Perhaps one of the most frequent complaints a disability advocate will hear starts out with, “I know somebody collecting disability…” Then there is some description of the person which paints them as the picture of health. The complaint ends with something like, “he ain’t disabled… And if he is, then I should be found disabled too.” While we have touched on how our hypothetical complainer can prove his or her disabilities and begin receiving benefits, we have not talked about people that are already receiving benefits. Specifically, what benefit recipients must do continue receiving benefits.
For the most part, life on disability is the same as life without it. However, there are some requirements that disability beneficiaries must keep to as long as they are collecting benefits.
First off, an applicant for disability must remain disabled. This seems like common sense. However, some disabilities go away: cancer can go into remission, back surgeries are successful more often than not, a psychiatrist can finally find the right medication to control symptoms, etc. If a claimant experiences a significant improvement in medical symptoms he or she must report this improvement. The cynical reader would say this is how so much of the tremendous disability fraud is allowed to happen as the typical claimant is sure to not report these changes.
The Social Security Administration, though, is not content to take claimants’ words for it. Another major requirement for claimants is that they comply with Continuing Disability Reviews (CDR). CDRs take two primary forms and which form it takes is currently chosen by a computer. According to the Deputy Commissioner of SSA, the agency uses statistical modeling to determine which cases are most likely to need a continuing review. While the deputy commissioner did not specify how this modeling works, it is a reasonable assumption that the more a determination of disability depends upon subjective evidence at the outset, the more likely it is to receive a more intensive review.
CDRs can be done in paper or in a doctor’s office. Many disability claimants will have been required to visit a doctor as part of developing their claim. The examination they receive after they have been approved is essentially the same examination. The most major difference is that the doctor might assume at the outset that the claimant’s conditions were, in fact, disabling when the claimant was awarded benefits and is now looking to see if they still are. The rest of the CDR may involve an interview with the claimant, running earnings reports, and querying bank databases to ensure compliance with earning and asset rules.
A paper CDR is what is assigned to cases that are less likely to see an improvement in symptoms or that were awarded based on very solid objective evidence. In these reviews, the Administration sends claimants function reports, disability questionnaires, and work activity reports, among others, to record statements from the claimants about how they live their lives and what treatment they are getting. Any suspected medical improvement or unreported work will trigger the more intensive CDR.
Beyond the CDRs, claimants are responsible for notifying the agency of any material changes in their lives. This could be a simple change of address or, in some circumstances, things that seem less relevant such as the marriage or death of a dependent. Generally, these requirements are much more stringent for claimants receiving SSI than they are for those only receiving SSDI as these individuals can only exceed the original qualifying criteria under certain circumstances.
For instance, an SSI claimant that is single with no children is required to have $2,000 or less in the bank at all times. If the claimant does not report to SSA even a single time when their bank account may be over the allowable limit (a lump sum child support payment for instance) they can be deemed overpaid and required to repay all of the benefits that they have received after the overpayment occurred. So, in order to maintain benefits, a claimant will need to educate themselves as to the requirements applicable to his or her situation.
While these requirements may not seem to be particularly taxing, the ramifications for an individual who is relying upon these benefits to make ends meet are enormous. So, while it may appear that that neighbor, friend, or relative is not disabled, SSA has reviewed their case and will continue to do so to ensure that they are, in fact, disabled.
If you have questions about maintaining your benefits or applying for disability contact us today!