The Social Security Administration conducts continuing disability reviews to determine whether Social Security Disability benefit recipients still qualify as disabled. During these reviews, the SSA considers the recipient’s medical condition and work activity to determine ongoing eligibility for benefits. People in Illinois can prepare for upcoming reviews by gathering necessary information and maintaining strong medical records of their disabling conditions.
Medical reporting
The SSA begins a continuing disability review by sending the SSD recipient a report form. The SSA will send the shorter Disability Update Report for conditions not expected to improve. For conditions that might improve, the SSA sends the more comprehensive Continuing Disability Review Report. Both reports ask for the following information:
- Employment and monthly earnings
- A professional evaluation of the recipient’s ability to work
- Signs of medical improvement
- Visits to the doctor during the last year
The SSA always conducts medical reviews if a condition could reasonably improve. SSD recipients who receive a CDRR form can ensure an accurate review by submitting medical records along with the form.
For other conditions, the SSA uses the Disability Update Report to determine whether a medical review is necessary. If an SSD recipient reports monthly income over $1,070, medical improvement or failure to visit a doctor recently, the SSA will likely order a medical review. Thus, recipients who report these changes should consider directly submitting medical evidence to the SSA.
Common missteps
SSD benefit recipients should provide the most accurate information they can during their disability reviews. Anything considered fraud or deception could provide grounds for the loss of benefits later. The SSA often corroborates the information a recipient provides with information from outside sources.
As an example, the SSA may conduct disability reviews due to trigger events. These events include changes in work status or income, medical improvement and third-party reports of failure to follow treatment. Recipients risk benefit loss if their reports do not match the information the SSA already has obtained.
SSD benefit recipients should also make sure their treating physicians still properly understand the disabling condition. If check-ups or treatments are infrequent, a physician may not appreciate a condition’s severity or debilitating effects. Regular visits help the physician remember and accurately evaluate the condition.
Benefit recipients should also be careful when discussing small or temporary functional gains with their treating physicians. Exaggerations or poorly chosen comments could lead a physician to mistakenly believe a condition has improved significantly. This opinion could be decisive in determining whether the individual continues qualifying for benefits.
