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Matthew Sanchez

Social Security CDR after judge noted 'medical improvement expected' - what to expect for my SSDI review?

My disability hearing finally went in my favor last month (after 2 denials and 15 months waiting for a hearing). When I got my Notice of Decision letter, I noticed the judge wrote: 'Medical improvement is expected with appropriate treatment. Consequently, a continuing disability review is recommended in 12 months.' This has me really nervous. I've been continuing all my recommended treatments and keeping all my doctor appointments religiously, but my condition (severe rheumatoid arthritis with complications) hasn't improved much at all. Has anyone gone through the Continuing Disability Review process when the judge specifically noted 'medical improvement expected'? How difficult are these reviews? Do I need to prepare differently since the judge specifically mentioned this? I'm terrified of losing my benefits when I'm still unable to work.

congrats on getting approved! dont worry too much, CDRs usually arent as bad as the initial application. just keep seeing ur doctors and get copies of ALL your medical records before the review.

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Thank you! I'm definitely keeping ALL my medical records organized. Does it matter that the judge specifically noted they 'expect' improvement? That's the part that has me worried sick.

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yeah thats normal language they use. they put everyone in categories - MIE (medical improvement expected), MIP (possible) or MINE (not expected). MIE just means they check u sooner, like at 12-18 months instead of 3 or 7 years.

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The judge has classified you as "Medical Improvement Expected" (MIE), which is one of three categories SSA uses. This simply determines when they'll review your case, not necessarily the outcome. For MIE cases, they typically review within 6-18 months. During the CDR, they're looking for substantial medical improvement related to your ability to work. For your CDR preparation: 1. Maintain all treatment as prescribed 2. Ensure your doctors document your limitations in detail 3. Keep a personal journal of symptoms and limitations 4. Get copies of all medical records before the review begins 5. If your condition hasn't improved or has worsened, make sure this is clearly documented The good news is that the standard for removing benefits is actually quite high. They must show significant medical improvement related to your ability to work. It's not enough to show minor improvements if you still can't sustain full-time employment.

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This is NOT entirely accurate. My brother got put in the MIE category and they terminated his benefits even though he was still having serious issues!! The system is RIGGED against disabled people. They WANT to kick people off to save money. Once they decide you're "expected" to improve, you're already on their radar as someone to remove!!!!

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Thank you so much for this detailed explanation! I didn't know about the three different categories. I'm definitely keeping up with all treatments and appointments. Should I ask my rheumatologist to specifically note in my records that my condition hasn't improved significantly? Or would that seem suspicious, like I'm trying to game the system?

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My mom had the exact same situation with her SSDI for MS. Judge wrote similar language, but when the review came around she just filled out the short form they sent (I think it was like 6 pages asking about doctors, meds, daily activities). She sent in the form with her recent medical records and got a letter 3 months later saying the review was complete and benefits would continue. I think as long as you're still seeing doctors and your condition isn't dramatically better, you'll be fine.

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That's reassuring! Did she have to go through another medical exam with their doctors? That initial consultative exam was awful.

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Nope! They didn't make her see any of their doctors. Just the paperwork and her regular medical records were enough.

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When I had my CDR last year, I was SO frustrated trying to get through to Social Security by phone to ask questions about the paperwork. I would wait on hold for HOURS only to get disconnected, or the offices were closed due to COVID. I finally used this service called Claimyr (claimyr.com) that got me through to an actual SSA agent in about 20 minutes instead of waiting for hours. They have a video showing how it works at https://youtu.be/Z-BRbJw3puU if you're interested. Made the whole process much less stressful since I could actually get answers about what documentation they needed for my CDR.

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Does that service actually work? I tried calling SS last week and waited 1hr45min before I had to hang up for another appointment. Never got through.

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That's helpful to know. I've had trouble reaching them by phone too. I'll check it out if I need to discuss my CDR with them directly. Thanks!

