Getting approved for disability benefits is one thing. But keeping it is another matter altogether.
As you may well know, not all Social Security disability benefits are permanent. If the SSA deems that your disabling condition can improve in the future, you will be scheduled for a continuing disability review (CDR). A medical CDR is performed at least once every three years. If your condition is not expected to improve, the review will be performed once every five to seven years.
During a continuing disability review, the SSA will look at two factors:
- your medical improvement
- your capacity to engage in a substantial gainful activity (SGA)
Due to the fluctuating nature of psychological disorders, some mental impairments are considered permanent. As such, they are usually labeled as Medical Improvement Not Expected (MINE). Beneficiaries with permanent psychological disorders are generally subjected to CDR once every five to seven years.
But if the SSA determines your mental disability is treatable, you will be scheduled to a CDR more often. They will stop your benefits once they decide your condition no longer prevents you from engaging in SGA.
Though the CDR passing rate is relatively high, it still pays to be prepared. Here’s how you can pass a continuing disability review for mental disorders.
HOW SSA CONDUCTS DISABILITY REVIEWS FOR MENTAL DISORDERS
You need to know that physical and mental disorders are treated the same during a continuing disability review. There are no separate evaluating criteria for mental disorders. As long as your condition prevents you from earning the same income before your disability, you can keep your benefits.
Once your schedule for CDR is up, the SSA will send you a notice. It will include a form you need to complete and mail back. Depending on your disability, it can be either the long or short form. The Disability Update Report (short form) is for those with conditions that are not expected to improve. In comparison, the long form (Continuing Disability Review Report) is for those with conditions labeled Medical Improvement Expected (MDE).
Failure to submit the completed form can cause you to lose your benefits. After you submit the form, the SSA will evaluate your answers to determine your eligibility for disability benefits. If they need more information, they will schedule a further evaluation. They will review your medical condition and whether you are working at this stage.
However, not everyone receiving SSI and SSDI benefits will be subjected to work and medical review. Beneficiaries with permanent disabilities (those who received the short form) are usually spared from further evaluation. You’ll also be exempted from a medical review if:
- you have received disability benefits for at least 24 months
- you are participating in the agency’s Ticket to Work Program
PASSING THE MEDICAL REVIEW
Because there are mostly no physical manifestations, it is difficult to determine the level of medical improvement in mental impairment cases. Here’s what you can do to pass the medical review:
1. KEEP COMPLETE MEDICAL RECORDS
Since they do not have any physical basis, the SSA will rely primarily on your medical records. So be sure to keep all your medical reports, psychological test results, and records of all your therapist visits. This will help the SSA evaluate your case more thoroughly.
2. SPEAK OPENLY ABOUT YOUR SYMPTOMS
Mental disorders remain a taboo topic in our society. People suffering from mental illnesses are often stigmatized. As a result, it can be difficult for you to discuss what you’re going through openly.
However, speaking more openly about your symptoms can help you pass your CDR. Remember that the SSA relies heavily on therapists’ and mental health professionals’ medical reports and observations. Your therapists, in turn, rely primarily on what you tell them. If you aren’t honest about your condition, they won’t be able to diagnose it accurately.
3. FOLLOW PRESCRIBED TREATMENT PROTOCOLS
Part of the SSA evaluation is determining if you are consciously trying to improve your condition. If you are not following prescribed treatment protocols, it means you don’t want to get better and go back to work. The SSA can use this as a basis for stopping your benefits.
PASSING THE WORK REVIEW
Aside from medical improvements, the SSA will check if you are working. And if you do, they will evaluate how much you are earning. Your benefits will cease if your monthly income exceeds their prescribed SGA amount or you have returned to work and did not inform the SSA.
To avoid such, notify the SSA of any changes in your employment status. You can also participate in approved vocational rehabilitation programs like the Ticket to Work Program. These programs allow disability beneficiaries to “test the waters” for them to decide if they are now fit to work. If you enroll in such programs, your benefits will continue even if you earn a full-time income.
SSA BLUE BOOK
The SSA Blue Book is a guide used by the Social Security Administration to evaluate disability claims. It outlines individuals’ medical criteria to qualify for SSDI or SSI benefits.
