Will my Social Security Disability claim be reviewed again after I am approved for benefits?

Learn how often the Social Security Administration may review your Social Security disability claim after you are approved for SSDI benefits.

When Your Claim May Be Reviewed for Continuing Disability

The Social Security Administration may review your Social Security Disability claim after you have received benefits for a while. The purpose of the review is to determine whether you are still disabled and eligible for benefits.

At the time your claim is approved, the claims examiner will project the likelihood of your recovering from your disability. If you are expected to have medical improvement, then your claim will normally be reviewed within six to eighteen months after your benefits start. If improvement is considered possible, but not necessarily expected, then your claim will usually be reviewed after three years. Finally, if you are not expected to have significant improvement then your claim would not be routinely reviewed any sooner than seven years from when benefits started. Your disability could also be reviewed outside of a scheduled review if there was an indication that you had recovered from your disability.

Notification of Continuing Disability Review (CDR)

Usually your award letter will state when your claim will be reviewed medically. When the time comes for a CDR, the Social Security Administration will notify you and will send you a questionnaire to complete about your current medical condition and any work or school since the last review. Accordingly, it is important to keep Social Security notified of your mailing address even if you are receiving benefits by direct deposit to a bank account or DirectExpress card. (Of course, if you receive Supplemental Security Income [SSI] all changes of residence must be reported by the tenth of the month following the month of the move). 

How can I prepare for a continuing disability review of my Social Security medical disability claim?

Learn about the medical and work information to submit when your approved Social Security medical disability claim comes up for review.

The Importance of Medical Information for Your Continuing Disability Review

When you are notified that your Social Security or Supplemental Security Income (SSI) disability claim will be reviewed to determine whether you are still disabled under Social Security law, you will be asked to complete a continuing disability statement and to sign an authorization for release of information.

Because your continuing eligibility for benefits is being revisited, a continuing disability review should be treated with the same seriousness and care as the filing of a new claim. To complete the continuing disability forms, you may need to gather the same kinds of information that you submitted for your original application. For example, you will need to submit a statement of why you can’t work or why you can’t work more than you are currently working. You will also need to provide a list of your medications and health care providers, the dates you saw the providers, the conditions for which you were seen, and the treatment they gave. It’s also a good idea to schedule an appointment with your doctor to let him or her know that your claim is being reviewed and that the Social Security Administration may request information.

Social Security considers all your limitations, so in addition to your main diagnoses and symptoms, list again any old conditions that limit you even if they are not the primary basis for your claim and even if you already told Social Security about them—that old football injury that keeps you from walking too far or the fall from the ladder ten years before your Social Security disability date that limits how long you can sit. Also list any new conditions you may have if you have new limitations associated with them.

The Importance of Clear Vocational Information

If you have worked since your benefits began, you will also be asked for the dates you worked, the names and addresses of your employers, your job title, a description of your duties, and the physical and mental requirements of the job. Be sure to describe any difficulties you have or had with the work you are doing or did and any special assistance you receive or received on the job. If you are receiving special assistance or accommodations, it could be helpful to submit a letter from your employer that confirms the accommodations. Use form SSA-3033 Employee Work Activity Questionnaire for an employer statement.

If your health limits your ability to gather all the information for this important review of your Social Security disability claim, it may be a good idea to enlist the help of a capable friend or relative or a disability lawyer to prepare your statement.

Continuing Disability Reviews

When your Social Security or Supplemental Security Income (SSI) claim is approved for disability payments, the approval decision will include a determination of when Social Security believes your health is likely to improve to the point that you will no longer be disabled. If that is the case, your approval letter may tell you that your claim will undergo a medical review at a certain point in time, typically in one year, three years, or seven years from the date your claim was approved, although the time frame could be less.

What About a Social Security Disability Review After Age 60?

When facing a Social Security disability review after the age of 60, it’s crucial to present a strong case to ensure continued benefits. Gather up-to-date, comprehensive medical records that highlight the ongoing nature of your disability and its impact on your ability to work. Obtain detailed reports from healthcare providers to support your claim.

Highlight any new medical conditions or worsening symptoms since your initial application. Emphasize how your disability affects your daily activities and work capabilities, especially considering the challenges often associated with aging.

Differences Between Disability Reviews Before and After Age 60

A disability review after age 60 differs from a review conducted before this milestone. Once you reach age 60, the Social Security Administration applies different standards to assess your eligibility. The focus shifts from your ability to perform any job to your ability to perform substantial gainful activities (SGAs). This change in criteria acknowledges that it becomes more difficult for individuals to find suitable employment as they approach retirement age. Highlighting these differences in your argument can significantly strengthen your case for continued benefits.

Navigating a Social Security disability review after age 60 requires careful preparation and understanding of the specific criteria. By following these guidelines, you can effectively advocate for your deserved benefits.

How to Appeal If Your Disability Payments Are Cut Off

If Social Security determines that you are no longer disabled and terminates your benefits, you have the right to appeal.The basic appeal form for benefit cessation due to a continuing disability review is different from the appeal form used for other appeals. You will need to file your appeal either online or by submitting a paper appeal. Either way, the form to use is SSA-789 Request for Reconsideration – Disability Cessation. 

