Improvement in Your Medical Condition

The most common trigger for a disability redetermination review is a change in your medical condition. If the SSA believes that your condition has improved enough that you may be able to work again, they may initiate a review. In particular, if your medical condition was initially expected to improve over time, the SSA might schedule a redetermination to verify whether you still meet the qualifications for disability benefits.

For example, if you were granted disability benefits for a temporary disability or condition that has the potential to improve (such as certain injuries or illnesses), the SSA will likely conduct a redetermination review within a specified timeframe to confirm your continued eligibility.

Return to Work or Increase in Earnings

If you return to work or start earning income that exceeds the Substantial Gainful Activity (SGA) limit, a disability redetermination may be triggered. The SSA uses the SGA threshold to assess whether your earnings indicate that you are able to engage in work and earn a living, which would disqualify you from receiving disability benefits.

If you start working part-time or full-time, or if your income exceeds the SGA limit, the SSA will initiate a redetermination to evaluate whether you can continue to receive disability benefits based on your ability to work.

Changes in the Disability Listings

The SSA regularly updates its Listing of Impairments, which is a document that details the medical conditions and their severity that qualify for disability benefits. If the SSA changes the criteria for qualifying conditions or removes a medical condition from the list, this could prompt a disability redetermination review for individuals whose conditions no longer meet the updated criteria.

If you have a condition that was previously approved for benefits but no longer meets the revised requirements in the listing, the SSA may review your case to determine if you are still eligible for benefits.

Receipt of New or Updated Information

A disability redetermination may also be triggered by new information that the SSA receives about your medical condition, work history, or other aspects of your case. This could include updates from your healthcare providers, new diagnoses, or changes in your living situation that might impact your eligibility.

For example, if you report to the SSA that your medical condition has worsened or if there is a significant change in your ability to work, the SSA may initiate a redetermination review to assess whether your disability benefits should be continued.

The SSA’s Random Reviews

The SSA also conducts random disability redeterminations for some beneficiaries to ensure that the disability benefits system is functioning properly. These reviews are not necessarily triggered by any specific event or change in circumstances. They are part of the SSA’s routine checks to confirm that beneficiaries still meet the eligibility requirements.

Changes in Your Financial Situation

If there is a significant change in your income or assets, such as receiving an inheritance or a large financial settlement, it could trigger a redetermination review for Supplemental Security Income (SSI) recipients, as SSI is based on financial need. The SSA will review your financial status to ensure that you still meet the program's income and resource limits.

A Request by You or Your Doctor

If you or your doctor request a review of your disability status, it can also trigger a redetermination review. This often occurs if you or your healthcare provider believes that your condition has worsened or improved significantly, warranting a reassessment of your benefits.