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Receiving Disability Benefits? You May Be Chosen for a Continuing Disability Review


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12/16/2015
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Obtaining disability benefits from the Social Security Administration is an important financial lifeline for many people suffering from a disability. The initial approval process itself may be somewhat nerve wracking, so when the benefits are awarded, many people feel relief. Unfortunately, however, the process does not end upon approval. The Social Security Administration conducts a continuing disability review every few years in order to determine whether your condition has improved. For most people, the review will occur every three years. For people who are older than 55 or who have a condition that is unlikely to improve, the review may occur as infrequently as once every seven years. Other reasons that a review may take place include earning too much money, unless you are enrolled in the Social Security Administration’s return to work plan.

How You May Fail a Disability Re-evaluation

If your time has come for a continuing disability review, your case will be sent to the Disability Determination Service in your area. Your case will then be reviewed by a claims examiner. The examiner will look at any new medical records that have been added to your file since your initial approval. In addition, the examiner may order you to undergo an examination by a doctor hired by the Social Security Administration.

You may “fail” the review only under certain circumstances. Generally, the following two situations must apply to your case:

  1. You have had a medical improvement as it relates to your ability to work. This is determined through the use of a test known as the “medical improvement review standard.” If the test shows that your impairments have lessened as they relate to your specific disabling impairment, then you may be deemed to have had a medical improvement. The claims examiner may look at your current medical records in order to make this determination. Similarly, the claims examiner may find that you have had a medical improvement if you have returned to regular employment.
  2. You have the ability to engage in substantial gainful activity. This is typically defined as being able to earn at least $1,090 per month as a result of working. In addition to determining that your disabling condition has improved, the claims examiner must also find that the improvement is related to your work. This means that you have had an increase in your residual functional capacity. In making this determination, the claims examiner will look at your current residual functional capacity and compare it to the residual functional capacity you had when applying for benefits. For example, if your original residual functional capacity held that you were capable of only doing “less than sedentary work,” but you have since undergone medical treatment that has improved your condition such that you can now do some types of sedentary work, the claims examiner will consider the medical improvement as being related to your ability to work. It is important to note that not all improvements may be related to your ability to do work. For example, if your overall pain level decreases, but you still do not have the ability to sit or stand for prolonged periods of time, this improvement is not considered to be related to your ability to do work since your work-related restrictions have not changed.

Once the claims examiner finds that your condition has medically improved and that it relates to your work, therefore giving you an increased residual functional capacity, the claims examiner must then determine whether you can work at a level that equals “substantial gainful activity.” The claims examiner will assess your original impairments and the new restrictions you may have developed since your initial approval for benefits in order to make this determination.

If you have been selected for review relating to your disability benefits, it is important to consult with an attorney for guidance through this process. We encourage you to contact us today for a free consultation at 888-904-6847.



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