Understand Why Redetermination Happens

The SSA conducts disability reviews to determine if:

• Your medical condition has improved.
• You’re able to return to work.
• You continue to meet the eligibility criteria.

In New Jersey, these reviews typically happen:

• Every 3 to 7 years for most cases.
• Every 6 to 18 months for conditions expected to improve.
• Less frequently for permanent disabilities.

Receive the Redetermination Notice

You will receive a notice by mail from the SSA letting you know that your case is under review. This notice includes:

• An explanation of the review process.
• Deadlines for submitting required information.
• Forms you need to complete (usually the SSA-455 or SSA-454).

Tip: Don’t ignore this notice! Prompt action is crucial.

Complete and Submit Required Forms

You’ll be asked to provide updated details about:

• Medical treatment: List of all doctors, hospitals, and treatments.
• Medications: Current prescriptions and dosages.
• Daily activities: Changes in your ability to perform daily tasks.
• Work activity: Any work you’ve performed since your last review.

Be honest and thorough. Missing information can delay your case or lead to an unfavorable decision.

Provide Updated Medical Evidence

The SSA relies heavily on medical records. Make sure to:

• Request updated records from your healthcare providers.
• Include documentation that shows your current condition.
• Submit any new diagnoses, test results, or specialist reports.

Pro tip: Doctors’ opinions about your limitations can strengthen your case.

Undergo a Consultative Examination (If Required)

In some cases, the SSA may schedule a consultative examination (CE) with an independent doctor if:

• Your records are incomplete.
• More information is needed about your condition.

While this exam is free, it’s essential to attend. Missing it can result in benefits termination.

Wait for the Decision

After reviewing your file, the SSA will decide if you continue to qualify. Possible outcomes include:

• Benefits continue if your disability persists.
• Benefits end if evidence shows significant improvement or ability to work.

You will receive a written decision in the mail.

Appeal If Necessary

If you disagree with the decision, you have the right to appeal. In New Jersey, you typically have 60 days from the date of the decision letter to request an appeal.

There are four levels of appeal:

1. Reconsideration
2. Hearing by an administrative law judge
3. Appeals Council review
4. Federal court review

Consulting an experienced disability attorney in New Jersey can improve your chances at every stage of appeal.