Who Gets Reviewed
WHO GETS REVIEWED?
WHAT TRIGGERS A REVIEW?
Every decision awarding disability is characterized by
SSA (Social Security Administration) according to expected
improvement and should be reviewed according to a set
schedule.
The frequency of review is based on the assigned category
and is between every six months or every seven years after the
final administrative decision.
- Medical improvement expected - review will occur
between 6 and 18 months after the final administrative decision.
This includes conditions from which recovery can be
anticipated. Example: a fracture that is expected to
heal.
- Medical improvement is possible; non permanent
impairment - review every 3 years. This includes impairments
for which improvement cannot be predicted at the time of the
decision, and conditions that are not expected to improve, but are
not considered as severe as a permanent impairment.
Examples: regional enteritis,
hyperthyroidism, chronic ulcerative colitis.
- Medical improvement not
expected, permanent impairment - review will occur every 5 to 7
years. Includes extremely severe conditions that are considered
permanent, or, because of the individual's age or lack of recent
work experience would suggest less likelihood of recovery and
return to the work force. Example: Parkinson's Syndrome, ALS,
amputations.
Other reasons for review:
- Advances in, or improvements of, medical or occupational
therapy received by an individual or that could affect an
illness.
- An individual returns to work and successfully completes
a trial work period, or substantial earnings are reported on an
individual's earning record.
- An individual reports that he or she has recovered or has
returned to work.
- A state vocational rehabilitation agency reports to SSA
that their services are complete and that the individual is now
working or is able to work.
- Someone in a position to know tells SSA that the
individual is working, is not following prescribed treatment of an
SSA provision, or is no longer disabled.
- Other evidence that the SSA has questions about regarding
the individual's continuing disability.
- The individual is scheduled for review because he or she
completed vocational therapy, training or education.