Have your Social Security benefits been approved? Did you know that you could be at risk of losing those benefits due to something called medical improvement?

Today we’ll discuss medical improvement in a Social Security disability case. This is something that you only need to be worried about once your benefits have been approved. Most of the time, at the end of an ALJ decision, they will detail whether a medical improvement is expected and how long it will take to get there. This is documented, and they will follow up with you, questioning your continuing disability and whether you’re entitled to continue receiving benefits.

Comparison Point Decision Date

The Social Security Act definition of medical improvement is any decrease in the severity of your impairment from the most recent favorable decision. Recently they’ve added something new called the Comparison Point Decision Date, which could be even more recent than your last decision. For example, if you were on benefits ten years ago, and they don’t have records when they check on you, they use a comparison point decision.

I will give you two examples: one where the individual continued being approved, and the other where the individual lost their benefits. The most important thing to take away is that you should continue going to the doctor and receiving treatment, even if that means going to a different doctor every 60 days. This is not for the sake of treatment but rather documentation of the pain and severity of your disability.

When Medical Improvement is Considered in Social Security Disability Cases

The first example is an individual who had herniated disc surgery and ended up with failed back surgery syndrome, meaning that the surgery did not work. Immediately after their surgery, they had an MRI which confirmed that the procedure didn’t work. They also had testing for range of motion and strength. They are approved for Social Security benefits, and the determination is that medical improvement is expected in two years. That means they will contact the individual after two years to assess MRI results, signs, and symptoms. This is different than a worker’s compensation case, where they would assess partial improvement as being stable. They are always looking to take people off their Social Security benefits by seeing if they are following up with their doctors. In this example, the individual had follow-up MRIs which showed the same thing as the first MRI, and they are still going to the doctor to document their daily functioning. These are all good things.

The second example would be that of Rheumatoid arthritis. In that case, there is a blood test to determine how high their arthritis is, as well as range of motion and strength testing. In this example, if the patient were to go on a treatment that reduces their rheumatoid levels, swelling, and the severity of their symptoms, they could lose their benefits because of medical improvement.

Hopefully, this has been helpful to you. If you have any questions about medical improvement or Social Security benefits, please reach out to us. We would be happy to help you. Contact us online for a free case evaluation or call #(847) 577-4476.