What to Expect During an SSDI Eligibility Review

Once a person is approved for benefits through the Social Security Disability Insurance (SSDI) program, they will need to anticipate that the Social Security Administration (SSA) will review their eligibility at some point (and on a routine basis) in the future. The timing for eligibility review generally depends on the person and the nature of their disability. An initial review will typically occur within 6 to 18 months if your health care provider anticipates improvement. In situations where improvement is possible but unlikely, reviews generally occur every 3 years. When a person is approved for SSDI payments and has a disability that is considered permanent and not expected to improve, then reviews typically happen every 7 years.

You will be able to plan ahead in some fashion because your initial review letter will indicate when you should expect the SSA to review your case and your ongoing eligibility. Once a review is set, what should you expect during the process? Consider the following information from our SSD eligibility attorneys.

How a Medical Review Process Starts 

The routine eligibility reviews that the SSA conducts are known as medical reviews. This review process starts with you meeting with an SSA representative and providing certain information. You will be asked to provide information about your medical condition and whether or not it has improved. According to the SSA, you will need to provide the following information:

• Contact information for your health care providers;
• Patient record numbers and related information for any providers or facilities where you have been treated since you were approved for SSDI benefits; and
• If you have worked since being approved for benefits, the dates you have worked since your approval or last review, the amount of compensation you received, and the type of work you performed.

SSA Performs Its Review

Next, you will essentially wait for the SSA to conduct its review. The SSA will send all of your information to the Disability Determination Services in the state where you live and receive benefits, and it will gather information from your health care providers about your medical condition. In some cases, you will be asked “to go for a special examination or test for which we’ll pay,” the SSA explains. If you are required to do this, the SSA will provide you with details in advance.

The SSA will then review all of the facts of your case, determine if your condition has improved (and if so how your benefits should be affected), and whether you remain eligible for SSDI benefits.

Just as you can appeal an initial denial of benefits, you can also appeal the SSA’s decision that comes out of a medical review if you do not agree with the decision.

Contact a National SSD Eligibility Attorney Today for Assistance with Your Review 

Whether you are anticipating that your SSDI eligibility will be reviewed by the SSA this year, or you simply want to understand what to expect during the eligibility review process when you are due for review by the SSA, one of the experienced national SSDI eligibility lawyers at the Law Offices of Stephen Barszcz can assist you. We can provide you with more information about SSD eligibility and answer any questions you have about your initial application or the review process. Contact our firm today for assistance.

Source:

ssa.gov/pubs/EN-05-10053.pdf