Why Might You Fail a Redetermination?

You could fail a redetermination for several reasons:

• Medical Improvement: SSA determines your condition has improved and no longer qualifies as disabling.
• Non-Medical Reasons: For SSI recipients, your income, resources, or living situation may now exceed eligibility limits.
• Lack of Documentation: Missing or outdated medical records, skipped consultative exams, or failure to complete paperwork can result in a negative decision.

What Happens After a Failed Redetermination?

• Benefits May Be Stopped: If SSA finds you're no longer eligible, you’ll receive a Notice of Cessation explaining why your benefits will end and the effective date.
• Right to Appeal: You have the right to appeal the decision within 60 days of receiving the notice.
• Continue Receiving Benefits During Appeal: If you appeal within 10 days, you can request that your benefits continue while your appeal is reviewed. However, if you lose the appeal, you may need to repay those benefits.

How to Appeal a Termination Decision

If you believe the SSA made a mistake:

• Request Reconsideration: The first step is to file Form SSA-789. You can request a hearing and submit new evidence.
• Submit Updated Medical Records: Show ongoing treatment and how your condition continues to limit your ability to work.
• Ask for Help: Navigating an appeal on your own can be tough, especially under stress.

What to Do if You Missed a Requirement

Sometimes, failure to complete or return SSA forms, attend a scheduled exam, or provide updated information leads to failure:

• Respond Immediately: If the deadline hasn’t passed, send in the missing documents or request a rescheduled appointment.
• Call SSA: Let them know you want to comply and explain your circumstances.
• File an Appeal: If your benefits are stopped due to non-cooperation, you can still appeal and explain why.

Can You Reapply?

If you lose your appeal or miss the appeal window:

• You Can File a New Application: Even after a failed redetermination, you can start the application process again.
• New Evidence Is Crucial: To improve your chances, submit updated and stronger documentation with your new claim.