The Blue Book has two parts: for adults and infants and children. Each piece covers different body systems and includes specific conditions and impairments. Meeting a listing in the Blue Book isn’t the only way to qualify; the SSA also considers a person’s ability to work. Healthcare professionals and supporting medical evidence are crucial when making a disability claim.
MENTAL DISABILITY LIST
For the childhood listing, examples of conditions evaluated include developmental coordination disorder, separation anxiety disorder, and autism spectrum disorder, among others. These conditions are listed under section 112.00-Mental Disorders-Childhood, in the Blue Book.
For the adult listing, the Blue Book provides a range of listings covering different body systems. Some examples of these listings include mood disorders, anxiety disorders, neurocognitive disorders, and psychotic disorders.
It’s important to note that meeting a specific listing in the Blue Book is not the only way to qualify for disability benefits. The SSA also considers an individual’s ability to work and perform substantial gainful activity (SGA) when evaluating disability claims. If an individual’s condition does not meet or equal a listing, the SSA will assess their residual functional capacity (RFC) to determine if they can engage in any work.
FREQUENTLY ASKED QUESTIONS (FAQS)
DOES THE CDR FOLLOW A SEQUENTIAL EVALUATION ANALYSIS SIMILAR TO THE INITIAL APPLICATION FOR SSI AND SSDI BENEFITS?
Yes, the Continuing Disability Review (CDR) process follows a sequential evaluation analysis similar to the initial SSI and SSDI benefits application. The CDR process involves multiple steps to determine if a beneficiary’s disability continues or if a medical improvement would allow them to return to work. This includes evaluating substantial gainful activity (SGA), reviewing medical evidence, assessing medical progress, and considering exceptions to continuing disability. The sequential evaluation process used in CDRs ensures consistency and fairness in determining ongoing eligibility for disability benefits.
CAN YOU CONTINUE TO RECEIVE BENEFITS DURING AN APPEAL?
Yes, you can continue to receive benefits during an appeal. If you are appealing a determination that your disability has ended, you can ask in writing for your benefits to continue. According to the Code of Federal Regulations, if you are working, your benefits will not be stopped because of your work. At the same time, your appeal for the medical cessation of your disability is ongoing. It’s essential to request the continuation of benefits immediately, usually within ten days of receiving the denial, to ensure that your benefits are not interrupted during the appeal process.
IS MENTAL ILLNESS A DISABILITY?
Yes, according to the Social Security Administration (SSA), mental illnesses can be considered disabilities. The SSA recognizes a range of mental disorders as disabling conditions that may qualify individuals for disability benefits. However, it is essential to note that having a mental illness does not automatically qualify someone for disability benefits. The severity and impact of the condition on an individual’s ability to work and perform substantial gainful activity (SGA) are also considered during the disability evaluation process.
TO SUM UP
Passing a Continuing Disability Review (CDR) for mental disorders requires careful preparation and attention to detail. It is important to keep complete and up-to-date medical records, openly discuss your symptoms with healthcare professionals, and follow prescribed treatment protocols.
Understanding the purpose and requirements of a CDR is crucial, as the Social Security Administration periodically reviews cases to determine ongoing disability. While there are no guarantees, being well-prepared and providing comprehensive documentation can increase the chances of successfully navigating the review process. It is advisable to consult with legal professionals or disability advocates who can provide guidance and support throughout the process.
VICTOR MALCA – Florida Workers Compensation & Social Security Disability Attorney
Victor Malca P.A. has over 27 years of litigation experience in Workers Compensation and Social Security Disability lawsuits. His experience and continued success when fighting for his clients puts him among the most trusted workers’ compensation attorney’s in Florida. He specializes in representing injured workers on compensation benefit cases and disabled individuals claiming lost social security disability benefits.
Book a free consultation today. Our unwavering advocacy for employee rights and privileges are recognized by our past clients across South Florida.
About The Author
Judy Ponio is a writer and editor for the Victor Malca Law P.A. website and blog. She enjoys helping people in need with questions about social security disability and workers compensation law. She has a passion for helping those in need and the elderly with accurate legal information that can make a positive difference in their lives.