Will I have to repay the SSA?

September 6, 2021 4:49 PM

Would I be required to repay the SSA for continued SSDI funding received during their current review backlog, if they determine I no longer qualify for aid?

Hi everyone. So in 2016 I applied for and was granted SSDI for a disability and I've been receiving disability payments ever since. This past year, I underwent a kind of surgery that often improves a patient's health enough to end their SSDI benefit, which I've known all along would likely be my result as well. We're required to notify the SSA about this surgery, so I called up their national number to tell them, and they thanked me and let me know they'd notify my local office to handle next steps.

Typically, notifying the SSA of this particular surgery would trigger a Continuing Disability Review (CDR), where they send you a form that asks lots of incredibly detailed questions about your current health status, and then the SSA would look over all your CDR responses and medical stuff and doctors' notes and make a determination on whether your SSDI would continue.

However, the SSA is tremendously backlogged right now, especially in sending out CDR materials. It's been three months since I called them and I haven't heard from them at all.

Does anyone know whether payment stops based on the CDR decision date or is it based waaaaay back to the date of the medical change/notification? My recovery has been unexpectedly rocky and I'm not yet able to work, so I'm not eager for payments to stop, nor am I super eager to nudge them to prioritize my review while I'm still getting back on my feet. I do plan to return to work as soon as I am able.

Obviously YANA/ML and I'll consult a disability lawyer if my condition is such that I'm still unable to work by the time I hear from them. Right now I'm just trying to figure out how much of a mess this might be if they go all the way back to the notification date several months ago.

Not sure if this will be helpful but:

- My last periodic CDR was in 2019, which was pre-surgery and was decided in my favor, and my SSDI was continued without issue. CDRs are sent out both periodically and based on triggering events like my surgery
- My local branch is unreachable by phone (for years, the system works by placing you on hold for exactly 15 mins and then disconnecting you without ceremony) and the offices are closed, so if I did have to contact the SSA I'd be calling the national number

As always, thanks for your help!

posted by mochapickle to Law & Government (2 answers total)

From SSA's site: "The cessation month generally coincides with the month of the notice. Find retroactive cessation only in the situations outlined in DI 28005.205C, items 2-9, in this section."

You can double-check that list, but as I read it, if you followed the rules, as you did, any benefit cessation would be for future benefits only.
posted by Mr.Know-it-some at 7:22 PM on September 6, 2021 [2 favorites]

Here's a link to the Programs Operations Manual System that I think is useful. It indicates that in most cases benefits cease the month the determination letter is sent out, and then there's a table below that lists exceptions.

I don't know the details of your disability listing, but would your doctors say you're currently unable to return to work? That seems to be the most relevant factor, assuming you haven't returned to work and are cooperating with both the SSA and your prescribed treatment.

(I am not a lawyer, and certainly not your lawyer.)

On preview, what Mr.Know-it-some said.
posted by the primroses were over at 7:26 PM on September 6, 2021 [1 favorite]