The appeal must be received by the Social Security Administration within sixty-five days of the date on the notice of termination. If Social Security does not receive your appeal within the sixty-five days, it is likely that you will lose your right to appeal. If you appeal within ten days of the termination notice, you can request that your benefits continue while the appeal is being processed and decided.

For your appeal, you will need to explain specifically why Social Security’s decision to terminate your benefits is incorrect. At this point, it would be desirable to have a disability lawyer who is experienced in Social Security Disability help you formulate an argument for continuation of your benefits. However, if you request payment continuation, it will be difficult to get attorney assistance because you will have no back pay from which the attorney can be paid. Of course, if you have the resources to pay a retainer fee, securing representation could be possible. You might also try to obtain representation from a non-profit that provides assistance to disabled individuals.

Special Appeal Rules for Disability Terminations

Unlike appealing a new claim denial, when your benefits are to be terminated due to a determination that you are not medically disabled, you can request an informal hearing with a hearings officer rather than relying on just a file review for your appeal. If your appeal is denied, you can still move to the next level of appeal, which is a hearing before a Social Security administrative law judge (ALJ).

Additional Appeals

If your reconsideration (with or without a hearing with a hearings officer) is denied, you can appeal a second time with a request for a hearing before an administrative law judge (ALJ). If your ALJ hearing is denied and you believe procedural errors or mishandling of facts occurred, you can request review by the Social Security Appeals Council. If the Appeals Council denies your claim for continued benefits, you can file suit in Federal court. 

I can’t live on the Social Security Disability benefit I am getting. Is there a way I can get more money from Social Security?

See how the Social Security Disability benefits you are getting can increase and how Supplemental Security Income may be a source of income for you.

Your Primary Insurance Amount

Your Primary Insurance Amount, which is called PIA for short, determines the amount of the Social Security disability benefit you are getting. Your initial PIA is based on your earnings before you became disabled. There are only two ways that your PIA can increase.

Cost-of-living Adjustments

The most widely known type of increase is a cost-of-living adjustment, commonly called a COLA. COLA’s apply to the benefits of all Social Security beneficiaries and Supplemental Security Income (SSI) recipients. Social Security COLA increases take effect the December of the year in which there has been an increase in the Consumer Price Index for Urban Wage Earners and Clerical Workers. For example, in 2014 the Index rose 1.7%, so the December 2014 Social Security benefits, paid in January 2015, went up 1.7%. There was no increase in the Consumer Price Index in 2015, therefore, there was no COLA increase in benefits for 2016, but a COLA of 1.6% is being paid in 2020, based on a 1.6% increase in the Index for the year ending with the third quarter of 2018. Supplemental Security Income (SSI) COLA increases take effect in the January following the year with the Consumer Price Index increase.

Recalculation for Later Work Earnings

The second way that your PIA can rise is through a recalculation of your benefits to give you credit for your previously un-credited earnings. This recalculation is called an AERO recalculation. Here’s how an AERO works. When your benefits start, Social Security uses the earnings information they have available for you through the previous year. Later the money you earned during the year your disability began and your prior year’s earnings, if they were not available previously, are reviewed to see if the amounts you earned will increase your benefit. When your PIA goes up, your family maximum benefit (FMB) may also increase providing an increase for any eligible dependents you may have.

AERO recalculations are done automatically twice a year, once in March and once in October. If you are eligible for an increase because of any prior year’s earnings, you will be notified by mail. Your increase will be retroactive to the January after the income was earned. Sometimes the retroactive benefits are paid in a separate payment and sometimes they are included with your regular monthly check. Either way, you may receive the money before the explanatory letter arrives.

Other than those two types of increases, your Social Security PIA will remain the same. Your benefit amount, however, could increase if it has been less than your PIA due to workers compensation offset and the offset ends. At that time, the benefit would increase to the full PIA

Supplemental Security Income

The Social Security Administration administers a second disability program called Supplemental Security Income (SSI). If your Social Security disability benefit is less than the maximum income allowed to get SSI and your total income and resources are within SSI limitations, you may qualify for SSI disability payments to supplement your Social Security benefit. 

Will my SSD benefit amount increase if my disability gets worse?

Learn when a worsening medical condition could allow you to have more income or health insurance while on Social Security Disability.

Worsening of Health for Social Security Disability Beneficiaries

A downturn in your heath with increasing level of disability will not result in an increase in benefits. Your Social Security Disability payment amount is not based on your degree of disability. Instead it is based on your Social Security-covered earnings before your disability began. 

Exception Related to Vision

Although Social Security Disability benefits do not increase when you develop new medical conditions or a worsening of your disabling condition, there is a potential for additional earned income if you are receiving disability due to low vision and your condition progresses to legal or full blindness. Individuals who are blind or legally blind can earn more money from work while continuing to receive Social Security Disability, so their overall income is higher. 

Individuals who are approved for Social Security Disability for a non-kidney illness and later develop kidney failure that requires regular dialysis or transplant can become eligible for Medicare coverage before the 24-month Medicare waiting period is met.