Continuing Disability Review to Determine Continuing Eligibility for Benefits

People are often confused about Social Security Disability law and the rights it provides. With a number of formalities, forms, appeals, reviews and red tape, applying for disability benefits can prove to be really tedious and complicated. Disability benefits are paid on the basis of an illness, injury or disability that prevents a person from doing gainful work. Therefore any decision is made on the basis of a detailed review of the applicant's medical records. Applicants for SSD or SSI benefits can avoid the confusion and effort associated with the entire disability benefits application process by obtaining the services of a social security disability attorney. They will be provided with clear explanations regarding the various aspects of the benefits available. The attorney will after a detailed consideration determine the best approach to have the claim approved for his/her client. Medical record review for attorneys is an important service in this regard that helps speed up the process of application.

CDR (Continuing Disability Review) Conducted at Scheduled Intervals

Once a claimant is granted disability benefits, the SSA (Social Security Administration) conducts a CDR (continuing disability review) of his/her medical condition at scheduled intervals. This will help determine whether the claimant is medically improved and still eligible for benefits. If the SSA finds that the beneficiary's medical condition has significantly improved, they may stop paying benefits. However, most beneficiaries' benefits continue.

>>A CDR is performed every three or seven years.

>>The frequency of the reviews would depend on the severity of the disability and the possibility that improvement will occur.

>>The three categories on the basis of which reviews are scheduled are:

• Medical improvement expected - The beneficiary is expected to recover and the review will occur in not less than 6 months or more than 18 months.
• Medical improvement possible - The beneficiary's condition is expected to improve but the impairment is not considered permanent. The review will be conducted every three years.
• Medical improvement not expected - The disability is considered permanent and reviews will be conducted every five to seven years.

A social security disability attorney would help clients prepare for a review and advise them to do the following:

>>Maintain all copies of the documents received and sent to the SSA

>>Maintain documentation of all medical tests and treatments

>>Ensure constant communication with the claimant's doctor regarding the claimant's medical condition

>>Inform the SSA of any change in address

When a medical review is being scheduled, the SSA will send a notice to the beneficiary informing him/her of the same, following which the beneficiary's medical and employment evidence has to be submitted. A report, the SSA-454-BK, Continuing Disability Review Report will have to be completed in most cases. Information to be filled in include medical conditions, treatment received, medications taken, education and training, daily activities and vocational rehabilitation and employment. Beneficiaries whose disability is permanent will be sent a Continuing Disability Report Short Form, a shorter version of the SSA-454-BK. This has to be completed and returned, which will then be sent to the Disability Determination Bureau (DDB) for review.

In case the benefits are terminated, the claimant can appeal the medical review termination decision and request for continuation of the benefits during the appeal process. The appeal has to be made 60 days from the date the termination notice is received. The request to continue the benefits must be made within ten days. At the Reconsideration Stage, the applicant is allowed an in-person hearing. A DDB Hearing Officer makes the final reconsideration decision. The process of appeal could go on to a Hearing by an ALJ or Administrative Law Judge, review by the Appeals Council and Federal Court review.

How Disability Attorneys Can Help

At each level of appeal, the disability attorney would ensure that any additional evidence that may support the claim is submitted. This would include medical records, doctor reports, and supportive witness statements among others. A medical record review company assisting attorneys would ensure that all relevant medical evidence is extracted from the healthcare records and presented in an easy-to-understand, summarized form. Applicants will find the service of an attorney invaluable during the appeals process that may take a long time to complete. The entire appeals process is long winded but it is worthwhile to pursue it if the case is legitimate, and a number of people win at the ALJ hearing than at the reconsideration level.

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