Disability
A Guide to Continuing Disability Reviews for SSD/SSI Claims
This information last reviewed: 10/9/2013

1. What is a CDR?

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. See What is the Difference Between SSD and SSI? for an explanation of SSD and SSI 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.

2. What can I do to prepare for a CDR?

  • Keep copies of the documents you send to SSA so they are easier to complete for your next review. Also, SSA loses paperwork sometimes and it’s good have a copy.
  • Maintain a good relationship with your doctors and make sure they know about your medical condition. Keep a list of all medical tests and treatments, and understand how to get copies of those records (See How to Get a Copy of Your Medical Records in New Jersey) if you need them.
  • Keep SSA informed of any change in your mailing addresses. Otherwise you might not get your CDR notice and your benefits could be denied.

3. What do I do if I get a CDR notice?

  • Don’t worry. The SSA is not looking for a reason to end your benefits. If you can show that you still have the medical condition that is keeping you from working and that you are under medical care, your benefits will likely continue. Over 90% of adults who undergo CDRs have their benefits continued.
  • Open and read the notice. Get help if you don’t understand what it says.
  • Respond on time to SSA’s requests for information. If you cannot respond on time, contact SSA and ask for more time. If you need help gathering requested information, ask for it. SSA will require you to submit supporting evidence and to complete either a short or long CDR form. SSA may also ask for additional information. If you do not cooperate, your benefits could stop.
  • See Completing the short form CDR, Completing the long form CDR, and Documenting your claim and requesting records.

Completing the short form CDR

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:

  • Fill out the form exactly as instructed and answer truthfully.
  • Several answers are likely to trigger a closer review of your file, such as stating that your doctor told you that you could work (question 3), stating that your health is better (question 4), or that you have received no medical treatment (questions 5 and 6).
  • Ask your doctors to discuss whether you should be doing full-time competitive work, considering all of your medical conditions in combination. If they say that you can, ask them to provide a detailed list of your mental and physical job restrictions. Include those in the form and then consider consulting with the state vocational rehabilitation agency. See Vocational Rehabilitation (from The New Jersey Department of Labor and Workforce Development).
  • Consider asking other people to submit statements that show why you could not sustain work activity.
  • If some basic information like your address or phone number is different from that on the form, submit a separate written request to SSA to update that information.
  • You may have new medical conditions that are closely related to the ones in your original disability application. If so, point that out in the “remarks” section, especially if they are complications of the original one.
  • Cooperate with the local SSA office as much as possible and respond to them in a timely matter. If you need extra time to respond, request that in writing and save a copy.

See Social Security Administration Disability Update Report Information and Completion Instructions (SSA-455) for an example of a completed short form CDR.

Completing the long 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:

  • Follow the same advice as listed for the short form.
  • The form asks that you list a person familiar with your medical condition. Make sure the person you select is aware of how your medical conditions affect what you can do.
  • Be very thorough when describing any medical conditions that limit ability to work, or for children, to do the same things as other kids their age (question 2a). Name all of the medical conditions, and go into detail about how they affect what you can do, both physically and mentally. Don’t forget to cover the conditions that you had when you were approved for benefits and describe how they have changed (question 2b). If you need more space, attach an extra page.
  • You have a duty to report any work you did since you were found disabled (question 7). If you have worked, be sure to describe any special assistance you may have received in the workplace. Accurately report the job hours, duties, and amount of earnings. If you had to stop the job or reduce hours because of your disability, say so.
  • Tell your doctors that a CDR is being done on your file and that SSA may contact them for information. Submit any medical records and attend any medical examinations or tests that SSA requires. This article explains how you can get copies of your medical records. See How to Get a Copy of Your Medical Records in New Jersey.
  • The form asks if you believe you can work, and if any doctors told you that you can work (questions 7e and 7f). Ask your doctors to discuss whether you should be doing full-time competitive work, considering all of your medical conditions in combination. If they say that you can, ask them to provide a detailed list of your mental and physical job restrictions. Include those in the form and then consider consulting with the state vocational rehabilitation agency. See Vocational Rehabilitation (from The New Jersey Department of Labor and Workforce Development).
  • The form asks if you have any difficulty with some normal daily activities (question 9). Make sure your answers accurately describe those difficulties. For example, if you can only sometimes do certain activities, or cannot do them as well, as quickly, or as long, be sure to say so. Describe activities with which you need help.
  • Cooperate with the local SSA office as much as possible, and be diligent in following up to make sure that they have received your medical records and any other important evidence.

See Continuing Disability Review Report (SSA-454-BK) for an example of a completed long form CDR.

Documenting your claim and requesting records

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. An explanation of how to obtain your medical records is available at How to Get a Copy of Your Medical Records in New Jersey. 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 (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.

4. How does SSA evaluate CDRs?

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.

Adult SSD and SSI Claims

  • In adult claims, Social Security follows a multi-step process. The first step, which applies to some SSI and SSD claims, is to determine whether you are working at substantial gainful levels. There are some limited exceptions for people using SSA’s work incentive programs.
  • Social Security then checks to see if you meet the requirements of its “Listing of Impairments,” which is a list of medical conditions that SSA considers disabling. If yes, your benefits continue. If no, then you go to the next step. See Listing of Impairments - Adult Listings (Part A) from the Social Security’s website.
  • SSA then considers if you are medically improved in ways related to your ability to work. If no, then your benefits will continue unless you fall into one of the limited exceptions, such as fraud or non-cooperation. If yes, then you go to the next step.
  • If you are medically improved in ways related to your ability to work, SSA will ask more questions similar to the ones it uses in new disability claims. It will determine if your medical conditions affect your ability to do any basic work activities. If no, then benefits cease. If yes, then you go to the next step.
  • SSA then determines if you can do any of your past relevant work. If yes, then your benefits will cease. If no, you go to the final step.
  • SSA then considers if you can do and sustain other substantial work. If yes, then benefits cease. If no, benefits continue.

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.

Child turning 18 years old

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.

Child SSI Claims

Children receiving disability benefits also get CDRs from time to time, before they turn 18. Social Security follows a multi-step process.

  • SSA asks if the child’s condition medically improved. If no, the benefits continue (unless one of the limited exceptions applies). If yes, then go to the next step.
  • SSA asks if the child’s medical condition meets or equals the requirements of the “Listing” it met before. SSA has a list of child medical conditions it considers disabling in its “Listings of Impairments,” which are available on its website. See Listing of Impairments - Childhood Listings (Part B) from the Social Security website. If the requirements are met, benefits continue. If not, then go to the next step. This step can sometimes be difficult because SSA often does not tell families which listing was met when their child was originally approved for benefits.
  • SSA then considers all of the child’s medical conditions and determines whether they meet the regular child disability standards, mentioned on Social Security’s website: see Understanding Supplemental Security Income SSI for Children (2013 Edition).

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.

What should I do if I get a notice ending my benefits after a CDR?

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 (see How to Get a Copy of Your Medical Records in New Jersey) 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.

FAQs 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?
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: