications for both pain and depression. I see my doctors regularly, including my internist, every two months. I am starting to panic that I will be denied.

Answer

Most claimants who are approved for either SSI or Social Security disability are granted continuing benefits when their claim is re-evaluated at a continuing disability review, or CDR. When your case will be reviewed is set when you are initially approved for disability benefits. This date should be in Your Certificate of Award. When a case is set to be reviewed ("diaried") after one year, it can indicate that an approval was somewhat "borderline." In your case, though, it could simply reflect that an expected change in the severity of your impairment warrants an earlier reappraisal. And, in fact, disability cases involving cancer often fit this mold. Also, sometimes an early CDR can be triggered by reports of a disability recipient working over the SGA amount.

You shouldn't worry too much about losing disability benefits, because you do have continuing depression and pain (and you are not working). In addition, you said your psychiatrist and oncologist both feel that you will be unable to return to work. If their records and statements reflect this position, and the reasons why, your benefits will most likely be continued. Also, the fact that you maintain regular contact with your doctors is a plus, because, in addition to developing the relationship you have with your medical providers, it guarantees that when your case is looked at again there will be ample—and recent—medical records on which to base a decision.

If you haven't had any medical improvement in your depression and you are still unable to handle the mental requirements of working, your benefits should be continued. In fact, most recipients whose cases come up for review ARE granted continuing benefits. In 2016, 85% of SSI recipients who went through a CDR passed; only 15% had their benefits terminated. (However, the chance of getting terminated might be higher for someone who had cancer and then went into remission, and who had no other impairments.)

Children and the Chances of Continuation of SSI Benefits

The chances of losing SSI are much higher for children who go through a CDR. Almost 37% of children in 2016 lost their benefits after a CDR. And over half of children who turned 18 or who had been granted benefits for low birth weight as infants lost their benefits.

For information on how Social Security re-evaluates disability cases and the medical improvement requirement, see our article on when Social Security can stop your benefits after a disability review.

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