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I've been through two CDRs since getting SSDI for a spinal condition. Here's what happens: You'll get a form called the CDR Report (SSA-454-BK), which asks about your medical treatment, medications, daily activities, and whether your condition has improved. Be thorough and honest, but make sure to emphasize your ongoing limitations. There are actually two types of CDRs - a mailer (short form) and a full medical review. Since the judge specified a 12-month review and categorized you as MIE, you'll likely get the full medical review. My practical advice: - Get a copy of your entire SSDI file through a Freedom of Information Act request NOW, so you understand exactly why they approved you - Contact all your doctors BEFORE the review to ensure they have proper documentation of your continued limitations - Keep a symptom journal with dates, severity, and how symptoms limit your activities - If you've tried to work at all, even part-time, be ready to document how your condition affected your ability to sustain work The CDR isn't the same as having to prove disability from scratch. They must show actual medical improvement related to your ability to work. The standard for terminating benefits is higher than the standard for initially denying them.

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This is super helpful, thank you! I haven't tried working at all since I simply can't with the pain and fatigue. How do I go about requesting my file through FOIA? I would really like to see exactly what the judge based the decision on.

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You can submit a FOIA request directly to your local SSA office. Write a letter specifically requesting your entire SSDI file, including all medical records, determinations, the judge's full decision, and any notes. Include your name, SSN, contact information, and signature. They should provide it within about a month. Having this file is incredibly valuable - it shows exactly what medical evidence they found persuasive, which helps you focus on those same issues during your CDR.

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The whole system is designed to kick people off! I went through a CDR last year and they terminated my benefits even though I was still disabled! They just decided I was "improved enough" to do some made-up job sitting at a desk 8 hours a day - completely ignoring my doctor's statements about pain and fatigue. I had to get a lawyer to appeal and it took 7 MONTHS to get my benefits back. During that time I almost became homeless!! Make sure you have EVERY SINGLE medical record and get your doctors to specifically write that your condition has NOT improved enough to sustain full-time work!

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Oh my god, that's exactly what I'm afraid of! I'm so sorry you went through that. Did you have a lawyer help you with the initial CDR or just for the appeal after they cut you off? I'm wondering if I should get a lawyer involved from the start.

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I didn't have a lawyer for the initial CDR because everyone told me it would be easy if I was still disabled. BIG MISTAKE. Definitely get a lawyer from the beginning! The CDR forms have TRICK QUESTIONS designed to make it seem like you've improved even when you haven't. Like they ask if you can go shopping - well yes I can for 30 minutes with help, but then I'm in bed for 2 days recovering! But they just see "yes" to shopping and mark you as improved!

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i forgot to mention but keep taking ur prescribed meds even if they dont help much. my cousin stopped taking some of her meds cuz of side effects and SSA used that against her saying she wasnt following treatment so she must be better!

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That's a really good point! I've been taking everything as prescribed, even though some of the meds have pretty rough side effects. I'll definitely continue everything through the review period.

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I just did my continuing disability review last spring. I have lupus and they had me as medical improvement expected too. The form they sent me was actually pretty simple. I just had to list all my doctors, treatments, and how my condition affects me day to day. My advice is don't exaggerate but don't minimize either. If you have bad days and good days, make sure they understand that. They approved my continued benefits with no issues.

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That's encouraging! My rheumatoid arthritis sounds similar to your situation with lupus - I definitely have good and bad days. On a good day I might be able to do a few basic tasks, but then I'm wiped out. Were you worried about how to describe those fluctuations?

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Yes! That was exactly my concern. What helped me was keeping a symptom diary for about a month before filling out the form. I wrote down exactly what I could and couldn't do each day. That way when the form asked about daily activities, I could honestly say something like "On my best days (2-3 days/month) I can cook a simple meal and do light housework. On average days (15-20 days/month) I need help with most tasks and rest frequently. On worst days (5-8 days/month) I'm completely bedridden." That specific information seemed to help them understand the reality of living with a fluctuating condition.

