The Termination of Benefits

Welcome to Season 1, Episode 20 of Winning Isn't Easy: Navigating Your Social Security Disability Claim. In this episode, we'll dive into the complicated topic of "The Termination of Benefits."

Join host Nancy L. Cavey, expert disability attorney, as she tackles one of the most stressful and confusing moments in the Social Security Disability process: when your benefits are at risk of being taken away. You fought hard to get approved - but now, a letter, a work report, or a medical review threatens to undo it all. In this episode of Winning Isn’t Easy, Nancy breaks down the three biggest reasons benefits get terminated and what you can do to protect yourself. First, she explains how medical improvement can trigger a loss of benefits - and what the Social Security Administration actually looks for during a continuing disability review. Then, she walks through the risks of returning to work too soon or without proper documentation. Finally, she clarifies the rules of the trial work period, and how to use it strategically without jeopardizing your income or your eligibility. If you’re facing a potential termination - or just want to stay a step ahead - this episode is essential listening. It’s about strategy, survival, and knowing your rights before it's too late. Don’t wait for the system to surprise you. Tune in to learn how to protect the benefits you fought so hard to earn. Let’s get into it.

In this episode, we'll cover the following topics:

1 -  What You Need to Know About Termination of Your Social Security Disability Benefits Due to Medical Improvement

2 - What You Need to Know About Termination of Your Social Security Disability Benefits Because You Returned to Work

3 - What You Need to Know About the Social Security Administration’s Trial Work Period

Whether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.


Listen to Our Sister Podcast:

We have a sister podcast - Winning Isn't Easy: Long-Term Disability ERISA Claims. Give it a listen: https://wiedisabilitypodcast.buzzsprout.com


Resources Mentioned In This Episode:

LINK TO YOUR RIGHTS TO SOCIAL SECURITY DISABILITY: https://mailchi.mp/caveylaw/your-rights-to-social-security-disability-benefits

FREE CONSULT LINK: https://caveylaw.com/contact-us/


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Need help with your Social Security Disability claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.

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Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals.

Transcript

Nancy Cavey [00:00:00]:
 Foreign welcome back to Winning Isn't Easy. Social Security Disability Benefits. This is a podcast where we break down everything you need to know about navigating the Social Security disability system. I'm your host, Social Security disability attorney, Nancy Kavy. Now, before we get started, I have to give you that legal disclaimer. This podcast is not legal advice. The Florida Bar association says I have to tell you this. And now that I've told you it, nothing is ever going to prevent me from giving you an easy to understand overview of the Social Security disability claims process, the games that are played during this process, and what you need to know to get the disability benefits you deserve.
 
 Nancy Cavey [00:00:49]:
 So off we go. In the last episode, we covered the appeals Council. Now in today's episode, I'm going to shift gears. I'm going to talk about what happens when your Social Security disability benefits are at risk, whether due to medical improvement, returning to work, or triggering a continuing disability review. So I'm going to talk about staying informed, survival and strategy. Let's get into this. And I'm going to cover three specific things. What you need to know about the termination of your Social Security disability benefits due to medical improvement.
 
 Nancy Cavey [00:01:25]:
 Two, what you need to know about termination of your Social Security disability benefits because you've returned to work. And lastly, what you need to know about the Social Security Administration's trial work period. Got it. But before we head into this episode, let's take a break. Okay.
 
 Speaker B [00:01:46]:
 Are you considering filing for Social Security disability or has your claim been denied already? Either way, you require a copy of your rights to Social Security disability benefits, which will cover everything you need to know about the Social Security disability claims process. Request your free copy of the book@kvlaw.com today.
 
 Nancy Cavey [00:02:12]:
 Welcome back to Winning Isn't Easy. Ready to get started? What you need to know about the termination of your Social Security disability benefits due to medical improvement. Now, just because you have been awarded your Social Security disability benefits doesn't mean that you're going to receive them until retirement age. You must have a serious impairment that is expected to result in death or at least last at least a continuous period of 12 months and be unable to earn what's called substantial gainful activity. Sga. Now, as of the date of this article, it's if you earn more than $1,650 per month, you're no longer eligible for Social Security disability benefits. Regardless of how disabled you might be. Once you are awarded Social Security benefits, the Social Security Administration is going to schedule your case for a review to determine whether you remain eligible.
 
