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Social Security: Continuing Disability Reviews

Return To Work And Continuing Disability Reviews

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The fact that a person works, in and of itself, is not supposed to trigger a Continuing Disability Review (CDR).

The law also "immunizes" from CDRs people whose work attempts are part of an Individualized (return-to-) Work Plan approved by a state vocational rehabilitation department or a similar private Employment Network under the Ticket to Work law. Individualized (return-to-) Work Plans can last up to 60 months.

  • During the first 24 months, you do not need to work at all.
  • During months 25-36, you must earn above Substantial Gainful Activity level for at least 3 months only.
  • During months 37-48, Substasntial Gainful Activity earnings must be reached for only 6 out of 12 months.
  • During months 49-60, earnings must finally push you over Supplemental Security Income or Social Security Disability Insurance levels.

Even though CDRs are suspended during successful Individualized (return-to-) Work Plans, working can still bring greater scrutiny and a CDR by the DDS if you return to work without first getting your work attempt approved by Vocational Rehabilitation or an Employment Network. Only their sign-off will bring you immunity from a CDR.

If the DDS determines that you're not disabled anymore, you'll lose your SSDI or SSI. Even worse, if the DDS finds that you're no longer disabled you'll lose your right to Medicare or Medicaid too -- even if you've already given up SSDI or SSI to work and you only need the Medicare or Medicaid alone!

So a good way to "immunize" yourself from being declared "not disabled enough anymore" by the DDS --and losing your SSDI, SSI, Medicare or Medicaid--- is by signing an Individualized (return-to-) Work Plan with your state's vocational rehabilitation program or a local Employment Network. Check under "vocational rehabilitation" or "rehabilitation" in the state government section of the telephone book for state vocational rehabilitation agencies. For employment Networks serving your area which can service persons with your particular disability, call 866.968.7842.

Individualized (return-to) Work Plans can and do offer protection from CDRs for many months before substantial time in training, classes or job placements have to be finally committed to or engaged in. This is important for protecting your benefits from a possibly threatening CDR if, in fact, you don't feel completely ready to work because of your health, or if you discover (as is true in many states) that the vocational rehabilitation or Ticket Employment Network programs are geared exclusively to mentally retarded or mentally ill people and only offer training and placement in menial jobs. A person who has already begun an Indiviaulized (return-to-) Work Plan with a state vocational rehabilitation program or Ticket To Work Employment Network on the day a CDR finds that he supposedly stops being disabled is "immune" from being dropped from SSDI, SSI, Medicare or Medicaid. Again, this is so even if the DDS or Social Security declare him to be "no longer disabled". This immunity lasts as long as a person's Individualized (return-to-) Work Plan with the vocational rehabilitation agency or the Ticket to Work Employment Network is in effect (up to 60 months).

The Ticket to Work law can even protect continuing Medicaid for patients whose remissions have, in fact, left them "no longer disabled enough anymore" - but only if their state specifically elects to allow such coverage as a sub-option under a wider federally-offered option to extend Medicaid to working disabled people with incomes above regular SSI and Medicaid levels. Only a few states-- Arizona, Colorado, Indiana, Kansas, Pennsylvania and Washington --- have taken this sub-option, however.

Still another way to protect against being declared "not disabled enough anymore" is to make sure that your continuing health problems, symptoms and their effects on your daily activity capabilities is fully written-up in your doctor's notes and records. It also helps if the doctor's records are supplemented by your own and your loved ones' personal diaries, datebbooks and medical logs. Careful record-keeping by the patient, the patient's doctor and the patients loved ones in their own contemporaneously written letters, diaries, datebooks and journals can document the many small, often-un-noted ailments which can support a finding of continued disability: For example, it helps to note symptoms which can help determine disability such as:  Flu-like symptoms, exhaustion, sleep disorders, unsteady gait, numbness, pain, skin problems, anxiety, depression, digestive and cardiovascular abnormalities, mental confusion and inability for focused and concentrated thought..

Such strengthened medical and personal records (and supporting statements from loved ones too) can then be submitted to SSA and the DDS when and if they order a CDR.

The information in this section was provided as a courtesy by Thomas McCormack, author of The AIDS Benefits Handbook (Yale University Press)


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