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SSA determined I am eligible for Disability Benefits. Will I be re-evaluated in the future? Will my case be reviewed more than once?

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Yes and most likely yes.

The frequency with which your claim will be reviewed through a process called a Continuing Disability Review (CDR) will vary depending on several factors. CDRs are known to occur as frequently as every 6 months to as infrequently as 7 years. A helpful reference to use as a starting point is the Certificate of Award, the notification you received advised of your claim approval. That Certificate may indicate the Agency’s position on whether it has determined you are likely to improve. However, there really is no way of telling exactly when this CDR will occur. To help wrap your head around the Agency’s rationale for its CDRs, you will need to know the different categories it organizes a Beneficiary’s claim. There are three: 1) Medical Improvement Expected (MIE); 2) Medical Improvement Possible (MIP); 3) Medical Improvement Not Expected (MINE)

If, when SSA approved your claim, the Agency determined that your condition was likely to improve, that would increase the frequency of the CDRs. So, if you are seeing more CDRs than you anticipated or more than another beneficiary of disability benefits, chances are you are in the MIE category. Something to note is that the older you get, the less frequent these CDRs are likely to occur. Once you turn 54.5 years of age, your case will probably evolve out of this MIE category. There are, of course, exceptions to this rule.

The SSA will categorize your claim in the MIP category if it determined upon approval that it is medically possible for your condition to improve but, generally speaking, there is no good way to anticipate when that improvement may occur. If you have experienced a CDR approximately every 3 years, you are likely in the MIP category. Age is also a consideration in the MIP category, with exceptions, as noted above.

The last category Medical Improvement Not Expected is about what it sounds like. If your claim is categorized as a MINE, you will likely see the least frequency of CDRs – approximately every 5-7 years. Examples of such conditions include deafness; Down syndrome; multiple sclerosis; traumatic brain injury. Moreover, the older you are at approval, the more likely your case is categorized as MINE.

One last point to note is that, depending on the Agency’s overall backlog of claims and general operating budget, a CDR may not happen “on time.” The bottom line: you really will not know with any degree of certainty when a CDR is approaching. Just know that once you are approved, it is incumbent upon you to continue seeking medical treatment and staying compliant with your treatment. The Agency will, at some point, conduct a CDR. When it does, your treating physician’s notes and opinions will be a top priority for the Agency.

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