There have been so many posts recently from people who have begun to worry about their CDR before the ink is even dry on their Award letter. For many this is because they were approved for something different than what they thought their worst disability to be. For others it is because of the Medical Improvement diary.
Whatever the reason, worry will do you more harm than good. So we asked Different Perspective to tell you a little more about the CDR process. For those of you that don't know, Different Perspective was once a DDS examiner, so his insight is a great asset to our members. And, I believe this article will help alleviate some of your worries and anxiety. I know you will all join me in thanking him for the time he took to write this for everyone:
Fear is an amazing thing. It can save lives – think fight or flight. It can paralyze and kill – think deer in the headlights. It can eat one alive – think ulcers.
There are two ways to overcome fear: knowledge and action. There has been a noticeable increase in the number of posts dealing with the fears of the CDR process. I have wanted to offer some ideas but was stopped by my fear. Fear that the post would be too long, fear that I could not be able to make the very technical process simple enough to be understood. Recently a private email prompted me to address my fears. I have done a little research and am now ready to take action.
Let’s start with the basics. There is absolutely nothing that could be better for the disabled than to have health restored and be able to live a normal life. Fortunately, each year there are new medical treatments that dramatically improve health. All disabling conditions are not permanent and, fortunately, many people whose conditions met the SSA standard of disability yesterday have their health improved and are able to return to gainful employment.
Someone who meets a Listing for kidney failure may receive a new kidney that functions near normal. Should the people who pay the SSDI premium, or the taxpayer at large, who pays for SSI payments, continue to give money to people who can work? Congress, and I dare say, most citizens do not think so. Because of this Congress mandated the CDR (Continuing Disability Review) process, a program designed to identify those whose condition had improved to the point that they can now work.
In the past there were atrocious examples of, mostly mentally disabled, people who were cut off but who, obviously, were incapable of gainful employment. This is ancient history and will not be discussed except to say that Congress stepped in and had SSA implement the MIRS or Medical Improvement Review Standard. That standard acknowledged that the beneficiary/recipient of a SSDI/SSI check was disabled at the time they were allowed and that the only way benefits could be ceased was through due process.
Under MIRS, a person would not have their check stopped unless there was demonstrated medical improvement of the condition(s) that caused the person to be considered disabled in the first place. In addition, that improvement must be related to the ability to perform work related tasks. (A person who weighed 400+ pounds when allowed but had bypass surgery and only weighed 300 pounds at the CDR had medical improvement but did it really affect the ability to perform work tasks?) It should also be noted here that to receive benefits, the applicant must prove the disabling condition meets SSA standards. The CDR process requires SSA to prove the person is no longer disabled. The burden of proof shifts from the person receiving a check to the SSA.
There is much concern about why an applicant is allowed – the fact that the applicant alleged one condition and was allowed for another. For reasons of efficiency, both to reduce processing costs and to get a check to the disabled as quickly as possible, SSA, through the State Agency, stops development of a case as soon as a fully favorable decision can be made. See https://secure.ssa.gov/poms.nsf/lnx/0424505030
If SSA cannot prove the condition(s) that originally determined as disabling has not shown medical improvement related to the ability to perform work related tasks then development is stopped and the check is continued.
If the condition(s) that originally allowed has improved, other steps must be taken before the check can be stopped. See https://secure.ssa.gov/poms.nsf/lnx/0428005010
for the CDR Sequential Evaluation process. Basically, if one gets through medical improvement state, the case proceeds like an initial case.
Questions have been asked about subsequent medical conditions that have arisen and how this will affect the CDR process. In most cases the new condition(s) will have absolutely no affect on the process. Why? Because SSA will not be able to show medical improvement related to the ability to perform work activities in the original condition(s) that caused the person to meet SSA standards of disability. If, and only if, the original condition(s) are proven to have improved will the new condition(s) be considered.
Another item of concern is the expected date of the CDR. There have been other posts that explained the three basic diaries: 1 year, 3 years, or 7 years. This post will not rehash that. What will be stated is that a diary date does not mean a CDR will be done when the diary date is reached.
Congress allocates money in mysterious ways. Studies have shown that if as few as 5% of CDR’s result in cessation of benefits the entire CDR process is paid for from savings resulting from the reduced number of checks being sent out. Despite this, Congress continuously fails to allocate enough money to process CDR’s on all of the expired diaries. There appears to be no rhyme or reason to explain which cases do, or do not, get examined on a given diary date.
I am aware of cases where the ALJ expected medical improvement and placed a one year diary on the case but it was not reviewed for 15 years. Talk to disability examiners or adjudicators any they will tell you it is not uncommon to receive a case from SSA where no CDR has been done for 20, or 25 years and the person is now over 60 years of age. If, in such a case , medical improvement can be proven, this person will have no prior work history (only the most recent 15 years is considered) and the person will probably GRID out.
The last fear to be addressed is medical treatment – how much is enough? Back to the basic preaching. One should go to a medical provider for only reason – that is to improve one’s health. Anyone who is going to a medical provider to receive, or keep receiving benefits is hurting themselves. Anyone who is not completely honest with his/her medical provider is hurting themselves. Get the treatment you need – no more, no less. Some conditions can only be maintained, and if stable treatment is only needed periodically. Some conditions need frequent and visits to a treating source. How often one receives treatment or medical care is a decision to be made by the treating source and the patient, not by SSA.
Do not fear the CDR process, embrace it. My prayer for each and everyone who receives SSDI or SSI is to find the magical cure and become capable of resuming work. Obviously this is not going to happen for most people but wouldn’t it be great if you were the one for whom medical improvement occurred and you were able to go back to work?
In the mean time do not worry about things that probably will not happen and which you cannot control anyway. Type the following and put it on your mirror to read every day.
God grant me the serenity to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.
Living one day at a time;
Enjoying one moment at a time;
Accepting hardships as the pathway to peace;
Taking, as He did, this sinful world
as it is, not as I would have it;
Trusting that He will make all things right
if I surrender to His Will;
That I may be reasonably happy in this life
and supremely happy with Him
Forever in the next.