Continuing Disability Review (CDR) FAQs

About Continuing Disability Reviews (CDRs)

1. What is a Continuing Disability Review (CDR)?

CDRs are periodic reviews that determine whether Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) recipients continue to be eligible for disability benefits. The Social Security Administration (SSA) must review individuals with non-permanent disabilities at least once every three years. SSA must also review individuals with permanent disabilities and individuals who have returned to work. The regulations governing CDRs are found here for SSI recipients and here for SSDI recipients. 

2. What is “medical improvement”?  

The Medical Improvement Review Standard (MIRS) is the legal standard for determining if disability continues in a CDR. SSA will compare the recipient’s current medical condition with their condition as of the most recent favorable decision date, which is called the comparison point date (CPD).

Generally, to terminate benefits under this standard, SSA must: 

1. Determine that there has been medical improvement (MI) (e.g., decrease in medical severity)[i] in any impairment(s) present at the CPD, and
2. Determine that such medical improvement is related to the ability to work. The MI will be considered related to the ability to work if the individual no longer meets or equals the listing under which they were found disabled or there is an increase in the individual’s Residual Functional Capacity (RFC) (i.e., ability to perform work-related tasks). 

3. Is a CDR for children the same thing as an age 18 review?​

• SSA uses the medical improvement review standard for CDRs for children under age 18[ii].
• However, child SSI beneficiaries turning 18 years old will instead be reevaluated to determine whether they meet SSA’s disability eligibility criteria for adults, also known as age 18 redetermination.
• The timeframes for child reviews are different than for adults. SSA will notify a recipient that a review has begun and will invite the recipient to submit evidence of continuing disability.

4. Are there any exceptions to MI?

There are two groups of exceptions to MI.

1. Group 1: There are certain limited situations when an individual’s disability can be found to have ended even though no medical improvement has occurred.
   1. Substantial evidence shows that they are the beneficiary of advances in medical or vocational therapy or technology related to the ability to work and are now able to engage in gainful SGA.
   2. Substantial evidence shows that they have undergone vocational therapy related to the ability to work and are now able to engage in SGA.
   3. Substantial evidence shows that, based on new or improved diagnostic techniques or evaluations, the individual’s impairment is not as disabling as it was originally thought and that the individual is now able to engage in SGA.
   4. Substantial evidence shows that the prior decision was in error.
2. Group 2: These exceptions may result in a determination that an individual is no longer disabled, even absent a determination that the person has medically improved or can engage in SGA. These exceptions may be considered at any point in the evaluation process.
   1. A finding that a prior determination was fraudulently obtained, or
   2. The individual fails to cooperate with the re-evaluation; or
   3. The individual cannot be located; or
   4. The individual fails to follow prescribed treatment, which is expected to restore ability for SGA. 

5. Does the CDR follow a sequential evaluation analysis similar to the initial application for SSI and SSDI benefits? 

6. When do benefits terminate? 

If benefits are terminated because of SSA’s re-evaluation, recipients must receive written notice of the decision, including an explanation of the grounds for the decision, the month in which benefits will end[iii], an explanation of appeal rights, and notice of the right to request benefit continuation pending appeal. 

7. Can you continue to receive benefits during an appeal?

Yes, at both the CDR Reconsideration and ALJ levels. With CDR termination due to a medical determination, recipients may elect to continue to receive disability benefits pending a Reconsideration or ALJ decision.

• To receive Aid Paid Pending, the appeal and the request to continue benefits must be filed within 15 days of the date of the notice, (i.e., 10 days from the date on the notice, plus 5 days for mailing), unless there is a good cause.
• If someone misses the 15-day deadline without good cause at the Reconsideration stage, they can request benefit continuation pending the ALJ decision, and benefits will begin again as of the date of the Reconsideration determination.
• If the ALJ later affirms the termination of benefits on medical grounds, the losing claimant will be charged with an overpayment. 

8. Is there anything you can do as the representative to waive an overpayment of continued benefits?

9. Our SOAR Program does not perform appeals or CDRs. How should we proceed in these cases?