A Social Security review checks medical or work changes and decides if benefits continue using forms, records, and clear rules.
Worried about your next checkup from Social Security? This guide shows how the continuing review process runs, what letters and forms show up, and who looks at your file. You’ll see timelines and what to send.
How A Social Security Disability Review Works Step By Step
Social Security runs two main reviews. A medical review asks whether your condition still meets the rules. A work review asks whether your earnings show steady work above the allowed level. The agency places every case in a diary group that sets how often checks return.
| Review Type | What Triggers It | What You May Need |
|---|---|---|
| Medical CDR | Routine diary date or new evidence | Form SSA-454-BK or short SSA-455, treatment updates, doctor contacts |
| Work CDR | Earnings reports, W-2/1099 data, or a tip that you worked | Form SSA-821 (employee) or SSA-820 (self-employed), pay records, hours, duties |
| Ticket To Work | Voluntary program while you test work | If “in use” and making progress, medical CDRs pause during ticket use |
What Letters And Forms Mean
Most medical reviews start with a short mailer called the Disability Update Report (SSA-455). It asks about treatment, meds, and any work since the last decision. If answers hint at change, or if your case is due for a full look, you’ll receive the longer Continuing Disability Review Report (SSA-454-BK). That one collects clinics, doctors, tests, and daily limits so the agency can order records straight from your sources.
Work reviews use the Work Activity Report (SSA-821 for employees or SSA-820 for people who file self-employment). These ask about pay, hours, unpaid help, and job duties so the reviewer can sort out trial work, special conditions, or subsidies that might lower countable earnings.
Where These Forms Live Online
You can read the full SSA explanation on the agency site. The POMS also details the three diary groups and timing. PDFs for the SSA-454-BK and SSA-821 are posted on ssa.gov/forms. Each file opens as a PDF online.
Who Looks At Your File
The first stop is your local office, which gathers forms and basic facts. For medical reviews, the file goes to a state Disability Determination Services unit. A medical or psychological consultant signs off with the examiner. For work reviews, an SSA claims specialist evaluates pay, applies work incentives, and checks months that count.
Medical Diaries And How Often Reviews Come Back
At the last approval, the agency set a medical diary. That diary predicts how likely change is. If improvement is expected, a check may come back in six to eighteen months. If change is possible, the cycle is usually about every three years. If change is not expected, the range is five to seven years. These ranges guide timing, but the agency can act sooner if new facts arrive.
What Reviewers Look For In A Medical Check
Reviewers compare today’s records to the comparison point decision, which is the last time you were found disabled. They ask one big question: did your medical condition improve in a way that increases your ability to work? They also check whether you still meet a listing, whether limits still prevent steady work, and whether any therapy, surgery, or assistive device changed your function.
How A Work Review Runs
A work review looks at earnings after your start date. The reviewer checks months of trial work, extended eligibility, and whether countable pay reaches the level that shows steady work. For people who are self-employed, the test uses countable income and the time you spend on the business. Special conditions and subsidies can lower countable pay when someone else’s help or job carving is present.
Many people join the Ticket to Work program to try jobs with coaching. While a ticket is “in use” with an approved provider and you make timely progress, SSA does not start a medical review. The work review can still run, since it tracks earnings, but the medical check pauses.
What To Send So Your Review Stays Smooth
Respond to letters by the due date. Fill each section. If a question does not apply, write “none.” List every clinic, doctor, therapist, and pharmacy since the last decision. Add dates, tests, and any emergency room visits. Include releases so records can be pulled without guesswork.
For work checks, gather pay stubs, employer letters, a duty list, and notes on help you receive on the job. For self-employment, include invoices, ledgers, Schedule C pages, and a log of time spent running the business. Keep copies of everything you send.
What Happens During The Review
After forms arrive, the reviewer orders records. Some cases close with the paper file. Others need a consultative exam to fill a gap. If the examiner sets an appointment, show up and bring a list of meds and a photo ID. If you miss it, call right away to reschedule.
