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Needs Improvement: Medical Continuing Disability Reviews


One of the great incentives of the Ticket to Work is that if you have your ticket assigned and if you’re making what Social Security terms ‘timely progress’ you are absolved of having to undergo the chore, infrequent though it may be, of the Medical Continuing Disability Review (CDR).

The purpose of the CDR is for Social Security to determine if a beneficiary has ‘medically improved’ over a period of time to such an extent that he no longer qualifies as having a disability. As is the case with initial disability determinations Social Security collects medical information on the beneficiary and hands over the case to the Disability Determination Service (DDS) for them to make the decision. With a CDR case DDS will look not at whether there is sufficient evidence of a disability (as it does when conducting an initial review) but whether there is evidence of improvement. If there is evidence of significant medical improvement then Social Security will terminate the benefits. Barring the appeals process, the erstwhile beneficiary would have to go through the whole application process again in order to get his benefits reinstated.

It is important to note that not all disabilities are treated the same. DDS, when making the initial determination, will decide at that point how likely they expect any medical improvement and will place the case under one of three categories: Medical Improvement Expected (MIE); Medical Improvement Possible (MIP); and Medical Improvement Not Expected (MINE). As might be expected, those cases in the MIE category will be reviewed more frequently than the others and could be subject to the CDR every couple of years. In contrast, those in the MINE category, whilst still expected to undergo reviews despite the lack of expectation of improvement, may go as long as 7 years before anyone has a look at any medical improvement.

It used to be the case that someone returning to work would cause Social Security to initiate a CDR. Social Security eventually realized that that was putting people off the idea of employment and so now if someone gets a job and he’s had benefits for 2 years or more he won’t trigger a CDR. However, those regularly scheduled CDRs will continue whether he’s working or not and the only way to get protection from them is, as stated above, to keep making timely progress with an assigned Ticket to Work.