How to Pass a Continuing Disability Review

The Social Security Administration (SSA) periodically reviews the cases of individuals receiving disability benefits to ensure they continue to qualify for Social Security Disability Insurance (SSDI) benefits. This process, known as a continuing disability review, requires recipients to complete a form detailing changes in their health conditions and working ability. 

What Is a Continuing Disability Review (CDR)?

A continuing disability review (CDR) enables the Social Security Administration to verify that recipients of disability benefits continue to be disabled and thus eligible for continued benefits. The CDR checks whether a benefits recipient’s condition has improved enough that they can return to the workforce to perform substantial gainful activity.

The frequency with which the SSA conducts CDR depends on a person’s medical condition and the likelihood that the condition will improve. The SSA may review conditions that are likely to improve every three years, whereas conditions not expected to improve may undergo CDR every five to seven years. Conversely, people with conditions expected to improve may have to undergo CDR every six to 18 months. 

Understanding the Disability Review Process

CDR takes place through one of two forms. The short-form SSA-455, or Disability Update Report, conducts a CDR when an individual’s condition is unlikely to improve. Alternatively, people expected to improve must complete the long-form SSA-454. The SSA-455 asks an individual to provide updates regarding their health, treatment, and work activity. The SSA-454 will ask for more detailed information about health, treatment, medical improvement, and activities. 

Before completing the continuing disability review report form, an individual should gather their medical records, which may contain the necessary information to complete the form. A person should gather notes and reports from doctor visits, treatment records, test results, medication records, and other medical evidence. If an individual attempts to return to work, they will need medical records to document why their return attempt was unsuccessful. 

During the CDR, the Social Security Administration will also review the income, financial resources, and living arrangements of benefits recipients to ensure they continue to meet the other requirements for their benefits program.

How to Fill Out the Disability Update Report (SSA-455)

The short-form SSA-455 asks seven basic questions about an individual’s health and working activities. These questions include:

• Whether they’ve worked for another party or engaged in self-employment within the past two years
• Whether their condition has gotten better, worse, or stayed the same
• Whether their physician has cleared them to return to work
• Whether they’ve attended school or work training programs
• Whether they’d consider rehabilitation or other services designed to get them back to work
• Whether they’ve undergone surgery or hospitalization in the past two years
• Whether they’ve visited a physician or clinic for their condition in the past two years

Special Considerations for Mental Illness Reviews

Individuals receiving Social Security disability benefits for a mental condition also need medical documentation to establish their current condition and document the treatment they have undergone. Medical records can show how the individual’s mental condition has not responded to treatment and explain how the condition continues to render them unable to work. 

Tips to Prepare for a Full Medical Review (SSA-454)

When the Social Security Administration sends you a long-form SSA-454, you will have to undergo a full medical review as part of your CDR. When filling out the SSA-454, tips you should keep in mind include:

• Provide honest, accurate information. Do not downplay your symptoms or leave out details that seem minor or unimportant.
• Explain your limitations in detail, using real-world examples as appropriate, and note any improvements you have made and if or how those improvements have affected your limitations or overall condition.
• Refrain from exaggerating symptoms or limitations, as the medical record may contradict your assertions.
• Ask for clarification on any questions you do not completely understand.
• Answer every question. If you don’t have an answer, you can respond “none” or “does not apply.” If you don’t know the answer, you can respond “don’t know.”

Records and information you will need to complete the SSA-454 include:

• Contact information of relatives or friends who know about your condition
• Names and contact information of healthcare professionals you have seen within the past 12 months
• Any prescriptions or non-prescription medications you’ve taken in the past 12 months
• Names of organizations that have medical information about your condition in the past 12 months, including social service agencies, case workers, workers’ compensation or health insurance companies, or attorneys
• Any education or training you’ve received since your last disability decision
• Any vocational rehabilitation or employment you’ve undertaken since your last disability decision

What Happens After You Submit the CDR?

After you submit your CDR form, the Social Security Administration may continue your benefits unchanged, alter your benefits (such as if you begin working part-time), or terminate your benefits if the CDR reveals you no longer qualify. 

What to Do if SSA Stops Your Benefits

When the SSA stops your benefits after a CDR, you can appeal that determination through the SSA’s administrative appeals process, including requesting reconsideration of the termination or a hearing before an administrative law judge. If the ALJ upholds the termination, you can appeal to the SSA’s Appeals Council and, from there, to the federal courts. 

You should contact a Social Security disability attorney immediately once you receive notice of the termination of your benefits after a CDR. 

FAQs About Continuing Disability Reviews

Questions that people have about continuing disability reviews include:

How long does a continuing disability review take?

An SSA-455 short-form CDR should take about one to three months to complete, whereas an SSA-454 long-form CDR can take six months to a year.

Can you lose disability benefits after a review?

The Social Security Administration may terminate your disability benefits after a CDR if you indicate that you earn income above the substantial gainful activity threshold, if you’ve obtained education or training for a specific job, or if your medical records and information indicate that your condition has improved enough for you to return to the workforce.

How often are mental illness cases reviewed?

Disability benefits for mental conditions undergo the same timeline of review as other conditions.

What is SSA-455 used for?

The Social Security Administration uses SSA-455 for individuals whose conditions are unlikely to improve. 

What if my doctor retired or changed?

You should see your doctor regularly as directed for your condition, so if you change doctors or your old doctor retires, the Social Security Administration can obtain your medical records from your current provider.

Get Help with Your Continuing Disability Review in Oklahoma City

When you receive notice of a continuing disability review, an experienced Social Security disability benefits attorney can guide you through the disability review process. Contact Ryan Bisher Ryan and Simons for a free, no-obligation consultation to learn more about what to expect during a CDR and what to do if your benefits are unfairly denied.