How Does the SSA Decide if You’re Still Eligible for Disability?

The Social Security Administration (SSA) will do a Continuing Disability Review (CDR). This process determines if an individual's impairment(s) has improved since the most recent favorable determination. It will determine if the person can perform any Substantial Gainful Activity (SGA). 

Benefits will continue if you still have a disability that stops you from working. Any person who receives disability benefits must have their medical condition reviewed in order for the SSA to make sure that you are still eligible for these benefits. How often the review of your medical condition takes place depends on whether or not your condition is likely to improve. This review is called a Continuing Disability Review (CDR).

• Your medical condition will normally be reviewed within 6 to 18 months after if it is likely your medical condition is to improve. 
• Your medical condition is reviewed about every 3 years if it is possible you are likely to improve. 
• Your medical condition will normally be reviewed every 7 years if it is less likely to improve.
  The first award notice will inform you as to when you can anticipate your first medical review. 

Two things can take place which could lead to the suspending or stopping of your benefits.
The first is after completing a 9-month Trial Work Period (TWP), you are working at a level that is considered substantial. After you complete the TWP, the SSA will suspend cash benefits for the months during which your earnings are over the substantial level during the 36-month re-entitlement period. If your earnings fall below what is considered the substantial level during that period, your benefits can be restarted. In 2023, average earnings of $1,470 or more per month ($2,460 or more per month if you are blind) are normally considered to be substantial. The amount of earnings considered to be substantial changes every year. 

The second is if the SSA decides that your medical condition has improved, and you are, thereby, no longer determined to have a disability. 

If the SSA stops your benefits, you can appeal the decision. On occasion, the SSA may conduct a Continuing Disability Review (CDR) and stop payments if it feels you no longer qualify. To avoid losing your benefits, you need to appeal this decision. This means you must make a request for a hearing or submit a request for continuation of disability benefits to the SSA in writing. After you receive the cessation notice, you have only 10 days to do this. If you fail to meet this 10-day deadline, you have a total of 60 days to submit your request or you will not be able to pursue an appeal. 

Upon receipt of your request, a staff member at your state's Disability Determination Services (DDS) office reviews your file. He or she may choose to reverse the decision and restore your benefits. If the review does not result in a decision to restore benefits, you then have a hearing with a DDS officer. 

If your hearing does not result in your benefits being continued, you will need to request a hearing with an Administrative Law Judge (ALJ). After this hearing, the ALJ will make a decision. If the decision does not result in a favorable outcome, the decision will need to be appealed through the Appeals Council, then the federal district court if it’s necessary.