Pennsylvania Social Security Disability Beneficiaries Face Continuing Disability Re-Evaluations
What is a Social Security Continuing Disability Re-Evaluation?
After the Social Security Administration (SSA) approves a beneficiary for disability benefits, they conduct periodic continuing disability reviews (CDR). The purpose of these reviews is to determine if a beneficiary’s medical condition has improved such that benefits can be stopped. Usually, CDR reviews occur every three years. If you are 55 or over, or if you have a chronic condition unlikely to improve, your review will take place every seven years until you reach retirement age.
The Disability Determination Service conducts medical CDRs. Here, your case will go through a process much like the one you experienced when you first applied for disability benefits. Medical records and any updated medical documentation since your first approval will be reviewed. Additionally, you may be required to undergo an examination with an SSA doctor.
The Standard for Stopping Benefits through a CDR
Disability benefits may be stopped only if there is: (1) a showing of a medical improvement relating to your ability to work; and (2) an ability to engage in substantial gainful activity (SGA). A medical improvement is demonstrated when an individual’s condition has improved based on recent medical records, or a return to employment. The reviewing claims examiner must determine both that your condition improved and that this improvement relates to your work.
In order to make this connection between a medical improvement and a capacity to work, the claims examiner looks for an increase in the beneficiary’s residual functional capacity. This means that they compare your present residual functional capacity to a former capacity. In other words, perhaps an individual’s medical situation improved such that they are now able to perform work in a different manner. For example, if you were approved for disability based on constant back pain preventing you from standing for more than an hour at time, but since your approval you have undergone back surgery and are able to stand for three hours, you are likely able to perform some types of active work. It is likely the SSA would deem this medical improvement “related to your ability to work.”
Finally, before stopping benefits, the SSA must determine that a beneficiary can work at the SGA level. Even if there is a medical improvement relating to an ability to work, the SSA will look at the original impairments and any potentially new restrictions since the initial disability approval.
If you have committed fraud, cannot be located, or fail to cooperate with the disability review, the SSA can stop your benefits after a CDR even if they have not shown you can engage in SGA.
At Needle Law, our attorneys are skilled in the process of securing Social Security disability benefits. We understand that going through a CDR is stressful, but the majority of beneficiaries do not lose their benefits. And if benefits are stopped, the decision can be appealed. Our experienced attorneys are available to provide information and guide you through this process. Contact our office for a free consultation by calling (570) 344-1266.