Benefits Pending a Continuing Disability Review Appeal

December 10, 2014

SSA has increased the number of medical continuing disability review (CDR).  Beneficiaries have a statutory right to continue to receive monetary benefits and Medicare pending the appeal if the review is based upon a “medical CDR”.  Benefits pending appeal are not available if benefits are terminated due to earnings above the substantial gainful activity level (which are knows as “work CDRs”).

Beneficiaries may be deterred from requesting continuation of benefits pending appeal because if the ultimate decision is that the medical cessation is upheld, the benefits paid pending appeal will be considered an overpayment.  It is important to note that the regulations specify that waiver of recovery of the overpayment will be found so long as the appeal was made in “good faith”.  Good faith is assumed unless the individual fails to cooperate with the processing of the appeal.

To receive benefits pending appeal, the beneficiary must file the appeal and request benefits pending that level of appeal within ten days of receipt of the notice of cessation.  Although SSA presumes the notice was received five days from the date on the notice, it is strongly advised to go to the Social Security District Office as soon as possible and make the appeal in person.  GET A RECEIPT DOCUMENTING THAT YOU WANT BENEFITS CONTINUED.

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