Being notified of an upcoming disability review might make you worry and fill you with questions. That’s not necessarily bad since being prepared for your disability review will increase your chances of passing it. But you may wonder, “When should I worry about a disability review?”
In general, continuing disability reviews have a less rigorous standard for evaluating recipients than when they are evaluating the initial application. Unless the medical condition that made it difficult for you to work has improved, there really isn’t much to worry about.
Keep reading below for more information.
What Happens When Your Disability is Reviewed?
When your application for SSDI is being evaluated, the judge usually sets a schedule of reviews that are intended to assess whether you still qualify for the disability. These usually happen at 3- or 7-year intervals, depending on how likely your condition is to improve and other factors such as age.
During the review, you will be asked to provide information on topics pertaining to your medical condition, employment, and living conditions. These are usually provided through two forms, Form SSA-455, and Form SSA-454.
The result of this information would either be that your disability payments continue or you are sent to an internist for a detailed medical evaluation in the event your medical condition is unclear. The results of this detailed medical evaluation will give more insight to a judge and allow him/her to conclude whether or not your disability benefits should continue.
When Should I Worry About a Disability Review?
Although continuing disability reviews (CDRs) are fairly easy to pass, there are circumstances where you should worry about them. These circumstances are discussed below.
Your Medical Condition Has Improved
If the medical or mental condition that was limiting your ability to work has improved, the SSA might find that you are no longer disabled. However, this only applies if this improvement is in relation to your ability to work or retain employment.
This is concluded after assessing your Residual Functional Capacity or RFC (more on that later). If your RFC has increased from what it was at the time of your initial application, then it’s likely that you will no longer be considered disabled.
Your Work Falls Under Substantial Gainful Activity
SGA refers to a level of work and income. If your monthly income exceeds a certain amount, you will be considered to be engaging in SGA. The tricky part is that you don’t have to earn money to be considered engaging in SGA.
Even volunteer work can fall under SGA, if the SSA deems it above a certain activity level.
Your Income is Too Much
If your monthly income exceeds the upper limit cap as defined by the SSA, your disability benefits will be discontinued. As of 2023, this income limit is $735 for single people and $1,103 for married couples.
You Return to Work
If the work history of the applicant shows any past relevant work in the last 15 years and the review finds that he or she is able to return to that work now, then the disability benefits will be terminated.
In such a case, it’s possible that the judge dismisses other practical considerations, such as whether a job of that kind is even available anymore.
You Are Able to Do Sedentary Work
Sedentary work is defined as work that is primarily done while seated, but can involve two hours of standing or walking. There are many jobs in the national economy that are considered sedentary.
If the SSA finds that you are able to do sedentary work, they will terminate your disability. However, there are ways to prove that you can’t do sedentary work if you can demonstrate any related restrictions.
What is Residual Functional Capacity (RFC)?
If you apply for Social Security Disability and state that you have a significant impairment, then Social Security will create an RFC for you.
Exertional Level
Depending on your physical impairment, your physical RFC may list the “exertional” degree of work you are capable of performing—sedentary, light, medium, or heavy. Your level of exertion depends on how far you can walk or stand as well as how much weight you can lift, carry, push, or drag.
Due to a number of factors, your physical RFC level significantly affects whether you are approved for disability benefits. Secondly, Social Security has a set of guidelines that specify when applicants with specific RFC levels should be automatically deemed disabled.
These guidelines are meant to streamline the disability assessment process.
For instance, if you’re over 49 and only capable of performing sedentary work (a desk job or other sit-down job), you’ll immediately be eligible for disability benefits unless your previous employment was sedentary or you have the necessary job skills or recent job training to enable you to perform sedentary work.
Non-Exertional Level
Non-exertional restrictions are those that do not require physical strength, such as the inability to use your fingers to manipulate objects or a poor sense of hearing.
Social Security will consider your non-exertional limits as part of a function-by-function assessment of your previous and prospective jobs to evaluate if your limitations will prevent you from performing any of the essential functions of the positions.
The inability to accomplish any of the following is an example of a non-exertional constraint
- Be subjected to harsh temperatures, sunshine, fumes, or dust
- Bend, squat, crawl, or climb
- Use your hands to reach for objects
- Type, see, hear, or speak
Mental RFCs
Social Security is mandated to investigate the severity of any mental disease or emotional disorder you list on your disability application. The agency must develop a mental RFC (or MRFC) for you if it determines that it is severe. An RFC reveals your capacity to:
- Comprehend, remember, and follow directions
- Maintain focus and attention for lengthy periods of time
- Carry out duties according to a timeline and continue with regular activities without additional supervision
- Make straightforward judgments and decisions
- Communicate with the public appropriately and react appropriately to supervisory criticism
- Get along with colleagues or peers without causing them to be distracted
- Uphold etiquette-compliant standards of cleanliness and neatness.
- Respond appropriately to changes in the workplace
- Accept reasonable stress levels
- Have a regular attendance schedule and be punctual
There are no specific grid requirements for mental RFCs, in contrast to physical RFCs. But, similar to a physical RFC, Social Security will assess your ability to perform the duties of your previous employment by comparing the tasks in your mental RFC to those necessary in that job.
If not, Social Security will assess whether there are any less mentally demanding employment you are able to undertake by comparing your RFC’s mental restrictions to those of other U.S. occupations. You will be deemed disabled if you are unable to perform any simple, unskilled jobs.
Social Security must take into account both your physical and mental limits before determining if there is a job you can learn to do.
Conclusion
95% of continuing disability reviews result in continuing benefits. Having said that, it’s important to do your research and prepare ahead of time for your continuing disability review. Your chances of passing a CDR increase based on your preparation.