 Nancy Cavey [00:03:04]:
 And what they're looking for, in part, is medical improvement. And there are two types of medical improvement reviews that are done by the Social Security administration. They are going to first do a medical review to determine whether your condition has improved to the extent that you can perform SGA significant gainful activity. And they're going to do a work continuation disability review to determine whether you are working above SGA during a period of time in which you are collecting Social Security benefits. So let's talk about medical improvement. Depending on your age and the nature of your medical condition, Social Security will conduct a medical continuing disability review, a cdr, normally every three to seven years. But that's not always the case. If you're a younger individual, if you've just had surgery or there is treatment that is expected to improve your condition, you, you might have a continuing disability review at years 1, 2, 3, maybe even 5.
 
 Nancy Cavey [00:04:06]:
 And the timing of the review depends on the Social Security administration's classification of the likelihood of medical improvement. The date of the CDR is established at the time of your award and is updated after each review if benefits aren't terminated. Now, Social Security uses two approaches to conduct a medical cdr. One involves a scoring model to assess the likelihood of improvement based on your condition. If Social Security determines that there's a high likelihood of improvement, it's going to conduct a full medical review. And Social Security is going to send you a mailer or a questionnaire asking for information about the physicians you've been treating with since your award. And they're going to request updated medical records. So what does that mean? Just because you're awarded Social Security disability benefits doesn't mean that you stop getting treatment.
 
 Nancy Cavey [00:04:57]:
 That's the kiss of death. It doesn't mean that you don't get treatment with the frequency with which your doctor recommends, because if you don't get the frequent treatment that your doctor is recommending, Social Security is going to say, you must have approved and you can do sga. Or if you're not compliant with the treatment, taking the medication, for example, Social Security is going to say, well, you must have improved and you don't need the medication. So you need to understand that continuing to get medical care is crucial to continuing to get benefits. Now they're going to request updated medical records. So you want to make sure that you are giving to your doctor a really good history of your symptoms and functionality, just like you gave when you applied for Social Security benefits. What are your symptoms and how often do these symptoms happen? How do they interfere with your ability to function. Now, they also may interview you.
 
 Nancy Cavey [00:05:57]:
 And if that happens, you know that trouble potentially is going to happen. And they also may ask that you undergo a consultative examination to determine if there has been improvement. You know, there's an issue if either of those things happen. Now, I will tell you what bluntly, regardless of your politics, during the Reagan administration there was an effort to remove people from the Social Security disability roles. And it was quite successful because the philosophy was we want to save money, not necessarily that we really want to determine if there's been improvement. During the Trump administration, there was a widespread effort to terminate disability benefits based on medical improvement. And I was involved in litigation during the, you know, CDRs during the the Trump administration. And I am quite sure that this effort is going to continue in his second term.
 
 Nancy Cavey [00:06:56]:
 So I am anticipating that there are going to be wide ranging CDRs during Trump's second administration. And you need to be ready for that. You need to do the things I just said. You get your medical treatment, do your documentation, and if you get notice of a cdr, then you need to be hiring your original Social Security disability attorney or another attorney. Now, for cases that have a lower level likelihood of improvement, Social Security may send a medical questionnaire to you asking about your medical treatment and your work activities. And based on your response, Social Security will determine whether a full medical review is needed. So again, if you haven't gotten the drift here, it's really important that you continue to get medical treatment and that your records are documenting your ongoing symptoms and functional limitations. Don't say stuff like, I'm better, I'm improved, I'm feeling great, I'm feeling fine, when in fact that is just platitudes that you exchange with a doctor or the doctor staff, tell them about your symptoms, tell them about your functionality.
 
 Nancy Cavey [00:08:06]:
 Now, According to a 2022 article by the center for Retirement Research at Boston College entitled Outcomes Following Termination of Social Security Disability Insurance, Social Security conducted 215,720 FMRs and 766,913 mailer based reviews in the fiscal year of 2019 that resulted in 39,056 cessations, which is just 3.974%. But think about all the resources that were spent terminating 39,056 people out of a pool of about 1.5 million. Clearly, Social Security scoring model is flawed and it has caused unnecessary hardship for a lot of folks. I don't think the scoring system has improved. In fact, I think that there might be an effort to make that scoring system more rigid. Because what better way to justify a claim termination is your scoring that can be manipulated. And I wouldn't quite frankly put it past the members of DOGE and the Trump administration to try to manipulate the method by which CDRs are conducted. I fully expect, as I've said, that we're going to see more CDR claims.
 
 Nancy Cavey [00:09:41]:
 Now, what happens if that happens to you? If you get a cessation notice, you have to file a request for reconsideration within 10 days of the date of the notice. If you appeal on time, your benefits will continue. But during the reconsideration process, if your reconsideration fails, then you can request a hearing in front of the administrative law judge, potentially take the case to the Appeals Council, even take the case to federal court. Now, according to the Social Security Administration Chief Actuary, after all, the appeals benefits are permanently terminated for about 2% of beneficiaries who underwent a medical CDR. So it's unclear based on this article and data whether that's 2% of all CDRs or just the 39,056 cessations. But either way it demonstrates the inefficiency of the Social Security process and a significant waste of Social Security resources. Now I will tell you the bad news is that the bottom line is that half of those terminated end up in poverty. The study found that fewer than half of the former beneficiaries whose benefits were terminated due to medical improvement had post termination earnings above the poverty level.
 
 Nancy Cavey [00:10:56]:
 It would be helpful to know what percentage could only work part time and how many hours they worked despite their disability in 2019. Now this is six years ago. The poverty threshold was $12,490 for a one person household and $16,910 for a two person household. So let's break this down Math wise. In 2019, SGA was $1220 per month. So if you earn more than that, you are not eligible for that. A one person household earning at poverty level would make $1,040 a month less than SGA. So what's the math difference here? About $180.
 
 Nancy Cavey [00:11:41]:
 In essence, Social Security forced a disabled individual back to work only to earn less than sga. Not only is that appalling, I think it's pretty stupid. The study found that age and certain diagnosis, particularly schizophrenia and psychiatric disorders were strongly associated with both post termination earnings below the poverty level and eventually above a return to disability benefits. And that aligns with our experience. But you can see by my words and my tone that I think that this reconsideration process is not functioning as it should. That isn't to say that there are people who should be, who shouldn't be terminated from benefits. And I'll talk about that in my next segment. But I really rarely see medical improvements such that a person is able to do cdr.
 
 Nancy Cavey [00:12:37]:
 But let's take a break before we talk about that other side of the coin. Got it? Foreign welcome back to Winning Isn't Easy. What you need to know about the termination of your Social Security disability benefits because you returned to work. Now, just because the Social Security Administration awarded your benefits, that doesn't mean you're going to get those benefits until retirement age. You have to continue to meet the Social Security disability criteria. You have to have an impairment that impacts your ability to do not only your past work, but other work in the national economy. And if you go back to work and earn a certain amount of money called SGA per month, your benefits are going to be terminated regardless of how disabled you are. Now that number varies from year to year and now it's 1650.
 
 Nancy Cavey [00:13:46]:
 Once you're awarded Social Security with disability benefits, Social Security is going to schedule periodic reviews to confirm your eligibility. They're going to do a medical review, which I discussed in the last segment, and and they are going to do a work continuation disability review to evaluate whether you have earnings that exceed your sga. Many people ask me, look, can I go back to work? And I say, yes, you can go back to work, but you have to do it carefully and consistent with the Social Security rules. Social Security has rules for what's called trial work periods, TWPs and extended periods of eligibility EPE. Now remember that the SGA level is adjusted yearly and Social Security Administration allows you to test your ability to work through a trial work period twp and after that, a 36 month extended period of eligibility can begin. Now, during EPE, if you earn above SGA in any month, you're not going to receive benefits for that month except for a three month grace period after you first exceeded sga. Now, once EPE ends, your Social Security disability benefits are terminated if you've engaged in SGA and the earliest termination can occur 45 months after you returning to work. So what is a work continuing disability review? You have to report your work activity.
 
 Nancy Cavey [00:15:14]:
 And don't think it isn't going to fly because Social Security will use unreported income or reported income in the form of tax returns and new hire data. So you're not going to be able to hide, and I would never ever suggest that anyone do that because it's fraud. If Social Security finds earnings near the annualized SGA level, it will conduct a work CDR to evaluate whether you're overpaid, whether you could work more hours, and as a result, whether your benefits should be terminated. Now remember, once you complete the trial work period and the EPE and a grace period and you have earnings over sga, your benefits are going to be terminated. I think this is a good opportunity for you to test your employability in the labor market. You may feel as if you can try to work, that you want to continue to contribute to society, but it also may be that ultimately you're not able to do that either on a full time basis or permanently. And so the trial work period that you need to sign up for is a great way to test your medical condition and your ability to work. Now, if your benefits are terminated due to work, you can request what's called an Expedited Reinstatement EXR and you can do that within 16 months of termination.
 
