If you receive disability benefits through Social Security and your disabling medical condition improves, and you are able to return to work and perform substantial gainful activity, your SSDI benefits will likely be discontinued. Under the Social Security Administration guidelines, SSDI benefits are subject to reporting requirements and disability reviews that show changes in a recipient’s medical condition or personal circumstances. If you receive SSDI benefits, your benefits can be suspended or terminated if you fail to report improvements in your medical condition.

For help with SSDI benefits in Illinois, contact the Social Security disability attorneys at Ankin Law in Chicago. Call 872-529-9377.

How Does SSDI Work?

The Social Security Administration (SSA) is the federal agency that is responsible for providing Social Security disability insurance (SSDI) to eligible disabled persons. To receive SSDI benefits, you must fill out an application and meet specific eligibility requirements under both federal and state guidelines.

In Illinois, the Bureau of Disability Determination Services (DDS) is the state department that makes the initial determinations about eligibility for Social Security disability benefits. When you apply for SSDI benefits in Illinois, DDS is the agency that is responsible for reviewing your application, gathering information to support your disability, and approving your disability claim. If your application is approved by DDS, you will be entitled to receive monthly benefit payments for your disability under federal and state guidelines.

How Does the SSA Determine Disability?

To determine disability, the SSA uses a 5-step process. To qualify for benefits, the applicant must meet two basic requirements: 1) – must have worked in jobs covered by Social Security, and 2) – must have a medical condition that meets the definition of disability under SSA guidelines. The 5-step qualification process is evaluated by asking the applicant these important questions:

1.      Are You Working?

The SSA uses earning guidelines to evaluate an applicant’s substantial gainful activity (SGA). If the applicant is working in 2024 and earning more than $1,500 monthly, or $2,590 if blind, the applicant will not be considered to have a qualifying disability. According to SSA guidelines and disability benefits 101, you are not allowed to engage in SGA if you are disabled.

2.      Is Your Condition Severe?

The applicant’s condition must cause significant limitations on his/her ability to perform basic work-related activities, such as walking, sitting, standing, bending, reaching, lifting, and remembering for at least 12 months. If it does not, the applicant will not be considered to have a qualifying disability.

3.      Is Your Condition on the List of Disabling Conditions?

The SSA maintains a list of medical conditions that are considered severe enough to prevent a person from performing SGA. If the applicant’s condition is not on the list, the medical condition is compared to similar conditions that are on the list and evaluated for disabilities.

4.      Can You Perform Your Previous Work Duties?

If the applicant’s impairments do not prevent him/her from performing any past work duties, the applicant will not be considered to have a qualifying disability. If previous work duties can’t be performed, the SSA will evaluate other types of work duties with similar characteristics.

5.      Can You Perform Any Other Types of Work?

The SSA will evaluate other types of work for the applicant based on his/her medical conditions, skill levels, past work experience, education, and age. If the applicant can do other types of work, the applicant will not be considered to have a qualifying disability.

It’s important to know how you get disability benefits and how much your benefits will be. Under the SSA guidelines, SSDI benefits are available to workers who have a disability that prevents them from working and who earn a sufficient number of work credits based on their taxable income. The amount needed for a work credit changes each year. In 2024, you earn 1 credit for each $1,730 in wages or self-employment income. When you earn $6,920, you earn 4 credits for the year. The number of work credits you need to qualify for disability benefits depends on your age when your disability begins. Generally, you need 40 credits, 20 of which were earned in the last 10 years ending with the year your disability begins. However, younger workers may qualify with fewer credits.

If SSDI benefits are approved, they are payable to (1) disabled or blind workers under 65 years of age, (2) the worker’s spouse or widower, (3) the worker’s children, and (4) adults disabled since childhood. The amount of monthly disability benefits allowed is based on the Social Security earnings record of the insured worker and the worker’s work history before the disability began. When SSDI benefits are approved and paid for two years, the worker will automatically receive Medicare coverage.

The SSDI Disability Review Process

When filing for Social Security disability in Illinois, your eligibility relies on your previous work history, the severity of your disability, how long you will be out of work, and proving that you can’t perform work duties. If your application for SSDI benefits is approved, you will be subject to an ongoing disability review process that assesses your medical condition and improvement. Continuing eligibility will rely on the findings.

The SSA is required by law to periodically review the case of every person who receives disability benefits. This process is called a continuing disability review (CDR) and is meant to identify recipients who might no longer qualify as disabled. If the SSA concludes after its CDR that your medical condition has improved enough that you can return to work, your Social Security benefits will end.

Typically, CDRs occur every three to seven years, depending on the severity of your medical condition and the likelihood of improvement. SSA guidelines require a medical CDR at least once every three years for people whose conditions are expected to improve. If the medical condition is not expected to improve, the CDR may occur every five to seven years. If the disabled person is a child, SSA initiates a CDR at least once every three years.

  • Medical CDRs – A medical CDR evaluates your current medical condition to determine if you still meet the SSA’s definition of disability. If your condition has improved, and you no longer meet the criteria, your benefits may be discontinued.
  • Work CDRs – A work CDR reviews your employment and earnings to determine if you are engaging in substantial gainful activity (SGA). Your SSDI benefits may be suspended or terminated if you earn above the SGA threshold.
  • Changes in Circumstances – Certain changes in your circumstances can affect your SSDI benefits. These include returning to work, receiving other disability benefits or workers’ compensation, and changes in your marital status.

If you receive disability benefits, you must report changes in your work status or income, changes in your living arrangements, changes in your marital status, receipt of other disability benefits, and improvements in your medical condition. Failing to report these changes can result in suspension or termination of your SSI or SSDI benefits.

Can You Get a Reinstatement of Benefits?

If your disability benefits ended because your medical condition improved, or you worked and had earnings, you should understand the easiest way to get disability benefits reinstated quickly. You can request that your benefits start again without having to complete a new application for SSDI benefits.

While the SSA determines whether you can receive benefits again, they can give you provisional (temporary) benefits for up to 6 months. Provisional benefits can be paid when you request Expedited Reinstatement (EXR). It will include cash payments and Medicare/Medicaid coverage. They usually do not have to be paid back if the SSA denies your request. Provisional payments are paid for up to six months but will end sooner if you are notified of an SSA EXR decision, you engage in SGA, or you reach full retirement age.

You are eligible for a reinstatement of benefits if:

  • You stopped receiving benefits because of earnings from work
  • You are unable to work or perform substantial gainful activity (SGA)
  • You are disabled from an impairment that allowed you to receive benefits for the same condition earlier
  • You make the request within 5 years from the month that your benefits ended

If you need SSDI benefits in Illinois, Social Security disability attorneys can help you through the filing process and improve your chances of an approved application. Research shows that having a professional representative increases an initial claim approval by 23 percent. Legal assistance can be even more important if your initial application is denied, and you need to file an appeal. Your attorney can prepare you and guide you through a hearing before an administrative law judge during the appeals process.

Once your application is submitted to a local SSA field office, it can take up to 5 months to get a decision. Generally, you must wait about 90 days to get a decision on whether your application is approved or denied. In Illinois, the DDS is responsible for gathering and reviewing the required information that supports your SSDI claim. This usually takes at least 60 days or longer, so 90 days is allowed to notify you of a decision.

For legal help with SSDI benefits in Illinois, contact us for information and questions on claims, benefits, and payments.