Is It Possible to Lose Social Security Disability Benefits Once You Are Approved?

Getting approval for Social Security Disability Insurance (SSDI) benefits is no small feat. For most applicants, the approval process is long and arduous, taking years in some cases. Once this hurdle is crossed, believing the hard part is over and regular income is secure would be a natural assumption. However, the Social Security Administration (SSA) does revoke and cancel benefits for some recipients under certain circumstances. The loss of these benefits is devastating and can come with little notice. Hundreds of disabled individuals living in the coal mining regions of Appalachia are currently dealing with the suspension of their SSDI benefits related to a fraud probe of the attorney who filed their disability claims. They are now forced to reapply for benefits, with the added burden of the SSA assuming their claims are false. While this is a unique situation that most SSDI recipients will not face, understanding how the SSA maintains and reviews the files of current SSDI recipients, as well as when the SSA will suspend payment, is important information anyone seeking SSDI benefits should know.

Periodic Reviews

The SSA is required to conduct “continuing disability reviews” for all recipients receiving SSDI benefits on a regular basis. These reviews are used to determine if someone no longer meets the definition of disabled under SSDI guidelines. If the SSA believes an individual is capable of returning to work because of improvements in his/her condition, benefits will end.

The frequency of these reviews depends upon the medical condition and the likelihood of improvement. If improvement is expected within a short period of time, the review will occur six to eighteen months after payments begin. For those with conditions where improvement is possible, the reviews are approximately every three years, and for conditions with little likelihood improvement, the reviews are every five to seven years.

Other Triggering Events and Payment Stoppage

In addition to periodic reviews, a review will also be triggered if the SSA learns that any of the following circumstances exist:

• the recipient returned to work;
• the recipient tells the SSA his/her condition improved;
• medical evidence indicates the recipient’s condition has improved;
• a third party notifies the SSA that the recipient is not following treatment protocol; or
• a new treatment for a condition is now available.

Once the review is complete, a letter is sent to the SSDI recipient informing him/her whether benefits will continue. If benefits are to be suspended, the person is entitled to appeal, during which time benefits will continue if timely requested. If no appeal is filed, benefits stop three months after the SSA decides the disability is no longer present. Note, however, that allegations of fraud result in the stoppage of benefits immediately until the individual can prove a qualifying disability exists.

Appealing Suspension

While recipients who are cut off do have the right to appeal, the timelines to request a continuation of benefits (10 days at each stage) are extremely short, so paying close attention to all documents sent by the SSA is crucial. Once someone receives notice that benefits will stop, he/she must ask for reconsideration within 60 days. If the reconsideration is denied, the person must again request a continuation of benefits and ask for a hearing in front of an administrative law judge. Further appeals are available beyond this stage, but are unlikely to be successful, and importantly, benefits will not continue, unless the case is sent back for a new hearing. Further, the SSA will demand repayment for benefits paid during the appeals process if the recipient is unsuccessful in his/her efforts to restore SSDI.

Talk to a Disability Insurance Attorney

Dealing with the potential loss of SSDI benefits is not a process you should face alone. The rules are very complicated and easily misunderstood, which, if not followed, can lead to devastating consequences. Working with an experienced disability law firm, like Farrell Disability Law, will give you a much greater chance at keeping SSDI benefits and avoiding any stoppage of payments. Farrell Disability Law represents clients throughout Florida and South Georgia, and can help you keep or obtain the disability benefits you need. Contact us for a free consultation.

Resources:

detroitnews.com/story/news/nation/2017/01/03/disability-social-security-fraud-probe/96095004/

ssa.gov/pubs/EN-05-10153.pdf