Social Security Disability Review Process

 Posted on March 03, 2010 in Already Applied for Disability Benefits

The following two similar questions were posted on my blog last week: "My husband is going to have his disability review after many years of receiving Social Security Disability Insurance (SSDI) payments, where can I go to find out more information about the review process?" and "Our primary physician lost our medical records, what can we expect to happen during our disability review?"

Before I answer those two questions, I think it is important to understand what a Social Security disability review is for and why the SSA has them. Once a claimant has gone through the long disability application process and is finally awarded SSDI or Supplemental Security Income(SSI) benefits, the disabled individual will begin receiving monthly payments from the Social Security Administration (SSA). Monthly payments will continue so long as the person remains limited by his or her conditions and is in fact disabled. The SSA will determine the status of the individual's condition by holding a "checkup." Those "checkups" are part of SSA's disability review.

(1) Where can someone find information about the SSA's disability review process?

The SSA has a great deal of information about the disability review process on their website. The SSA website answers commonly asked questions such as: How often will my medical condition be reviewed?; What happens during a review?; What if I disagree with the decision?; and What if I try to work? It should be noted that while the information provided by the SSA can be very helpful for those expecting to go through the disability review process, specific answers to your individual conditions will not be provided. The reason for this is because the disability review process is somewhat different depending on the individual's conditions. Depending on your condition, a disability review may be required every year or every six or seven years. Also, the extent of the medical records that need to be reviewed depends on the individual's condition and whether it was expected to improve or not. For specific questions relating to your condition and what can be expected at your disability review, it may be worth your while asking the SSA or a disability attorney.

(2) Our primary physician lost our medical records, what can we expect to happen?

This is a tricky scenario that I have personally never handled. I am still wondering how a primary physician could actually lose someone's medical records. However, if one of my readers is put in a similar situation it is important to know that the SSA has a lot of discretion how they will approach your case. If the SSA feels that they have received enough medical records from other clinics, hospitals, or physicians they may choose to make a determination on the evidence provided. Another option that the SSA could use is to send you to have a special examination. The SSA would then go ahead and give you the date and time for a no cost evaluation with a medical expert. In general, if your condition was expected to worsen and has, the SSA will review your case less frequently and have an easier time making a determination. If however, your condition was expected to get better and has, the SSA will need to go through the disability review process more frequently with you and typically in more detail.