The Disability Law Center

 

 

CONTINUING DISABILITY REVIEWS (CDR)

WHAT SSI AND SSDI RECIPIENTS NEED TO KNOW

Social Security law requires the Social Security Administration (SSA) to review the disability eligibility of most recipients regularly. Most cases are reviewed every 3 years, but SSA can decide to review a case sooner or later (as little as every 7 years). How often SSA reviews a case depends on many factors, including the type of disability, and the recipient’s age.

SSA notifies recipients when it plans to begin a CDR.. Recipients are asked to fill out forms about medical or other treatment, activities of daily living and any work activity. SSA will request reports from the recipient’s doctors and other treating sources. SSA may also require the recipient to go to a medical evaluation at SSA’s expense. SSA schedules these evaluations when the treating source does not provide the specific information needed or when there is conflicting information. Failure to attend these appointments may result in termination of benefits.

SSA reviews the evidence and decides whether there has been any medical improvement in the medical problems that were present the last time SSA decided the recipient was "disabled." If there has been no medical improvement, benefits will continue. If there has been medical improvement, then SSA must do a complete, current disability determination considering all the recipient’s medical problems - both the old and the new. If SSA decides that the recipient is still disabled considering all his or her medical problems, benefits will continue. If however, SSA decides that the recipient is no longer disabled, SSA will send a termination notice. (So far only about 20% of CDRs have resulted in termination notices.)

Recipients receiving termination notices have important rights to appeal and request benefits pending appeal. Recipients have 60 days from the date they receive the notice to file an appeal BUT those who appeal within 10 days can request that their benefits continue pending the decision on the appeal. The first appeal is called Reconsideration and it includes a hearing. Many who appeal and attend these hearings win. If a termination is upheld at Reconsideration, the recipient again has 60 days to file the next appeal. Again, if the appeal is filed within 10 days, the recipient can request that benefits continue pending the next appeal decision. This second appeal is a request for a hearing before an Administrative Law Judge (ALJ). Over 50% of those who appeal and attend this hearing win. After the ALJ appeal, there are further appeal rights but no further right to continued benefits pending appeal.

Continued benefits will be considered an overpayment if the recipient ultimately does not win on appeal. However, the recipient can request a waiver of overpayment. If the recipient filed the appeal in good faith, cooperated with the appeal, and cannot afford to repay the overpayment, the request for waiver should be granted by SSA.

For more information, call or email the Disability Law Center.

 (617)723-8455 or (800)872-9992. TTY (617)227-9464 or (800)381-0577


DLC Home Page