 Nancy Cavey [00:16:44]:
 So you've tried, you've been successful, but your condition has worsened or circumstances have changed. Your employer may no longer be accommodating you. For example, the EXOR allows you to resume your benefits without a new application if your disability worsens and you can receive up to six months of provisional payments while Social Security is determining your reinstatement eligibility. To qualify, you must not be earning SGA when you apply and you have to have the same or a related disability as when you were first awarded. So if you were awarded benefits based on a back condition and now you have a cardiac condition, that's not necessarily going to work. What they would be looking for is a worsening of your back condition after you attempted to go back to work. This process can be confusing and it's wise to enroll in what's called a ticket to work program. That is your start for attempting to go back to work.
 
 Nancy Cavey [00:17:40]:
 You also have to report all your earnings to Social Security and you need to ensure that your medical records continue to support your limitations. It might be that you can only do part time work, work every other day, work 20 hours a week, or your employer is accommodating. Whatever your restrictions and limitations are, that sort of stuff needs to be in your medical records. So the bottom line is that this study showed that the individuals whose benefits were terminated due to work were more likely to earn above the poverty level than those whose benefits ended due to medical improvement. And so being honest I think was certainly helpful. But it also found higher rates of re entitlement among those who were terminated because their condition worsened, their employer stopped accommodating them. Now I will tell you, as you probably already know, during economic downturns, disabled workers are often the first to lose their jobs. And so this program I am very supportive of.
 
 Nancy Cavey [00:18:42]:
 I think it is a good way to test your employability to maintain that employment and potentially get off the Social Security disability roles while protecting you. If that's not successful Got it. Let's take a break.
 
 Speaker B [00:19:00]:
 Struggling with your Social Security disability case? The right attorney can make all the difference. Get our booklet the Key to hiring a Great Attorney for your Social Security Disability case. Discover how to find an experienced attorney who will fight for your rights and navigate the process with ease. Don't leave your future to chance. Request your free copy@k kvlaw.com today and ensure you have the expert support you deserve.
 
 Nancy Cavey [00:19:30]:
 Welcome back to Winning Isn't Easy. More about what you need to know about the Social Security Administration's Trial Work period. Now, as I've spoken about, if you receive Social Security disability and feel ready to return to work, Social Security will allow you to test your ability to work without losing your benefits. But that's a big but. It's important that you notify Social Security when you start working to avoid the issue of overpayments which you will potentially have to repay. So what is a trial work period? Twp. It lets you work for nine months, not necessarily consecutive, within a 60 month period while still receiving your full Social Security disability benefits regardless of your income. Once that is over, you can then enter into a 36 month EPE extended period of eligibility during with during which you can continue to receive your benefits for any month that your earnings are below sga, whatever it happens to be that year.
 
 Nancy Cavey [00:20:26]:
 Now this amount changes annually and you can check it out at www.ssa.gov for the current SGA level. Well, what about expedited reinstatement? So if your benefits have stopped because you have substantial earnings and then your condition, which was the basis of your claim, worsens, you don't have to start over. You've got five years to request expedited reinstatement without doing a new application. Now what happens to your Medicare? Medicare coverage is crucial. Even if your SSDI stops your Social Security disability benefits due to earnings, free Medicare Part A continues for at least 93 months after your trial work period. After that you can purchase Part A coverage. And of course, if you have Part B. You you have to continue to pay the premiums to maintain that coverage.
 
 Nancy Cavey [00:21:16]:
 So what are my final thoughts? I think the decision to return to work should be made with input from your doctor and a qualified Social Security disability attorney so you understand what potentially is at risk. You should be talking to the Social Security attorney who represented you originally to get your questions answered. Or look at www.ssa.gov or regarding these types of programs if you have any questions. Obviously you want to be consulting with the Social Security Administration. Wow. We've covered a lot today and I want you to understand that the trial work period and the extended work periods benefits are really designed to help you return to the workforce if you can without jeopardizing your Medicare benefits. And I think that's a powerful incentive to return to work if you can do so ultimately on a full time basis and earn more than sga. Got it.
 
 Nancy Cavey [00:22:17]:
 Well, that wraps up this episode of Winning Isn't Easy. If you found this information helpful in understanding your rights, or you're facing a benefit termination or even other issues, know that you're not alone. Knowledge is your strongest ally. If you found this episode helpful, please take a moment to like our page, leave a review and share it with your family or friends. And please don't forget to subscribe to this podcast so you'll be notified when our next episode comes out. Join us next week for another insightful episode of Winning Isn't Easy, where I'm going to discuss Social Security misbeliefs and myths. Thanks for listening. J.