What if I have been awarded benefits and Social Security later decides to review my case?

Receiving a letter in the mail stating that Social Security is going to review your medical condition after you’ve been awarded benefits can by scary.  Our office receives many phone calls each week from individuals in receipt of such letters asking why their case is being reviewed and how the review process works.

Social Security is required by law to review the medical condition of all people receiving disability benefits from time to time to make sure they are still disabled.  As a general rule, if your health has not improved, or if your disability still keeps you from working, you will continue to receive benefits.

To assist in making the determination, Social Security will gather new information about your medical condition.  This means they will ask your doctors, hospitals, and other medical sources for your medical records. Social Security will also ask them how your medical condition limits your activities, what your medical tests show, and what medical treatments you have received.  If more information is need, Social Security will pay for and ask you to go to a special examination.

After gathering new information, Social Security looks at what your medical condition was when your case was last reviewed and any new health problems you may have.  At this point, a decision is made about whether your medical condition has improved.  If it has, a decision is made about whether your medical condition has improved enough to allow you to work.  Social Security will also consider whether your overall medical condition affects the kind of work you can do.

If Social Security decides you can work, your benefits will stop.  Your disability benefits also will stop if:

  • Social Security decides a mistake was made in an earlier decision to give you or continue your disability benefits.
  • You are not following the treatment your doctor ordered (without a good reason), and you probably could work if you followed the treatment.
  • You gave Social Security false or misleading information regarding an earlier decision.
  • You are not cooperating with Social Security, and you do not have a good reason for not cooperating.
  • You are working and your average monthly earnings show that you are doing substantial gainful work.

If Social Security decides your disability benefits will stop, and you disagree, you can appeal the decision. That means you can ask Social Security to look at your case again. When you get a letter telling you about the decision, the letter will tell you how to appeal.