Quesion: What Does a Review Mean and ...

If you get a notice that you are being reviewed, you might talk to your attorney and be sure that you are doing everything you should.

If you get a notice that your benefits are being terminated, YOU GENERALLY HAVE ONLY 10 DAYS TO APPEAL IF YOU WANT YOUR BENEFITS TO CONTINUE. If you want this, you should go down to the social security local office THAT DAY OR THE NEXT DAY and tell them you want your cash and health insurance benefits continued. It is usually a poor idea to go by an attorney's office first, because time is so short.

If you do ask for benefits to continue during your appeal, there is a chance that you will have to pay the benefits back; on the other hand you might be able to get a waiver. Whether to do this is a tricky question that requires a lot of thought; the best answer varies from case to case.

One problem in termination cases is that, if benefits continue, there are generally no back benefits out of which you can pay an attorney. For that reason, most attorneys ask for some money down and a small monthly payment to handle this sort of case. In some areas, legal aid will take these cases for no fee. It is smart to try to save up money in case you are ever turned down; this is also very difficult in light of the amount of most checks.

Author Message   Sue Egert Rating: N/A Votes: 0 (Vote!) Posted on Wednesday, April 11, 2001 - 10:09 pm:        We recently found out my husband has been approved for SSD. In the letter it states his case will be reviewed in 5 to 7 yrs. I'm dealing with 3 different dates here so I'm not sure when this review will take place. (I want to make sure I have all his medical reports ready for them again)..He became disabled in June 1998. However, due to a miss information from them, at that time, he waited until Oct. 2000 apply. They approved him on March 8, 2001, but paid him retroactive until Oct. 1999 (one yr prior to the month he applied. However, the letter states that he meet there definition of disabled in June of 1998. So when will the first review take place??? Will it be around June of 2003, Oct of 2004 or March of 2006??? Reply by Paul They are saying that he will be reviewed in 5 to 7 years from the date of the decision, that is March of 2001. But just because they say it, that does not mean it is so. The Administration has been running behind in its reviews. It is impossible to say whether it will still be running behind at that time. And certain events can cause earlier review; for example if there are substantial earnings on his record. Take care.   Susan Kendall Rating: N/A Votes: 0 (Vote!) Posted on Friday, March 22, 2002 - 9:57 pm:        Dear Mr. McChesney-I posed the question here on 2/18/02 about my S.S. Disability Review after 11 years (as far as seeing their Doctors.)I have had a review before, but they never sent me to their own agents. It was just filling out the long forms. Well, last week I received the good news. I am still considered disabled by their standards. Sounds silly, to be happy I am still disabled; but the prospects of me suddenly healing are quite remote. I don't know exactly what they based their decison on; and to be quite frank, I don't really want to ask. It could have been the Radiograph of my right leg (a typical Orthopedist probably has never seen a Pseudoarthrosis before--meaning false joint); or the fact I haven't worked since 1990; or because I'm 50 years old now. It could also be whatever my Dr. wrote--although she is not an Orthopedist, but has a special interest in Sports Medicine. I might add, this was a very cursory examination. The Dr.at IMA (S.S. Disability's agent here on L.I., NY) never even asked me to take my brace off to look at my leg. She seemed to have a hard time understanding that all four limbs were broken in a lot of places . A typical Dr. ,even an Orthopedist, is not really familiar with these type of injuries. I was taken to the trauma unit of Stony Brook University Hospital after my accident--where the Drs. are familiar with this sort of thing. Apparently,though, S.S. Disability has not yet put me on long-term Disability. The Form letter states "You will be reviewed from time to time to see if you are still eligible for benefits based on disability or blindness." I would like to add, for the benefit of other people who visit your site; at no time did I lie to these people. Also, I spent a great deal of time filling out my 10 pages of forms to the best of my ability. There wasn't even enough space for me to write all I had to say. I should also mention, again, the fact I live alone with no family nearby. Social Security, I would think--must take this fact into consideration. Well, thanks again for your help. I hope my experience will help other people who visit your site. I'm sure I'll be here again, as I have a friend who is trying to get Disability because she was recently diagnosed with Epilepsy. She got turned down the first time; but from what I've learned this is quite common. They turned me down the first time, and I was in a wheelchair with 24hr. home health care aides! Regards--Susan Kendall   robert busch Rating: N/A Votes: 0 (Vote!) Posted on Monday, January 07, 2002 - 9:39 am:        Social Security has made a ruling regarding my application for disability. The tell me it has been selected randomly for quality control review. They will not tell me what the outcome of the initial findings of the application. How long does it take for these "quality control" random reviews to be completed? Why do they decline to reveal the initial decision?   