Continuing Disability Reviews Reinstated

The SSA Reinstates Continuing Disability Reviews

In June 2024, the SSA suspended Continuing Disability Reviews (CDRs) for the remainder of the 2024 fiscal year. In October, SSA reinstated CDRs. This move may significantly impact those already relying on Social Security Disability benefits along with those in the application and reconsideration processes.

This suspension through the end of fiscal year 2024 was supposed to enable Disability Determination Services (DDS) to focus on addressing the significant backlog of initial disability claims and reconsideration cases. Unfortunately, from our anecdotal evidence, wait times have continued to rise, and the reinstatement of CDRs will likely impact processing times further. For those already working with a Louisiana Social Security disability lawyer, this development may bring important changes to their case management.

What is a Continuing Disability Review?

A Continuing Disability Review (CDR) is a periodic review conducted by the Social Security Administration (SSA) to determine if an individual receiving Social Security Disability benefits still meets the medical criteria for disability. These reviews are part of the SSA’s efforts to ensure that only those who continue to qualify for disability benefits receive them.

During a CDR, the SSA assesses your medical condition to determine if you continue to qualify for disability benefits. It’s essential to maintain thorough medical records and respond promptly to SSA requests to ensure the continuation of your benefits.

The frequency of CDRs depends on the likelihood of medical improvement:

• Medical Improvement Expected (MIE): Review within 6-18 months.
• Medical Improvement Possible (MIP): Review every 3 years.
• Medical Improvement Not Expected (MINE): Review every 5-7 years.

To prepare for a CDR, keep detailed medical records, follow prescribed treatments, and promptly respond to SSA communications. This diligence can help ensure the continuation of your disability benefits.

CDRs can be stressful, but if you continue to have a disabling condition, your benefits should remain intact. It’s essential to keep thorough records of your medical treatment and promptly respond to SSA requests during the review process.

The idea of a CDR is daunting, especially after a long and hard-fought battle to obtain benefits. For those receiving benefits whose conditions are expected to improve, you will automatically receive a Continuing Disability Review Report. This report is crucial for assessing your ongoing eligibility for benefits.

If your status is not “Medical Improvement Not Likely,” you must fill out a Continuing Disability Review Report, which is 10 pages long. The form includes questions about your condition, employment status, doctor visits, and even your daily tasks. Additionally, you’ll need to provide medical evidence from the past 12 months.

Generally, the review will cover the previous year, although the SSA can look back to the point when you were initially granted benefits. Once you send in this report, the SSA will conduct a full medical review of your case. This process typically takes 5 to 6 months or longer.

To initiate the Continuing Disability Review process, the Social Security Administration (SSA) will send you one of two documents. You might receive the Disability Update Report, which is a shorter form, or the Continuing Disability Review Report, which is more comprehensive. The type of document you receive depends on your specific medical condition and circumstances.

If you get the short form, it will include questions about your current health status, employment situation, and recent medical appointments or hospital stays.

Once you send in this report, the SSA will conduct a full medical review of your case. This process typically takes 5 to 6 months or longer.

If you are selected for a full Continuing Disability Review (CDR), it’s important to understand the steps involved and what to expect.

1. Initial Review and Selection: Initially, you will submit a Continuing Disability Review Report. While most individuals won’t be chosen for a full CDR, those who are will need to engage further with the process.
2. Additional Documentation: Being selected means you’ll have to fill out and submit an additional form. This step is crucial as it initiates a comprehensive review of your medical records by the SSA.
3. Timeline for Decision: The review process can be lengthy, taking up to five months for the SSA to reach a decision. Patience and thoroughness in your submissions can aid in a smoother process.

By understanding these steps and responding promptly, you can better navigate the review process and safeguard your benefits. Always ensure to meet deadlines and provide complete information to avoid interruptions in your disability benefits.

If you receive a CDR from the SSA and do not respond to it by the stated deadline, your Social Security disability benefits will be terminated.

Key Points About CDR:

1. Purpose: To verify if the medical condition that qualified you for disability benefits persists and still prevents you from working.
2. Frequency:
   • CDRs are typically conducted every 3 to 7 years, depending on the likelihood of medical improvement:
     • Medical Improvement Expected (MIE): Review within 6-18 months.
     • Medical Improvement Possible (MIP): Review every 3 years.
     • Medical Improvement Not Expected (MINE): Review every 5-7 years.
3. Process:
   • Notification: You will receive a letter informing you that a review is being conducted.
   • Forms: The SSA may ask you to complete forms such as the Disability Update Report (short form) or the Continuing Disability Review Report (long form), detailing your medical condition, treatments, and any work activity.
   • Medical Evidence: The SSA will review your medical records and may request additional exams or tests.
   • Decision: Based on the evidence, the SSA decides whether benefits will continue or stop.
4. Outcome:
   • If the SSA determines you still meet the criteria for disability, your benefits will continue.
   • If they find you no longer meet the criteria (e.g., your condition has improved), your benefits may stop. You have the right to appeal this decision.
5. Work and CDR:
   • If you have returned to work, the SSA evaluates whether your earnings exceed the Substantial Gainful Activity (SGA) threshold.
   • Work under the Ticket to Work program or within a trial work period generally won’t trigger immediate cessation of benefits.

Are there exceptions that could prompt an earlier Continuing Disability Review (CDR)?

Yes, certain circumstances can indeed lead to an earlier CDR. Typically, your case might be reviewed sooner if there is concrete medical proof suggesting an improvement in your condition. Another possibility arises if you decide to return to work, signaling that your disability might no longer limit your capabilities.

In these instances, the Social Security Administration (SSA) holds the authority to initiate a CDR at any time. This flexibility ensures that the SSA can adapt to any changes in your situation promptly and accurately.

What’s Inside the Short Disability Update Report?

When you receive the short Disability Update Report, it includes a series of straightforward questions designed to assess your current situation. Here’s what you can expect:

• Health Status: You’ll report any changes in your medical condition since your last review.
• Employment Information: The form asks if you have been employed, allowing you to provide details on any work activities and earnings.
• Medical Visits: It inquires about any recent visits to your doctors or hospital stays, helping to update your medical history.

This concise form simplifies the review process by focusing on key areas, ensuring that your disability status is accurately maintained.

The Importance of Maintaining Regular Medical Treatment During a CDR

Navigating the Continuing Disability Review (CDR) process can feel overwhelming, but maintaining regular medical treatment plays a crucial role in safeguarding your benefits. Here’s why consistency in medical care is key:

1. Demonstrates Commitment to Your Health:Seeing your healthcare providers on a regular basis shows an ongoing commitment to managing your condition. It underscores that you take your health seriously and follow medical advice diligently.

2. Keeps Medical Records Current:Up-to-date medical records are invaluable during a CDR. They provide comprehensive, accurate evidence of your condition and the continuity of care. Regular visits ensure all changes in your health status are documented, supporting your case effectively.

3. Validates Your Treatment Plan:Adhering to the prescribed treatments and medications is critical. Consistently following your doctor’s recommendations not only aids in managing your condition but also exemplifies compliance with professional guidance.

4. Provides Evidence of Medical Necessity:Regular treatment emphasizes the necessity of ongoing medical care. It helps establish that discontinuing benefits could jeopardize your health, as your condition requires continuous monitoring and intervention.

5. Prepares You for Potential Queries:During a CDR, questions regarding your treatment regimen may arise. Regular appointments equip you with detailed information about your care, placing you in a better position to answer confidently and accurately.

In summary, maintaining regular medical treatment is not just a procedural obligation; it’s a strategic approach that helps ensure a favorable outcome during your CDR. Embrace it as a vital part of preserving your benefits.

What Steps Should You Take to Ensure the Continuing Disability Review Process Goes Smoothly?

Navigating a Continuing Disability Review (CDR) can seem daunting, but taking proactive measures can help ease the process. Here’s a structured approach you can follow:

1. Maintain Consistent Medical Care

• Stay Engaged with Healthcare Providers: Regularly visit your doctors. Keeping open lines of communication helps maintain a comprehensive and updated medical history.
• Adhere to Treatment Plans: It’s crucial to follow your doctor’s prescribed treatments and medications. This demonstrates your commitment to managing your health condition.

2. Keep Comprehensive Documentation

• Organize Essential Documents: Collect and have easy access to all important documentation, such as medical records and any correspondence regarding your disability claim.
• Stay Up-to-Date: Make sure your medical records are current; include recent tests and treatment summaries to provide a thorough snapshot of your health status.

3. Monitor Any Changes in Your Condition

• Report Updates Promptly: If there are any significant changes in your medical condition, report them to the necessary agencies immediately. This ensures transparency and keeps your records accurate.

By following these steps, you can contribute to a smoother Continuing Disability Review process, reducing stress and increasing the likelihood of a favorable outcome.

Past CDR News

In January of 2021, President Joe Biden withdrew a Trump administration rule that required more frequent Continuing Disability Reviews (CDR).

The Social Security Administration places SSDI beneficiaries into three categories based on their condition’s severity and prognosis. They are “Medical Improvement Expected,” “Medical Improvement Possible,” and “Medical Improvement Not Expected.”

The predicted likelihood for improvement then determines the frequency of disability reviews.

These reviews happen every 3 to 7 years depending upon your classification.

The Trump rule would have added a new classification, “Medical Improvement Likely,” and singled out as many as 4.4 million recipients between the ages of 50 and 65 to prove they were still disabled at least every TWO years.

The new classification rule prompted much outcry and had little scientific basis since people’s conditions generally deteriorate as they age.

Senator Ron Wyden, the ranking member of the Senate Finance Committee, labeled the new requirement as “harassment of people with disabilities.”

LJB’s Take

While protecting the system is an admirable goal, doing so at the expense of the disabled and vulnerable was not the way to go.

Numerous congressional hearings and investigations have not uncovered widespread abuse of SSDI, and the process is already chock full of red tape.

In our experience as Social Security disability representatives, these “Continuing Disability Reviews” are often used to stop benefits to some truly disabled people, forcing disabled individuals to fight again for the benefits they need – which are often reapproved after going through the process again causing a waste of government resources. At the same time, the SSA is already severely understaffed and processing claims more slowly than ever.

This proposal was an unreasonable strain on disabled individuals who were already struggling to survive with no real benefit to the government’s bottom line. This change was a great decision.

Our office is happy to help our past clients if and when they face a continuing disability review. It’s one of many benefits of working with our office from the beginning.

Unfortunately, we are unable to assist anyone if we were not involved in their original application or appeal.