Disability Claims Get Reviewed

Tom Margenau
Tue, 24 Feb 2026 23:00:00 -0800
Lifestyle

For a couple of different reasons, a claim for Social Security disability benefits may be reviewed. One is what the Social Security Administration calls a "quality assurance review." The other is what the agency calls a "continuing disability review." I've gotten a couple of emails about this issue recently. Answering them will explain the difference between the two review processes.

Q: I applied for Social Security disability benefits about 3 months ago. I haven't heard yet if my claim has been approved. But I just got a letter telling me that they are reviewing my case and want my cooperation. What is this all about?

A: I am sure your case has been selected for a "quality assurance review." About one percent of all disability claims are selected for this kind of review. This review is essentially just a procedure that the SSA initiates to make sure your claim was processed correctly.
Updated: Wed Feb 25, 2026

For a couple of different reasons, a claim for Social Security disability benefits may be reviewed. One is what the Social Security Administration calls a "quality assurance review." The other is what the agency calls a "continuing disability review." I've gotten a couple of emails about this issue recently. Answering them will explain the difference between the two review processes.

Q: I applied for Social Security disability benefits about 3 months ago. I haven't heard yet if my claim has been approved. But I just got a letter telling me that they are reviewing my case and want my cooperation. What is this all about?

A: I am sure your case has been selected for a "quality assurance review." About one percent of all disability claims are selected for this kind of review. This review is essentially just a procedure that the SSA initiates to make sure your claim was processed correctly.

They will review all the medical evidence you provided, or that was obtained from your doctors and other health professionals, to make sure it supports whatever decision the agency's medical examiners made about your case. Most people don't know this, but the SSA (a federal government agency) contracts out medical decisions to state governments. In most states, the agency that does this is called the "Disability Determination Service." These quality assurance reviews are a way of making sure that the DDSs are following all the rules and guidelines for making Social Security disability decisions.

That's the good news. The SSA is making sure your disability claim will be adjudicated properly. The bad news is that it may slightly delay the decision-making process on your claim.

By the way, "back in the day," meaning back when I retired from the SSA in 2005, the agency also conducted these kinds of reviews on a small sampling of retirement and survivor benefit claims. But all the research I've done recently online about this seems to indicate those kinds of reviews have stopped. I can only find references to quality assurance reviews of disability cases. If any readers had a recent review of a non-disability Social Security claim, I would love to hear from them.

Q: After a long process, I started getting disability benefits about a year ago. And now, out of the blue, I just got a letter from Social Security telling me they want to review my claim. I think this is harassment! It took me almost 12 months and several appeals to prove to them that I am disabled in the first place. And now they are turning around and threatening to take my money away from me! How can they do this? And can you please refer me to a good lawyer so I can fight this?

A: Your situation is an example of the other kind of review I mentioned at the beginning of this column. And that is an occasional review of every disability claim.

You asked, "How can they do this?" Well, the SSA can do this because the law requires them to do it. That law says that every Social Security disability claim must be reviewed from time to time to make sure that the person getting monthly checks from the government still meets the legal definition of disability.

How often a claim gets reviewed depends on the severity of the impairment. In cases where the person's medical condition is expected to improve, the rules say the claim must be re-examined every 6 to 18 months. Obviously, your impairment must be in that category.

In situations where medical improvement is possible, but not probable, the claim should be reviewed every three years or so.

And even in cases where medical improvement is not expected, the law still requires that the case be reviewed once every five to seven years.

The good news is that you must have a condition that shows every sign of improving and you could be on your feet and off the government dole and back in the work force in the foreseeable future. But the tone of your email tells me you don't see it this way. You obviously think you are still disabled and deserve to continue receiving the benefits you are currently getting. So let me tell you what's going to happen.

You're going to have to fill out a form in which you will explain what your impairment is and how you believe it continues to keep you from returning to work. At the same time, you will be asked to provide updated medical reports. You very likely may be sent to a Social Security doctor for a medical examination. You certainly don't need a lawyer to deal with this first round of paperwork and possible medical exams.

Then, a couple of months later, you will either learn that your disability is still considered severe enough to merit continued monthly benefits. Or you will get a letter telling you that your condition has improved to the point where you no longer qualify for disability. That letter usually says your checks will stop in three months. If the latter happens, then you will immediately want to file an appeal. And it's at that point that you might want to start searching online for lawyers who specialize in Social Security disability cases in your area.