When the file is complete, the reviewer writes a comparison to the last approval. The outcome letter will say benefits continue, benefits end after the appeal window, or benefits pause due to work. If payments end for medical reasons, checks can keep going during appeal if you ask within the first deadline.
Timeline: From Letter To Decision
There’s no single clock, but a short mailer that shows no change can clear in weeks. Full medical checks often take a few months because clinics need time to send records. Work reviews range from a few weeks to longer if the case involves self-employment or many jobs. You can help by sending complete contacts and prompt updates.
Rights, Appeals, And Payments During Challenge
If you disagree with a medical decision, you can ask for reconsideration by the deadline on your notice. If you appeal within the time window and choose to keep checks going, any overpaid months may have to be repaid if the decision is later upheld. If reconsideration does not resolve it, you can ask for a hearing and then Appeals Council review.
Keeping Benefits Going While You Appeal
For medical cessations, you can ask to continue checks during the first appeal. For work cessations, payments can start again if countable earnings drop below the allowed level during the extended period. Read the dates and options on the letter and reply in writing.
How Ticket To Work Interacts With Reviews
Assigning your ticket to an approved provider can pause medical checks while you make timely progress. This gives room to train or try jobs without a fresh medical look hanging over you. If progress slips, the pause can end, but it can restart once progress resumes and the ticket is back “in use.”
Common Reasons Reviews Stall
Missing forms, wrong provider details, or old addresses push cases back. So do no-shows for consultative exams. The fastest reviews are the files with complete doctor lists, treatment dates, and clear work records. Keep a simple folder with meds, recent imaging, and therapy notes so you can respond fast when a letter arrives.
Smart Prep Checklist
For A Medical Check
- List every provider since the last decision, with phone, fax, and address.
- Note tests, imaging, surgeries, and therapy dates.
- Describe daily limits in walking, sitting, lifting, memory, or pace.
- Send releases so records can be ordered without delay.
For A Work Check
- Gather pay stubs, W-2/1099s, and any job coach notes.
- Write a short duty list, hours, breaks, and any help on tasks.
- For a business, pull bank statements, invoices, and a time log.
- Tell SSA about subsidies or special conditions that lower countable pay.
Outcomes And What They Mean
| Outcome | What SSA Checks Next | Your Next Step |
|---|---|---|
| Benefits Continue | Diary set for the next cycle | Keep treatment and report address changes |
| Medical Cessation | Improvement tied to work ability | File reconsideration and choose whether payments continue |
| Work Cessation | Countable pay above the level after trial work rules | Send proof of subsidies or lower earnings; ask about restart rules |
Realistic Expectations About Evidence
Reviewers give the most weight to treatment notes, imaging, test results, and third-party statements from clinics or employers. Personal letters help fill gaps, but medical and work records carry the decision. Clear timelines with dates and sources make the file stronger than any broad statement.
Ways To Avoid Overpayments
Report work changes as they happen. If you start, stop, or switch jobs, send a note and proof. Keep copies of every letter you mail or upload. If you think you were paid when you should not have been, call and ask about options to set up a plan or request a waiver if you meet the rules.
When To Call SSA
Call if you move, change phone numbers, start or stop work, enter the hospital, or cannot make an exam. Ask for extra time if you need records from a clinic that is slow to respond. Written requests and receipts help track your file.
Quick Links To Official Guidance
Read the agency’s continuing review page and the POMS policy on diary timing. Keep the current PDFs for the SSA-454-BK and SSA-821 handy. They show the exact questions reviewers use.
Bottom Line Rules
A review is a life-cycle check, not a restart of your original claim. The agency compares your current records to the last approval and checks earnings against work rules. Send complete forms on time, keep treatment going, and use ticket help if you plan to test work. Those steps make the process far less stressful. Stay organized and reply quickly.