Paul McChesney (Admin) Rating: N/A Votes: 0 (Vote!) Posted on Tuesday, January 29, 2002 - 11:30 am:        I think this might be a good sign. I have an unproved theory that the Administration reviews more favorable than unfavorable decisions. In my area it will add a couple of months to the process for this review to take place. I am sure that time added varies around the country. Occasionally one of the examiners tells me what they recommended. More often they do not. I am not sure what the internal rules are in regard to whether they are allowed to tell. Take care and good luck.   Teresa Rating: N/A Votes: 0 (Vote!) Posted on Wednesday, September 24, 2003 - 11:59 pm:        Hi,im new here and was wondering if anyone could help me?Ok my husband signed up april 2003 for SSI and SSDB and they sent him to two Doctors and in july they sent a letter stating that they needed the address and other information from a job he had back in '99'and thats all we've heard.. so today i called my local social security office and they told me that it was approved in frakfort,ky on august,03 and it has been put in the REVIEW BOARD since august26,03 and they told me within 7days from now they would contact me and let me know whats going on and he hasn't worked since oct2002 and my last contact with the social security office they also wanted to know if i was going to be over his check...so any answers would really help us out???? thanks so much   Paul McChesney (Admin) Rating: N/A Votes: 0 (Vote!) Posted on Thursday, October 30, 2003 - 5:31 am:        Again, we at least know that your husband must have a strong case, since the Disability Determination Section (as it is called in most states) apparently wants to award the case. Certainly if denied you should appeal. Winning at this level only becomes certain after the DDS's recommended decision is approved by the Quality Review staff.   Henry G. (Unregistered Guest) Unregistered guest Rating: N/A Votes: 0 (Vote!) Posted on Friday, July 01, 2005 - 11:30 am:        Okay, so my complain for SSDI was approved in March 2004. The date my disability began was determined to be July 2001. If the SSA conducts a full-scale CDR, which date will they use for the CPD (comparison point date) for the MIRS (medical improvement review standard)?   Paul McChesney (Admin) Board Administrator Username: Admin Post Number: 1297 Registered: 5-2004 Rating: N/A Votes: 0 (Vote!) Posted on Tuesday, July 05, 2005 - 10:00 am:        The date of your most recent decision finding you disabled, that is, July of 2001. See 20 CFR SEC 404.1594: "(1) Medical improvement. Medical improvement is any decrease in the medical severity of your impairment(s) which was present at the time of the most recent favorable medical decision that you were disabled or continued to be disabled." So, how often will they review? It depends onhow serious they think your condition is: 20 CFR SEC 404.1590 When and how often we will conduct a continuing disability review. "(d) Frequency of review. If your impairment is expected to improve, generally we will review your continuing eligibility for disability benefits at intervals from 6 months to 18 months following our most recent decision. Our notice to you about the review of your case will tell you more precisely when the review will be conducted. If your disability is not considered permanent but is such that any medical improvement in your impairment(s) cannot be accurately predicted, we will review your continuing eligibility for disability benefits at least once every 3 years. If your disability is considered permanent, we will review your continuing eligibility for benefits no less frequently than once every 7 years but no more frequently than once every 5 years. Regardless of your classification, we will conduct an immediate continuing disability review if a question of continuing disability is raised pursuant to paragraph (b) of this section." So, what are the circumstances in paragraph (b) that would lead to immediate review? "(b) When we will conduct a continuing disability review. A continuing disability review will be started if-- (1) You have been scheduled for a medical improvement expected diary review; (2) You have been scheduled for a periodic review (medical improvement possible or medical improvement not expected) in accordance with the provisions of paragraph (d) of this section; (3) We need a