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That symptom diary idea is brilliant! I'm going to start one right away. My RA is exactly like that - some days I feel almost normal (though still in pain), other days I can barely get out of bed. I think documenting those patterns will really help show that despite treatment, I'm nowhere near able to work consistently. Thank you for sharing your experience - it gives me hope that being honest about the fluctuations will actually work in my favor rather than against me.

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I'm new to this community but going through something similar - just got approved for SSDI after a long fight and now facing the reality of CDRs. Reading everyone's experiences here has been incredibly helpful, especially the practical advice about keeping symptom diaries and getting medical records organized. One thing I'm curious about - for those who've been through CDRs, how important is it to have your doctors specifically address work capacity in their notes? My rheumatologist focuses mostly on symptom management during appointments, but I'm wondering if I should ask him to document more about how my condition affects my ability to work full-time. I don't want to seem like I'm coaching him, but I also want to make sure the CDR reviewers understand the real impact of my condition. Also, has anyone had experience with CDRs during times when you might be having a "better" period with your condition? I'm worried that if my review happens to fall during a stretch when I'm managing slightly better, they might think I'm improved enough to work.

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Welcome to the community! Your questions are really important ones that I think many of us worry about. Regarding doctors documenting work capacity - I think it's totally reasonable to have that conversation with your rheumatologist. You're not coaching them, you're helping them understand what information is most relevant for your disability case. I plan to do the same thing before my CDR. You could say something like "I have a continuing disability review coming up, and it would be helpful if you could document in my records how my condition specifically affects my ability to maintain full-time employment." Most doctors understand this is important information to include. As for the timing concern about having a "better" period - that's exactly why the symptom diary suggestion from @Chris King is so valuable. If you re'tracking your patterns over time, you can show that even during better periods, you still have significant limitations that prevent sustained work. The key is demonstrating that any improvements are temporary or still leave you unable to work consistently.

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I went through a CDR about 3 years ago for my fibromyalgia and chronic fatigue syndrome, and I understand your anxiety completely. The "medical improvement expected" notation had me panicking too, but it turned out to be more routine than I feared. A few things that helped me get through it successfully: 1. **Be specific about limitations**: Don't just say "I have pain" - describe exactly how it affects you. For example, "I can only stand for 10-15 minutes before needing to sit, and after basic activities like showering, I need to rest for 2-3 hours." 2. **Document your worst days**: The reviewers need to understand that even if you have some better days, your condition is unpredictable. I kept a monthly calendar marking my pain/fatigue levels and what I could accomplish each day. 3. **Get your doctors on board**: I had a frank conversation with my rheumatologist about the CDR and asked if she could include more detail about functional limitations in her notes. She was very understanding and started documenting things like "patient reports severe morning stiffness lasting 3-4 hours daily" and "unable to maintain concentration for extended periods due to pain medication side effects." 4. **Don't rush the paperwork**: Take your time filling out the CDR forms. I actually drafted my answers first, then had a friend review them to make sure I was being clear about my limitations without sounding like I was exaggerating. The review took about 4 months from start to finish, and my benefits were continued without any issues. The key is showing that despite treatment, you still cannot sustain full-time work. Hang in there - you've got this!

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This is such comprehensive and reassuring advice, thank you! I especially appreciate the point about being specific with limitations - I tend to downplay things when talking to doctors because I don't want to seem like I'm complaining, but you're right that the CDR reviewers need to understand the real impact. The idea of keeping a monthly calendar is great too. I've been doing a daily symptom diary, but tracking it on a calendar format might make the patterns even clearer for the reviewers. Your point about not rushing the paperwork is something I really needed to hear - I was planning to fill it out quickly when it arrives, but taking time to draft and review my answers makes so much more sense. Thank you for sharing your experience and for the encouragement!

