Social Security periodically reviews your medical impairment(s) to determine if you continue to have a disabling condition. If we determine that you are no longer disabled or blind, your benefits will stop.
If the medical evidence you provide isn't up to date then an exam may be requested. Every three years that you are on disability, a disability review will be conducted by Social Security, but the time frame may change depending on your condition and when improvements are expected to be made.
What are the signs that Social Security is investigating you? Signs may include increased communication from the SSA, requests for documentation, discrepancies in records, monitoring of changes in your circumstances, patterns of claims, interviews or home visits, and suspicious activity reports.
Depending on individual circumstances, this can occur as often as annually or as infrequently as every six years, and it often includes examining bank accounts.
We redetermine eligibility and benefit amounts of most recipients once every 1 to 6 years. When you report a change that affects eligibility or payment (for example, marriage), we may review your record for other factors of eligibility such as income, resources, and living arrangements.
If the value of your resources that we count is over the allowable limit at the beginning of the month, you cannot receive SSI for that month. If you decide to sell the excess resources for what they are worth, you may receive SSI beginning the month after you sell the excess resources.
Social Security probably isn't going to actively spy on your social media accounts or hire a private investigator to conduct surveillance, but they could if they notice any red flags or have received a complaint.
Generally, CDI units investigate suspected fraud before the agency awards benefits, and support the Continuing Disability Review and redetermination processes when fraud may be involved. CDI investigations typically begin with a report of suspected fraud from SSA, State DDS, law enforcement, or the public.
Why are my Supplemental Security Income (SSI) payments under review? From time to time, we review your eligibility for SSI to verify you get correct payment amounts each month. During these reviews, we ask about your income, resources, and living arrangements—things that can change with time.
If improvement is expected, your first review generally will be six to 18 months after the date you became disabled. If improvement is possible, but can't be predicted, we'll review your case about every three years. If improvement is not expected, we'll review your case every seven years.
Some red flags on the Social Security disability update report include: Checking the box that states your doctor told you that you can work. Checking the box that says your health is better now than when you were approved for benefits.
The Final Review Process
While the medical review focuses on whether your disability meets the Social Security Administration's (SSA) criteria, the non-medical review ensures you meet other essential eligibility requirements.
If you're older than 55, you may qualify for disability benefits if you have an RFC of “light” or “sedentary.” This means that the medical evidence supports that you can only do “light” or “sedentary” work. You must also not have transferable skills or an education that enables you to perform skilled work.
Refrain from voicing personal opinions about your condition, treatment, or the disability determination process during the exam. Stick to factual information about your symptoms and medical history. Offering opinions can detract from the objective evaluation required for your claim.
Overall, however, the most approved disability for Social Security is disabilities involving the musculoskeletal system and/or connective tissues. According to the World Health Organization (WHO), such conditions include arthritis, back pain, and lupus.
The so-called “five-year rule” for Social Security disability allows people who have already received disability benefits to skip a required waiting period in the re-application process after they've returned to work.
CRIMINAL PENALTY FOR FALSE STATEMENTS
shall be fined not more than $25,000 or imprisoned for not more than five years, or both. (b) For civil monetary penalties for certain submissions of false claims, see section 1128A of this Act.
The SSA will focus its social media scrutiny on cases where they have reason to suspect fraudulent activity. Remember, it's not just Facebook that can be investigated; any publicly accessible platform, like Instagram, Snapchat, or YouTube, could be looked at as part of a claim review.
While reasonable suspicion of Social Security Disability fraud may rarely result in some surveillance, as our SSD lawyer explains, it is anything but routine. Nonetheless, the disability application process always involves the evaluation of someone's “Activities of Daily Living” (ADLs).
Where the overpayment is $2,000 or less and you file a request for reconsideration or waiver, Social Security will waive any collection of the over-payment (unless you were at fault in creating the overpayment). This is known as the SSI $1,000 Rule.
The value of the things you own must be less than $2,000 if you're single or less than $3,000 for married couples living together. We don't count the value of your home if you live in it, and, usually, we don't count the value of your car. We may not count the value of certain other resources, such as a burial plot.
Payments may be suspended because the recipient has excess earnings, excess unearned income, excess resources, or a change in living arrangements. For the purposes of this book, individuals who have had their SSI payments suspended for 12 months or longer are considered terminated from the SSI program.