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How the SSA decides if disability benefits should continue

| Sep 11, 2015 | Social Security Disability Benefits

When seeking or receiving Social Security Disability (SSD) benefits in Los Angeles, it is important to remember what qualifies as a disability. In many instances, the individual can improve sufficiently to no longer need the benefits. This is why the Social Security Administration (SSA) will conduct a review for certain claimants to make certain that the benefits are still required. Knowing how the SSA decides on whether the benefits should continue is key.

It is a legal requirement that the SSA periodically review those receiving benefits to make certain they are still disabled. If the illness or condition has not improved or if the claimant cannot work, the benefits will continue. When the review is underway, the SSA will accrue various pieces of information about the claimant’s medical condition. This will include asking medical professionals and going through medical records, looking for the current status of the illness or condition. If there is a need for more information, a special examination will be required, but the SSA pays for this.

The medical condition and meeting the medical requirements from the previous time the case was up for review will be studied. There might be new health problems that have arisen, and these too will be taken into account. A decision will be made as to whether the condition has improved. If it has, a decision will be made as to whether it has improved enough for the claimant to go back to work. The medical condition could also influence the kind of work the claimant can do.

The benefits will also stop if the following circumstances are in place: if advancements in medical treatment or vocational training have allowed the person to work; if there was a mistake in the earlier decision and benefits should not have been approved; if the claimant has not followed the treatment protocol; if the information provided originally was false or misleading; if there is a lack of cooperation with the SSA and no good reason for it; and if the claimant is working and the wages surpass the amount that is the average per month for substantial gainful work. Under federal regulations, it is allowable for claimant who disagrees with the decision to stop benefits to appeal that decision. With the review and the possible appeal, it is wise to have help from a legal professional.

Source: SSA.gov, “How We Decide If You Are Still Disabled,” accessed on Sep. 7, 2015

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