Reviewing Your Disability Benefits


Factsheet

Social Security

SSA Publication No. 05-10068
June 1997
(April 1995 edition may be used)


Reviewing Your Disability

If you receive Social Security or Supplemental Security Income (SSI) disability benefits, your case will be reviewed from time to time to make sure you continue to be disabled. Disabled means you have a physical or mental condition that prevents you from working for a least a year or is expected to end in death.

The review process is designed to give you every opportunity to show that you are still disabled and to assure that your benefits are not stopped incorrectly. All evidence about your condition will be completely evaluated. If you have more than one disabling condition, we'll consider the combined effect of all your impairments on your ability to work.

Following are some of the most frequently asked questions about Social Security disability reviews. If you have others, contact your Social Security office.

How Often Will I Be Reviewed?

It depends on the nature and severity of your condition and whether it is expected to improve.

  • If improvement is expected, your first review generally will be six to 18 months after the date you became disabled.
  • If improvement is possible but cannot be predicted, your case will be reviewed about once every three years.
  • If improvement is not expected, your case will be reviewed once every five to seven years.

How Will I Be Notified Of A Review?

Generally, we will send you a letter containing questions for you to answer about your condition. Based on your answers to these questions and other information in your case, we may decide to do a full medical review. If a full medical review is needed, we will send you a letter asking you to come to the Social Security office. If a full medical review is not needed, we will send you a letter telling you that we do not need to review your case at this time.

What Happens During A Review?

At the review, we will ask how your impairment affects you and whether it has improved. Bring your doctors' names, addresses and phone numbers. Also, bring patient numbers of any hospitals and clinics that have treated you since we last contacted you. If you have worked since you applied for disability benefits or since your last review, we also need information about the dates you worked, the pay you received and the kind of work you did.

Who Will Make The Disability Decision?

We will send your case to an agency in your state that makes disability decisions for Social Security. An experienced disability examiner and a doctor will carefully review all information and the evidence you have given, and will request detailed medical reports from the sources you have indicated.

How Will They Make The Decision?

In most cases, the decision will be based on the information from your doctors, hospitals or clinics. But, if the medical evidence is not complete or current, you may be asked to have a special examination at government expense. If an examination or test is needed, an appointment will be scheduled with your own doctor, another private doctor or other medical source. You will be notified in writing of the date, time and place.

What If I Disagree With The Decision?

You can appeal the decision. There are four levels of appeal and, generally, you have 60 days to appeal from one level to the next. The four levels are:

  • Reconsideration--Your case is independently reviewed by people who had no part in the original decision. You may appear before a hearing officer who will decide your appeal.
  • Hearing--If you disagree with the reconsideration decision, you may request a hearing before an administrative law judge.
  • Appeals Council--If you disagree with the administrative law judge's decision, you may ask for a review of the decision by the Appeals Council.
  • Federal Court--If you disagree with the - Appeals Council decision, or if the Appeals Council declines to review your case, you may bring a civil action in a federal court.

Under What Circumstances Will Benefits Be Stopped?

Generally, benefits will be stopped only if the evidence shows that your impairment has medically improved and that you can work. As long as your condition has not improved and you are not working, benefits normally will continue.

Your benefits will stop if you are doing substantial work. But, if you are working and are still medically disabled, benefits may continue.

What If I Try To Work?

Social Security has several special rules that can help if you want to work in spite of your disability.

If you are receiving Social Security disability benefits, you may have unlimited earnings during a trial work period of up to nine months (not necessarily in a row) and still receive full benefits. Other rules allow cash benefits and Medicare to continue while you attempt to work on a regular basis.

If you are receiving SSI disability benefits, you may continue to receive monthly payments while you work as long as you continue to meet the income and resource requirements. If your cash payments stop because your total income exceeds the SSI limits, you may still be eligible for Medicaid.

Other rules help with work expenses, training and rehabilitation. Ask your Social Security office for more information about special rules for people with disabilities who attempt to work.

Click here for a related Social Security document.

THE TEXT ABOVE IS PUBLIC DOMAIN MATERIAL AUTHORED BY AN AGENCY OF THE UNITED STATES GOVERNMENT AND NOT COPYRIGHTED BY THIS WEBSITE. To locate the original material (which may have been updated) click here.