The Social Security Disability Post-Award Review
Once you have won your Social Security Disability Claim and started receiving your disability benefits, one question that may come up is “will Social Security continue to check on my medical condition?”. Â The answer is YES!
The Social Security regulations require the Social Security Administration (SSA) to conduct reviews of claimants’ medical conditions periodically to make sure people who are receiving disability benefits continue to be disabled. Depending on the nature of the impairments, Social Security is supposed to conduct these reviews every three to seven years on each case; but in our experience, it does not happen quite that often. Actually, in some cases, especially if the claimant is older, they never even receive a follow up review.  Even the younger claimants with impairments that have a good chance of improvement do not always face a review at the three-year mark. This is in large part because of how backlogged Social Security is with handling claims; this is also the reason why it takes so long for a Social Security Disability claim to get through the whole process.
However, there are cases where the Administrative Law Judge (ALJ) specifically prescribes within his/her written decision for a review to be conducted within a certain amount of months or years after benefits have been awarded. This is usually the case for people with a condition that has great potential to improve such as individuals diagnosed with a form of cancer that is very curable, musculoskeletal conditions in younger people that may improve with surgery, or an infant with low birth weight.
So what actually happens if your condition comes up for review? First, Social Security will send you a letter that asks you to go to your Social Security office where you will meet with a SSA disability examiner.  This person will ask you whether or not your medical condition has improved or not. You should bring to the appointment a list of doctors and medical facilities that you have been to since you have been receiving disability; in addition, take your a list of your current medication and any dates of specific treatments you have had (such as surgeries).
Be ready to answer the question: “Have you attempted to return back to work since you have received disability?”.  The disability examiner will order your medical records from your doctors offices to evaluate your condition. Here is why our office consistently reminds our clients of continuing medical treatment after they receive their benefits; if you do not continue to get medical care, SSA assumes that your condition has improved.  If you have not seen any doctors since your disability benefits started, the medical examiner will either assume that your condition has improve, or he/she will send you to a doctor for a one-time exam fpr which the SSA will pay. The doctors who perform these exams do not usually do a thorough job of evaluating your condition, and they do not usually offer the most favorable opinions on the claimant’s behalf.  In summary, continue to get medical treatment after you receive your disability benefits so that your monthly benefits do not have to rely on the one-time evaluation of a doctor who does not know you and is paid by Social Security to review your health condition.
Once the review is complete, Social Security will either determine that the condition has not improved and disability benefits will continue, or the SSA may determine that your condition has improved and you may return to the workforce.  In this case, you will stop receiving benefits. If SSA does cease your benefits by finding that your condition has improved, you can appeal their decision and ask them to further review your case.
