Understanding the Disability Review Process

Why Are Disability Reviews Conducted?

The SSA is required to ensure that only individuals who continue to meet their disability standards receive benefits. Reviews check whether:

• Your medical condition has improved
• You are able to return to work at a level considered substantial gainful activity (SGA)

Frequency of Disability Reviews

How often your case is reviewed depends on the likelihood of your condition improving:

• Medical Improvement Expected (MIE): Review every 6 to 18 months.
• Medical Improvement Possible (MIP): Review approximately every 3 years.
• Medical Improvement Not Expected (MINE): Review approximately every 5 to 7 years.

The SSA will inform you of your review category when you are approved for benefits.

What Happens During a Disability Review?

• Initial Notification:
  – You will receive a notice from the SSA stating that your case is being reviewed.
  – The notice will include forms you need to complete about your current medical treatment, daily activities, and work status.
• Completing Disability Update Reports:
  – For some reviews, you will fill out a short Disability Update Report (Form SSA-455).
  – If more information is needed, you may be sent a longer Continuing Disability Review Report (Form SSA-454), requiring detailed medical updates.
• Medical Evidence Review:
  – The SSA will request updated medical records from your doctors, hospitals, and clinics.
  – They may send you for a Consultative Examination (CE) with an SSA-appointed doctor if your medical evidence is insufficient.
• Work Activity Review:
  – The SSA will evaluate whether you have been working and, if so, whether your earnings exceed SGA levels.
  – In 2025, earning more than $1,550 per month ($2,590 if you are blind) may result in loss of benefits.

Possible Outcomes of a Disability Review

• Benefits Continue: If your medical condition still meets SSA disability standards, your benefits will continue without change.
• Benefits End: If the SSA determines your condition has improved enough for you to return to work, your benefits may be stopped. You will receive notice explaining this decision and your rights to appeal.

Appealing a Disability Termination Decision

If your benefits are terminated after a CDR and you disagree with the decision, you can:

• File an appeal within 60 days of receiving the termination notice.
• Request continuation of benefits while your appeal is pending, but you must request this within 10 days of receiving the notice.