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I've been through this exact situation - got approved after a long fight and then saw that same "medical improvement expected" language in my decision letter. I know how terrifying it feels, but I want to offer some reassurance based on my experience. I had my CDR about 18 months after approval for multiple autoimmune conditions. Here's what actually happened: I received the CDR packet about 14 months after my approval (they sent it a bit later than the judge's 12-month recommendation). The forms were extensive but manageable - mainly asking about current treatments, medications, daily activities, and any changes since approval. The most important thing I learned was that "medical improvement expected" doesn't mean they expect you to be cured or fully functional. It just means they want to check sooner rather than waiting 3-7 years. They're looking for substantial improvement that would affect your ability to work full-time, not just any improvement at all. My advice based on what worked for me: - Start documenting everything NOW. I wish I had started a symptom log earlier - Ask your rheumatologist to note specific functional limitations in your records (like "unable to grip objects for extended periods" or "requires frequent position changes due to joint stiffness") - Keep copies of all your medical records and test results - When you fill out the forms, focus on your worst days and average days, not your best days My benefits were continued without any additional exams or appeals. The whole process took about 3 months from when I submitted the paperwork to when I got the continuation letter. You're not alone in this, and the fact that a judge already found you disabled works in your favor. Stay consistent with your treatment and be thorough with your documentation. You've got this!

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Thank you so much for sharing your experience! It's incredibly reassuring to hear from someone who went through the exact same situation. The fact that your benefits were continued gives me so much hope. I really appreciate the specific advice about asking my rheumatologist to document functional limitations - that's something concrete I can do right away. I've already started a symptom diary based on everyone's suggestions here, and I'm going to make sure to focus on documenting my limitations rather than just pain levels. Your point about the judge's decision working in my favor is something I hadn't really considered, but it makes sense - they already determined I was disabled based on my condition. The 3-month timeframe you mentioned is helpful to know too, so I can prepare mentally for that waiting period. This whole thread has been such a lifeline for me - I was panicking when I first saw that language in my decision letter, but hearing all these real experiences has helped me understand what to expect and how to prepare properly. Thank you again for taking the time to share such detailed and encouraging advice!

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I'm in a very similar situation and this thread has been incredibly helpful! I was approved for SSDI about 8 months ago for severe depression and anxiety disorders, and my decision letter also has that same "medical improvement expected" language with a 12-month CDR recommendation. Reading everyone's experiences here has really helped calm my nerves. I was spiraling thinking that the judge somehow made a mistake or that they're already planning to cut me off, but it sounds like this is just standard procedure for certain types of conditions. I'm definitely going to start implementing the advice shared here - especially keeping a detailed symptom diary and having a conversation with my psychiatrist about documenting functional limitations more specifically. My mental health symptoms fluctuate a lot day to day, so I think tracking those patterns will be really important for showing that I still can't maintain consistent employment. One question I have - for those with mental health conditions who've been through CDRs, do they handle psychiatric disabilities differently than physical ones? I'm worried they might think that since I'm on medication and doing therapy, I should be "better" by now, even though I still have severe symptoms that make working impossible. Thank you all for sharing your experiences so openly. This community has been a lifeline during such a scary and uncertain time!

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Hey Connor, I'm glad this thread has been helpful for you too! I can't speak from personal experience with mental health CDRs, but I wanted to reach out because your concerns about fluctuating symptoms really resonated with me. Even though my condition is physical (RA), I think the principle is the same - having good days doesn't mean we're cured or able to work consistently. From what I've learned reading everyone's advice here, it sounds like the key is documenting those fluctuations and showing that even with treatment, you still have significant limitations that prevent sustained employment. The fact that you're doing therapy and taking medication actually shows you're complying with treatment, which should work in your favor, not against you. I'd definitely encourage you to have that conversation with your psychiatrist about documenting functional limitations. Maybe they could note things like how your symptoms affect concentration, social interaction, reliability, stress tolerance - all the things that are crucial for maintaining employment. We're both in this scary waiting period, but reading everyone's experiences here has given me so much hope. It sounds like as long as we're thorough with documentation and honest about our ongoing limitations, the CDR process isn't the automatic termination I was fearing. Hang in there!

