A Continuing Disability Review (CDR) is a routine review done by the Social Security Administration (SSA). CDRs are done to make sure that people receiving Social Security (SSD) and Supplemental Security Income (SSI) disability benefits are still disabled and entitled to those benefits. Social Security looks at whether you have medically improved since you were found disabled. If SSA thinks you have improved, they check whether you still meet Social Security’s disability standard.
There are other reasons, in addition to medical improvement, in which people can lose benefits or have them reduced that we will not cover here. Examples include benefit overpayments or not meeting the resource and income requirements for SSI benefits. This article explains how CDRs are evaluated, what you should do if you receive one, and how to appeal if your benefits are stopped. You should not panic if you receive a CDR notice, but you should not ignore it either.
How often you receive a CDR depends on how likely SSA thinks it is that your medical condition will improve. If medical improvement is expected, SSA will review the claim in six to 18 months; if medical improvement is possible, SSA will review the claim every three years; if medical improvement is not expected, SSA will review the claim every five to seven years. Also, some events can trigger a CDR. Examples include the completion of a vocational rehabilitation program, an SSI child’s 18th birthday, when a baby turns one year old, and sometimes work-related income within the first 24 months of entitlement to SSD benefits.
If you are selected for a CDR, you will receive written notice from SSA along with forms to fill out and return. Social Security’s website has more information on CDRs. See What You Need To Know: Reviewing Your Disability.
If you receive the two-page short form CDR (SSA-455-OCR-SM), your condition probably has a low chance of medical improvement. A computer will read the form, but if it detects something unusual, a person will review it. Tips:
See Social Security Administration Disability Update Report Information and Completion Instructions (SSA-455) for an example of a completed short form CDR.
If you receive the 10-page long form CDR (SSA-454-BK), an SSA employee will read it, not a computer. This form is similar to the initial application for disability benefits and requests more detail. Tips:
See Continuing Disability Review Report (SSA-454-BK) for an example of a completed long form CDR.
There are several things you can do to document your claim and increase your chances. One is to make certain that all of your updated medical records are filed with Social Security. This can require some expense and effort, as doctors and hospitals usually charge fees for copies of medical records. You can ask them to waive the fees, but they are not required to do so. Social Security can help you gather your records for free if you provide medical releases and correctly identify all the places you have been treated. However, sometimes Social Security still does not successfully obtain all of your records.
Finding all of your medical records can be tricky. Sometimes, doctors or hospitals may not submit all the records. If your records contain information on HIV/AIDS or alcohol or drug use, you may have to specifically request or authorize release of that information. Sometimes you have to be persistent to get them to provide records. Social Security may lose records that were already sent. To catch such errors, ask to view your Social Security file and make sure everything was received. If not, ask for additional time and follow up. Failure to submit all medical records is a common reason for denying legitimate claims.
Consider getting a medical opinion report from the physician(s) most familiar with your medical condition. Any such report should address your medical conditions and how they affect what you can do. See a physician’s guide to Documenting Disability. The report should also address issues particular to the CDR process, such as whether you have medically improved since you were last found disabled.
Next, make sure that you report all of your medical problems and symptoms to Social Security and your doctors. How severe are they? How often do you get them? How long do they last? What do they keep you from doing, physically and mentally?
In some cases, your doctor may clear you to do some kind of work. If you believe you can work after consultation with your doctors, seek help from the state vocational rehabilitation agency. See Vocational Rehabilitation Services for Jobseekers with Disabilities (from The New Jersey Department of Labor and Workforce Development). The agency should help determine your vocational strengths and weaknesses, identify any barriers to employment, and work with you to overcome them and find work that you could realistically do.
SSA handles CDRs differently depending on whether they involve adult disability claims, redeterminations of benefits for children turning 18 years old, or child disability claims.
See DI 28005.010 CDR Evaluation Process - Title II and Adult Title XVI Beneficiary - Summary Chart A from the Social Security website, for a useful graph showing this process.
Drug or alcohol abuse, or unexcused failure to follow prescribed medical treatment, can sometimes result in denials, especially when they contribute significantly to the person’s disability.
Social Security’s disability standard is different for children than for adults. For that reason, all children receiving SSI benefits have their eligibility redetermined when they turn 18 using the SSA’s regular adult disability definitions and rules. See more information on adult SSI claims here.
There are some situations where people aged 18-21 can keep benefits even if they are no longer medically disabled. People using the Ticket to Work program, some vocational rehabilitation programs, and who are participating in an individualized educational program (IEP) can sometimes keep benefits. For more information, see SR 11-2p Titles II and XVI: Documenting and Evaluating Disability in Young Adults from the Social Security website.
Children receiving disability benefits also get CDRs from time to time, before they turn 18. Social Security follows a multi-step process.
Drug or alcohol abuse, or unexcused failures to follow prescribed medical treatments, can sometimes result in denials, especially when they contribute significantly to the person’s disability.
