What the Social Security Administration Calls a Reexamination
The Social Security Administration does not use the term "reexamination" for SSDI. Instead, it calls the process a Continuing Disability Review (CDR). This is the official name Social Security uses when it checks whether you still meet the medical requirements to receive SSDI benefits.
A CDR is a periodic review of your case file. Social Security sends you a letter telling you that you have been selected for review, and you must provide updated medical evidence showing that your condition has not improved enough for you to work. If you do not respond or if Social Security determines you no longer may have access to, your benefits can stop.
The term "reexamination" might appear in some older documents or in informal conversation, but the official process name is always Continuing Disability Review. When you receive mail from Social Security about your case being reviewed, the letter will use the term CDR or will say your case is being reviewed to see if you still may have access to.
Key Takeaways
- Social Security officially calls a reexamination a Continuing Disability Review, or CDR, which is the term used in all official letters and notices.
- A CDR happens on a schedule set by Social Security based on how likely your condition is to improve, ranging from every three years to every seven years.
- You must respond to a CDR notice within the important date given in the letter, usually 10 days, or your benefits will stop automatically.
- Social Security will ask for medical records, treatment history, and sometimes will schedule you for a medical exam to determine if you still may have access to.
How Often Social Security Schedules a CDR
Social Security does not review all SSDI cases on the same schedule. Instead, it assigns each case to one of three review cycles based on how likely your medical condition is to improve over time.
Cases assigned to a medical improvement expected cycle are reviewed every three years. These are typically conditions that often improve with treatment or time, such as some back injuries or mental health conditions that respond well to medication. Cases assigned to a medical improvement possible cycle are reviewed every five to seven years. These are conditions that might improve but usually do not, such as some forms of arthritis or chronic pain. Cases assigned to a medical improvement not expected cycle are reviewed every seven years or longer. These are typically permanent conditions like total blindness or severe cognitive impairment that are very unlikely to improve.
You will not know which cycle your case is on until you receive a CDR notice in the mail. The notice will tell you the reason for the review and what information Social Security needs from you.
What Happens When You Receive a CDR Notice
When Social Security sends you a CDR notice, it will include a specific important date for you to respond. This important date is usually 10 days from the date on the letter. The notice will ask you to provide medical records from your doctors, hospitals, or clinics that show your current condition and any treatment you are receiving.
You should gather records from all providers who have treated you since your last review or since you began receiving SSDI. Include records from your primary care doctor, specialists, mental health providers, and any emergency room visits or hospital stays. If you have had surgery, imaging tests, or lab work, include those records as well.
You can send the records yourself by mail to the address on the notice, or you can ask your doctors' offices to send them directly to Social Security. Many offices will do this at no cost, though some may charge a small fee for copying. If you miss the important date, you can still send records, but Social Security may make a decision without them, which could result in your benefits stopping.
Medical Exams During a CDR
Sometimes Social Security will schedule you for a medical exam as part of the CDR process. The agency will pay for this exam and will send you a notice telling you the date, time, and location. The exam is usually performed by a doctor or psychologist who works for Social Security, not your own doctor.
You must attend the exam. If you do not show up without a valid reason, Social Security may assume you no longer have a disabling condition and may stop your benefits. If you cannot attend on the scheduled date, call the number on the notice as soon as possible to reschedule. If you have a medical reason you cannot travel or attend in person, tell Social Security in writing before the exam date, and ask about a telephone or video exam instead.
The exam is not a test you can pass or fail. The doctor will examine you, ask about your symptoms and how they affect your daily life and work, and may perform tests related to your condition. The doctor will write a report that goes into your case file, and Social Security will use this report along with your medical records to decide whether you still may have access to for benefits.
What Social Security Decides After a CDR
After reviewing your medical records and any exam results, Social Security will send you a written decision. The decision will say one of three things: your benefits will continue, your benefits will stop, or your benefits will continue at a reduced rate.
If Social Security decides your condition has improved enough that you can work, it will stop your benefits. The notice will tell you the date your benefits end and will explain your right to appeal. You have 60 days from the date on the notice to file an appeal if you disagree with the decision.
If Social Security decides your condition has not improved, your benefits will continue. You will receive a notice confirming this and telling you when your next CDR will be scheduled. If your benefits are stopped and you later become unable to work again, you can file a new SSDI claim, but you will have to go through the full process process again.
What to Do If Your Benefits Are Stopped
If Social Security stops your benefits after a CDR, you have the right to appeal the decision. You must file your appeal within 60 days of the date on the notice. There are four levels of appeal: reconsideration, hearing before an administrative law judge, Appeals Council review, and federal court.
At reconsideration, a different Social Security employee will review your case and the evidence you submit. You can send new medical records or other evidence that shows you still have a disabling condition. Many people hire a lawyer or representative at this stage, especially if they plan to request a hearing. A lawyer can charge a fee only if you win your case, and the fee is limited by law to 25 percent of your back pay, up to a maximum amount set by Social Security each year.
If you continue to work while your appeal is pending, you may be able to earn money without losing benefits under a program called Expedited Reinstatement. This program allows you to get your benefits back quickly if you try to work and find that you cannot sustain work because of your condition. You have 60 months from the date your benefits stopped to use this program.
How to Prepare for a CDR
The best way to prepare for a CDR is to keep your medical records organized and current. See your doctors regularly and make sure they document your symptoms, limitations, and how your condition affects your ability to work. If your condition has worsened or you have new symptoms, tell your doctors and ask them to note this in your medical record.
When you receive a CDR notice, do not ignore it. Mark the important date on your calendar and start gathering records when ready. If you have a representative or lawyer helping with your SSDI case, send them a copy of the notice right away. If you do not have a representative and think you might need one, you can contact a lawyer or a non-lawyer representative who specializes in SSDI cases.
Keep copies of everything you send to Social Security. Write down the date you mailed the records and keep the mailing receipt. If Social Security later says it did not receive something, you will have proof that you sent it. If you send records by mail, use certified mail with return receipt so you have proof of delivery.
Frequently Asked Questions
Can I work while my CDR is pending?
Yes, you can work while your CDR is being reviewed. Your benefits will continue until Social Security makes a decision. However, if you earn more than the monthly limit set by Social Security (called substantial gainful activity), it may affect your case. Tell your doctor about any work you are doing so they can document whether you are able to sustain it.
What if I cannot find all my medical records?
Send whatever records you have by the important date. Contact your doctors' offices and ask them to send records directly to Social Security if you cannot get them yourself. In your response to Social Security, explain which records you could not obtain and why. Social Security can sometimes request records from your providers on your behalf.
Do I have to attend the medical exam if I have my own doctor?
Yes, you must attend the exam Social Security schedules. Social Security needs an independent medical evaluation as part of the CDR process. Your own doctor's records are important, but the exam by Social Security's doctor is required. If you cannot attend, contact Social Security when ready to reschedule.
How long does a CDR usually take?
A CDR typically takes three to six months from the time you receive the notice until Social Security sends you a decision. If Social Security schedules a medical exam, it may take longer. If you file an appeal, the process takes much longer — reconsideration alone can take several months.
What happens to my Medicare or Medicaid while my CDR is pending?
Your Medicare or Medicaid coverage continues while your CDR is being reviewed. If your SSDI benefits are stopped, your coverage may end or change depending on your state and your other circumstances. Social Security will send you separate notices about any changes to your health coverage.