Receiving approval for Social Security Disability Insurance (SSDI) is a significant achievement for individuals struggling with disabling conditions. However, it’s essential to understand that this approval is not the end of the process; it marks the beginning of a new chapter that includes ongoing assessments known as “continuing disability reviews” (CDRs). These reviews are crucial for maintaining eligibility and ensuring that beneficiaries still meet the Social Security Administration’s (SSA) stringent disability criteria.
Understanding Continuing Disability Reviews
After being approved for SSDI, the SSA will schedule a continuing disability review. These reviews typically occur every three to seven years, depending on the nature of the individual’s condition. The frequency of reviews is determined based on the expectation of medical improvement. For instance, conditions likely to improve, such as certain injuries or illnesses, may lead to more frequent assessments compared to chronic or degenerative diseases.
Walker Firm, operating under the client-facing brand Casa de la Justicia, helps Spanish-speaking clients with their Social Security Disability Insurance (SSDI) claims. Based in Los Angeles, CA, and founded in 2022, we maintain a remarkable over 70% hearing win rate, surpassing the national average of 55%. With our robust media strategy, we attract over 2,000 clients annually. In addition, we partner with other local attorneys to ensure the thousands of injured Latinos that call us daily have access to experienced Spanish-speaking attorneys for all their needs, including worker’s compensation, auto accidents and slip and fall cases. For expert SSDI support and broader legal services, we are your go-to resource.
The primary goal of a CDR is to confirm that the beneficiary still has a qualifying disability as defined by the Social Security Disability in California. This process involves evaluating medical records, treatment history, and any other relevant information related to the individual’s health status.
The Review Process
- Notification: Beneficiaries will receive a notice from the SSA indicating that their case is due for review. This notice typically outlines the process and what information will be required.
- Gathering Medical Evidence: The beneficiary must submit updated medical records to demonstrate that their disability persists. This includes reports from treating physicians, test results, and any other documentation related to their condition.
- Evaluation: The SSA will evaluate the submitted evidence to determine if the individual continues to meet the eligibility criteria for SSDI. This evaluation may involve a review by medical professionals employed by the SSA, who assess the severity and impact of the medical condition on the individual’s ability to work.
- Decision: After evaluating the evidence, the SSA will issue a decision. If they find that the individual still meets the disability criteria, benefits will continue as before. However, if they determine that the individual’s condition has improved sufficiently for them to engage in substantial gainful activity (SGA), benefits may be terminated.
What If Benefits Are Terminated?
If the SSA decides to terminate benefits, the individual has the right to appeal the decision. The appeal process involves several stages:
- Request for Reconsideration: The first step is to request a review of the decision. This involves submitting new evidence or arguing against the SSA’s findings.
- Hearing: If the reconsideration is denied, the individual can request a hearing before an administrative law judge (ALJ). During the hearing, the beneficiary can present evidence, call witnesses, and provide testimony regarding their disability.
- Further Appeals: If the ALJ denies the claim, further appeals can be made to the Appeals Council and, ultimately, federal court if necessary.
Tips for a Successful Review
To navigate the CDR process effectively, beneficiaries should:
- Stay Updated on Medical Care: Regularly visit healthcare providers and maintain accurate medical records. This documentation is crucial for demonstrating ongoing disability.
- Respond Promptly: Always respond promptly to any requests from the SSA for information or documentation. Delays can result in unfavorable decisions.
- Seek Assistance: Consider working with a disability attorney or advocate who can provide guidance through the review process and help gather necessary evidence.
Being approved for SSDI is a critical step for many individuals facing significant health challenges, but it’s essential to remain vigilant about ongoing reviews. Understanding the process and being prepared can help ensure that necessary benefits continue, providing financial support while dealing with the complexities of disability. As long as beneficiaries maintain their eligibility, they can focus on managing their conditions and improving their quality of life.