Is it me, or is the Social Security Administration (SSA) doing more reevaluations than ever before? Would you please explain what a continuing disability review from the SSA is all about?
(Column: Ask the Attorney)
Social Security Reevaluations: Some important things you need to know!
William Gottlieb, Esq.
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Social Security and SSI disability benefit recipients have felt less secure than ever this year, as the Social Security Administration (SSA) launched its drive to reevaluate the cases of 1.5 million current beneficiaries by 1999. Called "continuing disability reviews," or "CDRs", the reevaluations may lead to benefit cut-offs if disabled persons whose cases are reviewed are found to be medically improved and currently able to work.

The first indication that your case is being considered for a CDR may be an apparently harmless "disability update report" sent to you from SSA, containing several questions about your health and activity. The answers you make to the update questions are reviewed by SSA, and a decision is made about whether there are enough indications of medical improvement to justify full case development and review. A decision not to develop and review stops the CDR process cold and allows your benefits to continue.

SSA can stop your benefits only if it shows that, compared with the time you were found disabled, your medical problems have improved in a way that would allow you to work. Disability update questions are designed to elicit information that would show a change in your medical condition and functional capacity. You will be asked if you have worked or gone to a rehab program; what your doctor says about your ability to work; whether you think your health has improved, stayed the same, or gotten worse; and whether you've seen a doctor or been hospitalized recently, and if so, for what conditions.

SSA evaluation of update answers is shaped by the agency's basic rule of thumb: if you're not seeing a doctor and not taking medicine, you're not disabled. Failure to remain in treatment is the strongest indicator to SSA that a disabled person has gotten better. If you have remained in treatment and are taking appropriate medications, make sure to say so on the update report, noting the disorders you're in treatment for. Note first any medical conditions now that you also had when your original disability application was approved. Those are the conditions SSA will look at to decide about medical improvement. All conditions, however, including new ones, should be listed and will be considered in deciding if you are currently able to work.

Should SSA decide to review your case, it will gather information about your condition as it was when the agency found you disabled and as it is now. Information is sought from treating and consulting medical sources. If medical improvement and current ability to work is found, you will get a notice from SSA that you are no longer considered disabled and that benefits will stop.

It is vitally important for a recipient who gets a benefit cut-off notice to appeal the cut-off decision immediately. An appeal, called a request for reconsideration at this level, is filed by filling out a brief form available at local SSA offices. If an appeal is filed within 10 days of the cut-off notice, the recipient may continue to receive benefits until the reconsideration is complete. Similarly, should the recipient lose on reconsideration, an appeal must be made by filing an SSA form requesting a hearing with an administrative law judge (ALJ). If the appeal is filed within 10 days of reconsideration denial, the recipients benefits continue until a decision at the AJL hearing level is made--a process that may take over a year. At both levels, the right to appeal lasts 60 days, but after the first 10 days, without the right to continuing benefits.

Appeal of a cut-off decision is the only way a recipient may challenge SSA's decision to stop benefits. At the administrative judge level, at least, the beneficiary is likely to meet a decision maker who is aware of the law, familiar with medical facts, and willing to listen to reasons that Social Security's cut-off is wrong. Many cut-off decisions are reversed on appeal.
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