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Continuing Disability Reviews – What You Need to Know

continuing disability reviewWhen you are approved for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), that approval is not necessarily permanent. SSA is putting increasing efforts into conducting Continuing Disability Reviews (CDRs) to determine whether you still meet the medical criteria for disability. Members of Congress – both Democrat and Republican – are encouraging SSA to conduct more reviews because the Social Security trust fund is running out of money and they see CDRs as a tool to keep the disability trust fund solvent, and to avoid making difficult political decisions about actually fixing the problem.

In this post, I will explain what a CDR is, how the process works, the strategic decisions you must make if you receive a notice of intent to terminate benefits, and how ongoing medical treatment is your strongest line of defense.

 

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Are Claimants Required to Submit Unhelpful Medical Records?

There is no such thing as the “perfect” case.  Even the most deserving claimants may end up with a doctor who they don’t like or with whom they do not get along.  This is especially true in “pain” cases when narcotic medicines may be prescribed.  There are also doctors out there who do not believe in the concept of disability – as far as they are concerned no one is fully disabled and these doctors will not cooperate with a Social Security claimant at all (needless to say, it is helpful if you discover this trait in your treating doctors early enough in your case to find another doctor!).

What about unhelpful medical records?  I see this frequently in cases where there was a workers’ compensation case.  “Company doctors” often minimize symptoms and generate records indicating that a claimant has the capacity to return to work.   Other times I see unhelpful records in cases where my client just did not “click” with his or her physician or psychiatrist.

One of my blog readers wrote me to ask about his obligation to submit unhelpful records in the context of a continuing disability review:

I have been on SSI for 8 years for mental illness. One recently former psychologist would say I was never disabled while my psychiatrist, and my new psychiatrist (the present one is moving) say I am disabled. Continue reading →

Should Approved Claimant Report New Medical Problems to Social Security During Continuing Disability Review?

I don’t get a lot of questions about “continuing disability reviews” (CDR).  Here is one that raises an important issue.  For those not familiar with the term, a CDR is the process by which Social Security evaluates approved claimants to confirm that they still meet the requirements for disability under Social Security’s rules.

Sometimes, judges will specifically provide for a review in 12 months.  The official Social Security disability web sites provides that all cases are to be reviewed every 36 months (although it has been my observation that the 36 month reviews have been performed at random).  Although I have not seen any regulations to this effect, I suspect that the cases which are reviewed may be ones where improvement might be most likely.   For example, if your approval is based on a condition that could be corrected by (invasive) surgery, your case might be flagged for review.

You should also understand that disability attorneys like me rarely get involved in CDR cases.  Why?  Continue reading →

Working After a Favorable Disability Determination – Potential Problems

Jonathan, I have a question I hope you can help me with. I am a 57-year old computer programmer. In March of 1999 I suffered a stroke, and in July 2002 I filed for SSDI benefits. I was initially rejected but was approved following a hearing. My question is; I have been working full-time since mid_oct of last year, except for a two-month break. When I call the SSA, they either tell me that, if I continue working I will be subject to a CDR, or they tell me the exact opposite, that I can continue to work for three more years and still retain my disability status. I would very much appreciate it if you could tell me which is which, since I have to make a decision in the next two weeks whether or not to continue working. Thank you.

–Morris

Jonathan Ginsberg responds:  Morris, I think you are confusing two different issues.  A CDR (continuing disability review) is a review of your medical condition to determine whether you continue to meet the legal definition of “disability.”  In other words, does your medical condition still meet a “listing,” does your functional capacity prevent you from functioning as a reliable employee, or do you continue to meet the medical-vocational guidelines (the grids).   Often times the presence of an earnings record in a disabled person will trigger a CDR.  Again, the CDR is a medical review.

The 36 month issue falls into a different category.  After you start receiving benefits, you are eligible for a “trial work period” for up to 9 months during any 60 month period.  During that trial month period, you continue to receive your regular benefit even while you work.  Once you have used up your 9 months of trial work, you go into an “extended trial work period” of 36 months (which is apparently where you are now).  During that time, you would receive benefits for any month where your work is not “substantial” ($860 earnings per month).   The extended work period looks at your earnings and has nothing to do (presumably) with your medical condition.

Take a look at SSA publication 05-10095 for more information about the extended trial work period.

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