current medical or other report to see if your disability continues. (This could happen when, for example, an advance in medical technology, such as improved treatment for Alzheimer's disease or a change in vocational therapy or technology raises a disability issue.); (4) You return to work and successfully complete a period of trial work; (5) Substantial earnings are reported to your wage record; (6) You tell us that you have recovered from your disability or that you have returned to work; (7) Your State Vocational Rehabilitation Agency tells us that-- (i) The services have been completed; or (ii) You are now working; or (iii) You are able to work; (8) Someone in a position to know of your physical or mental condition tells us that you are not disabled, that you are not following prescribed treatment, that you have returned to work, or that you are failing to follow the provisions of the Social Security Act or these regulations, and it appears that the report could be substantially correct; (9) Evidence we receive raises a question as to whether your disability continues; or (10) You have been scheduled for a vocational reexamination diary review."   Henry G. (Unregistered Guest) Unregistered guest Rating: N/A Votes: 0 (Vote!) Posted on Monday, July 18, 2005 - 7:00 pm:        So if Vocational Rehab reports that you are working, your case might be reviewed under this provision? What if you are working far less than SGA, and with special on-the-job accommodations/supports? Will minimally work activity reported by the voc rehab agency be enough to get a review? In the case of a mental illness, for example, one might be able to do a minimal amount of work with special allowances. Yet, one might be able to undergo a minimal program. But it sounds like your case can easily be set up for review.   Paul McChesney (Admin) Board Administrator Username: Admin Post Number: 1403 Registered: 5-2004 Rating: N/A Votes: 0 (Vote!) Posted on Wednesday, August 03, 2005 - 5:36 pm:        Frankly, I am not sure how the Administration picks the claimants they review. But income does tend to trigger review. Not necessarily termination; just review.   Nancy M. Rating: N/A Votes: 0 (Vote!) Posted on Tuesday, December 16, 2003 - 12:58 pm:        I have filed for social security disability eight months ago and was told by our local office in Ohio it was approved by our state ssd, but it was "pulled" and sent to Chicago,IL for them to reveiw. Can you tell me what this means? Thank You.   Paul McChesney (Admin) Rating: N/A Votes: 0 (Vote!) Posted on Tuesday, April 27, 2004 - 5:37 am:        Nancy: When a file is "pulled" after the State Agency makes a recommendation, it means that the "Quality Review Branch" of the regional Social Security office is going to review the claim and might "correct" the State Agency's decision. That is bad news because the Quality Review Branch tends to recommend denial; but good news in the sense that a case that the State Agency recommends payment on is probably a strong one that should be appealed. Be sure to appeal any denial. And of course get an attorney.   Lisa M Rating: N/A Votes: 0 (Vote!) Posted on Friday, July 13, 2001 - 12:38 am:        When the AC gets a motion from QA to review an ALJ favorable decision and the AC decides to review based on the QA report. Does it take as long to get a decision from AC as the typical case. I read on hear that it took 8months to 2years at the AC level. Also does interim benefits last through the whole process or does it only last a month or two? Thank you in advance. Reply by Paul In a rare case, after the ALJ issues a recommended favorable decision at the hearing level, the Appeals Council will review the case. If the case is not paid by a certain time, benefits will be paid during the rest of the time that the Appeals Council takes to review the case. The time it takes for the Appeals Council to review any case is highly variable, and I confess I have never solved the mystery of why one case is reviewed quickly and another takes two years. I am not certain, but I think that these types of cases are reviewed more quickly than some others. In general, review used to take about 9 months, and has stretched to 2 years in some modules. But certian case are reviewed much more quickly, and the Appeals Council might be catching up, too. The interem benefits that you are paid during such a review last until the Appeals Council issues a decision.   joy s. (Unregistered Guest) Unregistered guest Rating: N/A Votes: 0 (Vote!) Posted on Saturday, November 26, 2011 - 8:53 pm:        I signed up for both ssi and ssd in may of 2009 and was denied I got a lawyer and I just got a letter stating that I was having a review on my case what does this mean?   LILY COOGLER (Unregistered Guest) Unregistered guest Rating: N/A Votes: 0 (Vote!) Posted on Thursday, March 22, 2012 - 7:25 pm:        WHY IS THERE NO REVIEW DATE ON MY AWARD LETTER FOR SSD.

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