Social Security Disability Reviews and CRPS or RSD
How can you prepare for a Social Security Disability Review?
Did you know even you were going to BE reviewed periodically?
Well if you didn't, get prepared. If you did, or you have then these guides may make your work a little easier.
I recently had a periodic review and I was checking on a question I had and did what everyone does now when they have a question, Google! Or Bing, or ASK.com or whichever search engine you prefer. I remember when I was little and didn't know the answer to a homework question or how to spell a word. I would ask my mom and she would say, "Look it up." We would pull out the dictionary and look it up." For all of you out there under the age of 45, before the age of computers there were these things called B-O-O-K-S and every home had a very, very thick one called a DICTIONARY. You could look up how to spell words and find their meanings. Yes, you actually had to "look up" how to spell words at one time, there was NO spell check! OMG! The hardest part was looking up how to spell a word you didn't know how to spell! ummm, Mom? How do you spell rime? Or sity? It could give you fits if you were ritinga paper and having to site all of your reffrnces. whew!
But I digress.
On a website called DisabilitySecrets.com they have wonderful information on preparing for your SSD Reviews which can be found here.
Here is the introduction to this section which describes the two different types, a short form and a long form and what the difference is between the two.
according to their website …
Every few years, depending on the severity of your disability and the likelihood that your medical condition will improve, the Social Security Administration (SSA) will notify you that it's time for your continuing disability review for your SSDI or SSI benefits.
It would be difficult to actually prepare in advance for a continuing disability review (CDR). This is simply because the cessation or continuance of your benefits is based entirely on your medical records (unless a cessation occurs following a SSI redeterminaton, for non-medical reasons such as too much income or assets).
You simply fill out the form the SSA sends you, and if the agency needs more information, it will request medical records from your doctor. In some cases, the SSA may send you for a consultative medical exam or test.
Why might the SSA send you the short form instead of the long form? According to DisabilitySecrets.com;
again, according to the DisabilitySecrets.com website;
If the SSA send you the short form, SSA-455-OCR-SM (Disability Update Report), it is not expecting that you've had any medical improvement, and the form's purpose is to catch any changes in your circumstances.
Typically for those of you who are on permanent SSDisability, if the SSAdministration is not expecting there to be any change in your medical condition they will send you out one of the short forms, the SSA-455-OCR-SM (OCR simply means it is Optical Character Recognition, optically scanned by the SSA). Be sure to fill out all your SSA forms with a number 2 pencil or a BLACK INK PEN not a blue ink pen. If the short form raises any Red Flags then they will do a full medical review. What would raise a Red Flag?
Let's go to the DisabilitSecrets.com website!
Red flags might be:
- entering earnings above $1,040 per month (the SGA amount)
- checking the box "my doctor told me I can work"
- checking the box saying your health is "better" than it was at your last review or approval, or
- saying you haven't visited a doctor since your last review or approval.
What if the SSA sent you the Long Form?
If the SSA sent you the long form, SSA-454-BK (Continuing Disability Review Report), the agency is doing a full medical review because it anticipates that your condition may have improved. One purpose of this form is to discover if you have visited a doctor, been hospitalized, or had any medical tests in the past 12 months. If you have, the SSA will request medical records from the doctors and institutions you include on the form. You are encouraged to submit any updated medical evidence to the SSA even though the SSA may also obtain this on its own (only if you were sent the long form, SSA-454. In general, the SSA will be reviewing the period of 12 months prior to the notice, although the agency can look at evidence from any time after you were initially granted benefits.
To get more information on both the Long and the SHort Forms please visit the DisabilitySecrets.com website or you can go to the SSA website directly.
SUBSTANTIAL GAINFUL ACTIVITY
Many of you might ask what is SGA, Substantial Gainful Activity, as far as the Social Security Administration is concerned?
This is a key question when it comes to filling out these forms.
In evaluating whether you are disabled, the Social Security Administration (SSA) will first look to whether you are currently working. If you are working part-time and not earning much money, you won't necessarily be denied disability benefits, but doing a substantial amount of work (such as working full-time) guarantees that you'll be denied benefits. Here's why.
As part of its definition of disability, the SSA requires that a disability claimant (applicant) be unable to perform what it calls substantial gainful activity (SGA). - ( again, from DisabilitySecrets.com )
What Is Substantial Gainful Activity?
Substantial gainful activity is generally work that brings in over a certain dollar amount per month. In 2013, that amount is $1,040 for non-blind disabled applicants, and $1,740 for blind applicants. If you are making more than that amount per month, the SSA figures that you must not be disabled (in their words, that you "are able to engage in competitive employment in the national economy"). In deciding whether you are doing SGA, the SSA does not include any income you obtain from non-work sources, such as interest, investments, or gifts.
There is more in this section on SGA and I suggest you visit this page of their website to read it as well as read their main page to see what else they offer that might interest you - DisabilitySecrets
The SSA is not trying to trick you by asking you these questions, not on your original application nor on any subsequent follow-up forms folks. it is a matter of making sure that those of us who are truly disabled are getting the SSD benefits and Medicare that we are entitled to as well as ensuring that those people who should NOT be getting them do not.
We have all seen those episodes on the news shows where people who are collecting W.C. or SSDisability are out working on top of houses, shingling roofs, or moving furniture, or doing all manner of ridiculous things and then they show them stepping out of the car at their Drs office where they suddenly put on their neck brace and start limping through the door as if they suddenly contracted the worst case of five herniated discs you ever saw in your life. We know how mad it makes us and we wonder how they get their benefits and remember how hard it was to get ours. Well, eventually the SSA catches up to those guys and gals through these forms.
We hope this has helped!
- American RSDHope