Thursday, July 11, 2013

Continuing Disability Review

Two of my clients with back problems received fully favorable Social Security Disability (“SSD”) decisions today from the same Administrative Law Judge (“ALJ”). One was an automobile mechanic who was over 50 years old, and the other was an operations agent who was less than 50 years old. The ALJ found that each was disabled and entitled to benefits. However, the ALJ closed his opinion for the operations agent by saying that medical improvement is expected with appropriate treatment, and therefore, recommended a continuing disability review (“CDR”) in twelve months. 

The regulations provide that Social Security should perform a CDR approximately every three years. However, if Social Security expects a medical condition to improve it could be sooner than that. Conversely, if Social Security determines that a condition is not expected to improve, it will still perform a CDR, but not as often as every three years. 

When Social Security performs a CDR, it must find that your condition improved in order to terminate SSD benefits. Medical reports indicating medical improvement obviously would provide evidence to support terminating benefits. Stopping or significantly reducing treatment can also be seized upon as justification for terminating benefits. 

Sometimes claimants reduce their frequency of treatment after being approved for SSD benefits because they had increased it simply to avoid Social Security from arguing their infrequent treatment reflected a medical condition that was not severe. Other times, the frequency of treatment is decreased because, once the claimant stops working, the symptoms are no longer exacerbated by the rigors of working. 

If treatment is reduced, the medical records need to reflect the reasons for the reduction, such as the above reasons, to show that the reduction is not due to medical improvement. That is particularly true for claimants under 50, as they are more likely to be designated for an early CDR.

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