If SSA determines that you are no longer disabled, your benefits will continue for only two more months at most unless you appeal and in a timely manner and ask for benefits to continue during your appeal. To appeal, submit a Request for Reconsideration form (SSA-789-U4) within 60 days of receiving your notice of denial.
Important note: If you want to have your benefits continued during the time your case is being decided, you need to submit the Request for Reconsideration within 10 days of receiving your denial and specifically ask for your benefits to continue during the appeal.
You can request a face-to-face meeting with a disability hearing officer. You can file the document at your local Social Security office, which should be listed on any denial letter. As with any correspondence to Social Security, it is wise to save a copy as proof that you filed it on time. See Request for Reconsideration form (SSA-789-U4) for an example of a completed form.
If you elect to keep receiving benefits and are not successful with your appeal, Social Security will assess an overpayment claim seeking those benefits back. You should receive a written notice of overpayment if that happens. You have the right to challenge the overpayment and/or request a waiver of it at that point. See Overpayments (from the Social Security Administration) for more information.
If you are late filing an appeal (or filing for the 10-day deadline to keep receiving benefits during your appeal), you can submit a statement establishing good cause to allow a late filing. “Good cause” might include not being able to retrieve the necessary information in time or having a limitation that prevented a timely filing. A list of reasons considered to be “good cause” is at Code of Federal Regulations§ 416.1411 Good cause for missing the deadline to request review from the Social Security website.
If the reconsideration request is denied, you can request a hearing with an Administrative Law Judge by filing form HA-501 with supporting documents at your local SSA office. See a completed sample HA-501 form. See How to Request a Social Security Disability Appeal Hearing (from DisabilitySecrets.com) for an explanation of how to request a hearing with the ALJ. You can elect to have benefits continue during your appeal to the Administrative Law Judge, but you must make another request for continuing benefits within 10 days of receiving your request for reconsideration denial.
If the judge denies your claim, you can request a review with the Appeals Council by filing form HA-520. See How to fill out SSA Form HA-520 (from Social Security Disability Help) for further instruction. At this stage, SSA will not continue your benefits. If that is denied, you can file a complaint in Federal District Court.
During each level of appeal, submit any additional evidence that might support your claim. Examples would include medical records, doctor reports, and supportive witness statements. This website helps explain how to request copies of those medical records and how doctors can document your disability (see Documenting Disability).
The appeals process may take a long time, but it is worthwhile to not give up and consider pursuing the appeal if you have a legitimate case. A much higher percentage of people win at the ALJ hearing than at the reconsideration level.
According to the frequency of review schedule, I should have had a CDR already, but I have not received any notice yet. What should I do?
Will they do a CDR when I am in my Trial Work Period?
If I am in a vocational rehabilitation program, can my benefits continue?
What if the medical condition for which I was getting benefits improved, but I have a new medical problem?
What if I develop a new impairment after SSA has ceased my benefits?
What if I can’t provide documentation or attend a meeting with SSA due to my disability?
When should I get a lawyer?
Where else can I turn for help if I can’t find a lawyer and still have questions?
Additional information and resources
According to the frequency of review schedule, I should have had a CDR already, but I have not received any notice yet. What should I do?
Don’t worry. SSA has a large backlog of cases it needs to review, so it is normal that your CDR might be delayed.
Will they do a CDR when I am in my Trial Work Period?
If you have received SSD benefits for at least 24 months or you are using the Ticket to Work Program, your work activity should not automatically trigger a CDR. However, you may still get regularly scheduled medical reviews.
If I am in a vocational rehabilitation program, can my benefits continue?
Yes. Under Section 301, your benefits can continue until you have completed the vocational rehabilitation program, if you meet program requirements. However, you must begin the program before the date of medical cessation, and SSA will determine on a case-by-case basis if your program increases the likelihood that you will not return to disability benefits.
What if the medical condition for which I was getting benefits improved, but I have a new medical problem?
When SSA evaluates your current condition, it will consider the new medical problem if it meets a listing or otherwise limits your functional abilities.
What if I develop a new impairment after SSA has ceased my benefits?
If you still have an appeal pending, submit medical evidence of your new impairment. If you no longer have a claim pending, consider filing a new disability benefit claim that includes the new impairment.
What if I can’t provide documentation or attend a meeting with SSA due to my disability?
Under the Rehabilitation Act, you can request assistance and accommodations from SSA. The law requires Social Security to provide reasonable assistance and accommodations to people with disabilities.
When should I get a lawyer?
If you have difficulty understanding the process, gathering the evidence, or otherwise advocating for yourself, consider getting an attorney. Some lawyers don’t take CDR and benefit cessation cases because fees are limited, particularly at the early stages of appeal. Most lawyers charge a percentage of the past benefits received, and any fee must be approved by Social Security before it is charged.
Where else can I turn for help if I can’t find a lawyer and still have questions?
Call LSNJLAWSM, Legal Services of New Jersey’s statewide, toll-free legal hotline, at 1-888-LSNJ-LAW (1-888-576-5529) or complete an online questionnaire.
For additional information and resources, visit:
This information last reviewed: May 17, 2017