Should I be fearful about a continuing disability review?

On Behalf of | Jan 9, 2024 | Social Security Disability

People in San Diego and across Southern California who have been approved for Social Security Disability benefits will feel a sense of relief. Injuries, illnesses and conditions that prevent people from working are financially, personally and emotionally draining. Knowing the SSD benefits are there can take a load off a person’s mind and let them focus on recovery and improvement.

However, just because a person was approved for benefits does not mean the will be paid indefinitely. The Social Security Administration is attentive to the possibility that people will improve and no longer need benefits. To check on a person’s progress, the SSA will periodically ask the person to go through a disability review.

Know the facts about a disability review

Just as a person’s condition will be scrutinized when they first apply for disability benefits, the disability review will again look at the facts, ask that the person take part in medical examinations, that they provide evidence regarding their progress and a decision will be made. Often, the benefits will continue unabated. In other cases, they will stop.

The reviews and when they take place hinge on the expectation of improvement. Those who have a condition that is expected to improve will have a review within six to 18 months from the date in which they were disabled. This is for people with broken bones, internal injuries or an illness from which it is reasonable to believe they will get better.

Those who have a condition in which improvement is possible but not guaranteed, the review will generally be conducted every three years. Someone with a persistent back issue could fall into this category. It also applies to those who have mental impairments where they could benefit from treatment, but might not.

Those for whom there is no reasonable expectation of improvement – a quadriplegic for example – will be reviewed every seven years and it is generally a formality. Those in this condition should not worry that they will lose their benefits.

The review is like the initial determination except the person’s progress will be assessed with medical reports, information and their activities. Just as ambiguity will warrant a special examination when first applying, the review could also require a special examination.

If it is determined that the treatment, vocational training and medical care has helped the person sufficiently so they can get back to work, the benefits will stop. They will also stop if there was mistake leading to the application being approved, the person is not adhering to the treatment protocol, there was misleading information provided, or the person is working and their average earnings surpass substantial gainful activity level. The person can go through the appeals process of reconsideration, a hearing, going before the Appeals Council or a lawsuit in federal court if the benefits stop.

Be prepared for a disability review

It is natural to be fearful about this process, but knowing the facts can assuage their worry. If there are issues or the benefits stop, it is important to understand the available options. It is useful to understand the Social Security Disability process and how the SSA assesses cases even if the person is receiving benefits and is still having issues. Cases and disability reviews are unpredictable, so it is wise to be aware of the process and know what can be done in every circumstance to continue getting SSD benefits.