1. Why SSA Conducts Disability Reviews

The SSA conducts disability reviews to:

• Determine if your medical condition has improved
• Assess whether your improvement allows you to return to work
• Ensure program integrity by confirming only eligible individuals receive benefits

2. When Will Your Disability Be Reviewed?

Your review frequency depends on the likelihood of improvement in your medical condition. Generally:

• Medical Improvement Expected (MIE): Review occurs within 6-18 months after benefits begin
• Medical Improvement Possible (MIP): Review happens every 3 years
• Medical Improvement Not Expected (MINE): Review is conducted every 5-7 years

Your initial award notice usually states when your first review will occur.

3. Types of Continuing Disability Reviews (CDR)

A. Full Medical Review

If SSA needs updated medical evidence to evaluate your condition, they will conduct a full medical review. You will receive:

• Form SSA-454 (Continuing Disability Review Report):
• This form requests information about your medical treatment, medications, daily activities, and work since your last review or approval.
• Provide detailed, accurate, and updated information to avoid unnecessary delays.
• Authorization Forms:
• SSA may ask you to sign medical release forms so they can obtain updated records directly from your healthcare providers.
• Consultative Examination (CE):
• If current records are insufficient, SSA might schedule an appointment with one of their contracted doctors for additional evaluation.

B. Mailer Review

Some beneficiaries with stable conditions receive a short-form questionnaire (SSA-455) by mail. This asks about:

• Recent medical treatments
• Any changes in your condition
• Whether you are working or have attempted to return to work

If your responses indicate no significant changes, SSA may continue your benefits without a full review.

4. What SSA Evaluates During the Review

During the CDR process, SSA determines:

• Has your condition medically improved?
• If improved, does it still prevent you from performing Substantial Gainful Activity (SGA)?
• Do you now meet the medical criteria for a cessation of benefits?

5. Outcome of the Disability Review

After reviewing your case, SSA will send you a written notice explaining their decision:

A. Benefits Continued

If SSA finds that your condition has not improved enough for you to return to work, your benefits will continue without interruption until your next scheduled review.

B. Benefits Stopped

If SSA determines your condition has improved and you can engage in Substantial Gainful Activity (SGA), they may stop your benefits. However:

• You will have the right to appeal this decision.
• If you file your appeal within 10 days of receiving the cessation notice, you may continue receiving benefits during the appeals process.

6. How to Prepare for Your Disability Review

To ensure a smooth review process:

• Maintain Regular Medical Treatment: Continue seeing your doctors and following prescribed treatments to document your ongoing condition.
• Keep Detailed Records: Save copies of medical reports, prescriptions, test results, and hospital visits.
• Update SSA Promptly: Report any address changes to ensure you receive all notices and forms on time.
• Be Honest and Thorough: Complete all forms with detailed, accurate information to avoid delays or questions about your credibility.

7. What Happens if You Are Working During the Review?

If you have attempted to return to work, SSA will evaluate:

• Your earnings and hours worked
• Whether your work qualifies as Substantial Gainful Activity (SGA)
• If you used any work incentives or trial work periods

Working does not automatically stop your benefits, but SSA will assess whether your earnings indicate your ability to engage in full-time employment.