How Can I Prepare for a Social Security Disability Review?

If you're receiving Social Security disability insurance (SSDI) or Supplemental Security Income (SSI) benefits, your case will likely be reviewed every few years to see if you're still medically qualified for disability. Whether and how often this might happen depends on a couple of factors:

• the severity of your disability, and
• the likelihood that your medical condition will improve.

The Social Security Administration (SSA) will notify you when it's time for a review to determine if you should continue to receive disability benefits.

Can You Prepare for a Continuing Disability Review?

It's difficult to actually prepare in advance for one of these continuing disability reviews (CDRs). This is simply because the decision of whether to continue or stop your disability benefits will be based entirely on your medical records.

(There is another type of review called an SSI redetermination. In this type of redetermination, Social Security will look for non-medical reasons to discontinue your benefits, like 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. Here's what you need to know about the review process and some tips to help you give yourself your best chance at passing the CDR.

Maintain Your Relationship With Your Doctor

If you haven't been to the doctor in the last year, Social Security might doubt that your disability is ongoing. To find out more about your medical condition, the SSA could send you to a consultative exam (CE).

This mandatory exam might not be helpful to your case because the doctor or psychologist performing the CE:

• works for Social Security (who pays the bill for the exam) and not for you
• has no knowledge of your long-term medical history, and
• might spend as little as 10 minutes examining you.

It's much better to have your own doctor's records document your ongoing symptoms and limitations. But keep in mind that the relationship you have with your treating physician can have an impact on whether or not your disability benefits are continued.

If you don't keep your doctor informed about your difficulties, your doctor at some point might conclude that you no longer have trouble walking effectively and note it in your medical records. To ensure your doctor understands your continuing limitations, be aware of what you say to your doctor.

For instance, if your disability is based on degenerative disc disease, you probably shouldn't tell your doctor that you felt well enough to mow the entire backyard—even if the mowing was followed by several days of unrelenting pain, fatigue, and discomfort. Remember that your comments could be taken out of context, and the part about your pain or fatigue might be left out.

Fill Out the Continuing Disability Review Form Properly

You'll need to fill out the continuing disability review form Social Security sends you (either Form SSA-455 or Form SSA-454) and send it in. If the agency needs more information, it will request medical records from your doctor.

In some cases, even if you've been seeing a doctor regularly, Social Security might 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 CDR Form SSA-455

If Social Security sends you the short form, SSA-455 or SSA-455-OCR-SM (Disability Update Report), the agency doesn't expect that you've had any medical improvement. You can complete the paper questionnaire or opt to complete Form SSA-455 online.

The form's purpose is just to catch any changes in your circumstances. If your answers to the questions on the form raise any red flags, the agency will then do a full medical review (using Form SSA-454).

What are red flags on form SSA-455? Any of the following:

• entering earnings above $1,470 per month (the SGA amount in 2023)
• 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's no need to send in medical records when you receive Form SSA-455.

How to Fill Out CDR Form SSA-454

If Social Security sent you the long form, SSA-454-BK (Continuing Disability Review Report), you'll face a full medical review because the agency expects that your condition might have improved. This longer CDR form can't be completed online.

Social Security uses Form SSA-454 to discover if you've done any of the following in the last 12 months:

• visited a doctor
• been hospitalized, or
• had any medical tests.

If you have, Social Security will request medical records from the doctors and institutions you include on the form. You might want to submit any updated medical evidence to Social Security even though the SSA might also obtain this on its own.

In general, Social Security will review the 12-month period immediately before the CDR notice. But the agency can look at evidence from any time after you were initially granted benefits or since your last continuing disability review.

In addition to the information on Form SSA-455 (the Disability Update Report), the Continuing Disability Review Report (Form SSA-454) also asks:

• if you're currently taking the medicine you were prescribed (Social Security wants to know if you‘re complying with the treatment prescribed by your doctor)
• whether you're working, and
• how well you can perform various daily activities, like:
  
  • driving
  • walking
  • shopping
  • dressing yourself
  • bathing yourself, or
  • getting along with people.

Social Security 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 first approved for benefits or at your last disability review.

If your medical records or answers on Form SSA-454 show that you've had some medical improvement related to your ability to work, you could be denied benefits. But it's difficult for Social Security to stop your benefits if your medical records don't show some medical improvement.

Tips to Pass a CDR

There's no trick or scheme that will ensure that you pass a continuing disability review. But here's a summary of our tips that can help give you your best chance of passing the CDR.

Continue to see your doctor. Having an ongoing relationship with your doctor ensures your treating physician understands your current condition and limitations. It also ensures you have current medical evidence that backs up your continued disability.

Follow your treatment plan. By sticking to your treatment plan, you're demonstrating to Social Security that you're doing what you can to improve your condition—even if your impairment isn't expected to improve.

Fill out the CDR form carefully. Answer every question completely and honestly. Missing or inconsistent information on the CDR form (SSA-455 or SSA-454) can raise red flags. Your credibility matters—especially if your disability is based on pain or mental illness, which are hard to measure with objective testing (like X-rays or lab tests).

What Happens After You File the CDR Form?

After you submit your continuing disability review form, you wait for Social Security to review it (and any related medical records) and make a determination. How long it takes to hear back about your CDR depends on two things:

• whether you received the short Disability Update Report, SSA-455, or the longer Continuing Disability Review Report, SSA-454, and
• how easy it is for Social Security to get your medical records.

Learn more about how long a CDR takes. And for more information on when Social Security can deny your benefits as the result of a CDR, see our article on your chances of being denied benefits after your disability review.

_{Updated January 10, 2023}