WHAT'S A CONTINUING DISABILITY REVIEW (CDR)?

Almost everyone who receives a disability benefit from Social Security will undergo a review to determine if their benefits should stop or continue. Here is what the Social Security Administration says about Continuing Disability Reviews:

Social Security periodically reviews your medical impairment(s) to determine if you continue to have a disabling condition. If we determine that you are no longer disabled or blind, your benefits will stop.

We call this review a continuing disability review (CDR). The law requires us to perform a medical CDR at least once every three years, however, if you have a medical condition that is not expected to improve, we will still review your case, once every five to seven years. We will reach out to you to obtain updated information about your condition using the SSA-454 (Continuing Disability Review Report) or SSA-455 (Disability Update Report) form. Those who are eligible to receive the SSA-455 now have the option to complete the Disability Update Report (SSA-455) form online.

When you are awarded Social Security Disability benefits, your case is categorized into one of three categories including Medical Improvement Expected (MIE), Medical Improvement Possible (MIP) or Medical Improvement Not Expected (MINE). Which of these categories your particular case falls into depends on when you will be receiving continuing eligibility reviews and how long your Social Security Disability benefits will continue.

If your case is labeled as MIE that means the SSA expects that your condition will improve and you will be given a continuing eligibility review in approximately six to eighteen months.

If your case is labeled as MIP, that means the SSA believes that it is possible that your condition will improve but is not likely. In this case, you will be given a continuing eligibility review in approximately two to five years.

If your case is labeled as MINE that means that the SSA does not think your condition will ever improve. You will still undergo continuing eligibility reviews, but those reviews will be conducted approximately every 5 to 7 years. As long as your condition does not improve, you will continue to receive Social Security Disability benefits until you reach retirement age, at which point your disability benefits will [automatically] convert over to Social Security Retirement benefits.

ADVICE FROM THE FORSYTHE FIRM ON CDRs

Many people don't think about a CDR until they receive notice that their case is under review, then they panic for fear their benefits are going to be discontinued (a real possibility). You should think about a Continuing Disability Review BEFORE it happens. Here is the best way to protect yourself and keep your benefits.

1 KEEP SEEING YOUR DOCTOR(S) AND FOLLOW MEDICAL ADVICE. Persons who rarely or never see their doctor after they begin getting disability benefits are in the most danger during a CDR. Just like you needed medical evidence to GET your disability benefit, you will also need medical evidence to KEEP your disability benefit. See your doctors regularly and be sure they make an adequate record to document your continuing disability.

2 Respond promptly to every notice from Social Security. Failure to respond to a Continuing Disability review will NOT make it go away. In fact, it will get your benefit stopped pretty quickly.

3. Try to get your doctor (the one you see the most) to write a letter detailing that you have had no significant medical improvement, that you are compliant with medical treatment, and state your prognosis. Ask him/her to detail your functional limitations. By the way, it does no good for the doctor to state that you cannot work or that you are disabled. Those decisions cannot be made by doctors because they are reserved to the Commissioner of Social Security. Ask your doctor, instead, to speak of your symptoms and lack of function. A function involves things like how long you can sit/stank/walk, how many pounds you can lift, how often you could bend, crouch, crawl, reach overhead, etc.

4. If you are eventually notified that your benefit is being terminated, APPEAL in writing within 10 days. By filing this immediate appeal, you may request to continue receiving benefits pending the appeal. (You must request that you want to continue benefits during appeal so your benefits will continue while Social Security considers your appeal. (If you eventually lose the appeal, you must repay the benefits that were paid during the appeal period). If you miss then 10 day deadline, you may still appeal within 60 days; however, you may not continue to be paid during the appeal.

5. Consider legal counsel. In this situation, you are responsible for paying attorney's fees out-of-pocket. Your lawyer will put your fee payments in escrow pending the outcome of the appeal. But consider how much money is at stake for you. Let's say your SSDI benefit is $1,500 per month. That's $18,000 per year in benefits. If you are 20 years away from retirement age, your potential loss is around $360,000, not to mention the loss of Medicare and the future cost of medical treatment. It's well worth considering an attorney to help you with the CDR. He/she certainly won't cost you anywhere close to $360,000. [Note: The Forsythe Firm does not handle Continuing Disability Reviews].