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I've been through two CDRs for my mental health conditions (bipolar disorder and PTSD), and I wanted to address your specific concern about psychiatric disabilities. The good news is that Social Security does recognize that mental health conditions can be just as disabling as physical ones, and they don't automatically assume you're "cured" just because you're in treatment. For mental health CDRs, they look at what's called your "residual functional capacity" - basically, can you handle the mental demands of work like concentration, social interaction, handling stress, following instructions, and maintaining attendance? Even if your symptoms have improved somewhat with treatment, if you still can't consistently perform these work-related mental functions, your benefits should continue. A few things that helped me with my mental health CDR: - My psychiatrist documented specific functional limitations like "patient can only concentrate for 15-20 minutes before becoming overwhelmed" and "experiences panic attacks 3-4 times per week that require 2-3 hours recovery time" - I kept a mood tracking diary that showed the unpredictable nature of my symptoms - I emphasized how medication side effects (drowsiness, brain fog, etc.) also impact my ability to work - I was honest about any improvements while clearly explaining that I'm still far from being able to handle full-time employment The fact that you're actively engaged in treatment actually demonstrates that you're doing everything possible to manage your condition, which works in your favor. Don't worry about them thinking you should be "better by now" - recovery timelines for mental health conditions vary greatly, and many people need ongoing treatment indefinitely. Stay strong and document everything!

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Thank you so much for this detailed response about mental health CDRs! As someone new to navigating the SSDI system, I was really worried that mental health conditions might be viewed as "easier to fix" than physical ones, but your explanation about residual functional capacity makes a lot of sense. The specific examples you gave of functional limitations are really helpful - I hadn't thought about documenting things like concentration timeframes or panic attack recovery periods, but those are exactly the kinds of concrete details that would help reviewers understand the real impact on work ability. I'm definitely going to start a mood tracking diary like you suggested. My symptoms are so unpredictable - some days I can barely get out of bed, other days I might feel okay for a few hours but then crash completely. I think showing those patterns will be crucial for demonstrating that even on "better" days, I couldn't maintain the consistency needed for employment. Your point about medication side effects is something I hadn't considered including in my documentation either. The brain fog and drowsiness from my medications definitely impact my cognitive function, which would be just as limiting for work as the underlying symptoms themselves. It's so reassuring to hear from someone who's successfully navigated this process with mental health conditions. Thank you for sharing your experience and for the encouragement!

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This is incredibly helpful information about mental health CDRs! I'm dealing with similar conditions and was really worried about how they'd evaluate psychiatric disabilities. Your point about residual functional capacity is so important - it's not just about whether symptoms have improved at all, but whether you can actually handle the sustained mental demands of full-time work. The specific examples you gave of functional limitations are exactly what I needed to hear. I'm going to ask my psychiatrist to document things like concentration timeframes and stress tolerance in much more detail. The mood tracking diary idea is brilliant too - my symptoms fluctuate so unpredictably that documenting those patterns will be crucial. Thank you for taking the time to share such practical and reassuring advice!

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I've been following this discussion as someone who went through a very similar experience - approved after a long fight with the judge noting "medical improvement expected" for my chronic pain condition. I wanted to add a few practical tips that really helped me during my CDR process: **Documentation timing is crucial**: Start your symptom diary NOW, not when you get the CDR paperwork. I began tracking 6 months before my review and it painted a clear picture of my ongoing limitations despite treatment. **Work with your medical team proactively**: About 3 months before my expected CDR date, I scheduled appointments specifically to discuss my functional capacity with each of my doctors. I asked them to document not just my symptoms, but how those symptoms specifically prevent me from working 8-hour days, 5 days a week consistently. **Understand what they're really looking for**: The CDR isn't asking "Are you still in pain?" They want to know "Can you sustain competitive employment?" Those are very different questions. Even if some symptoms have improved with treatment, if you still can't work reliably, that's what matters. **Save everything**: I kept copies of every medical record, prescription change, therapy note, and even parking receipts from medical appointments. The more you can show ongoing, active treatment for persistent symptoms, the stronger your case. My CDR was ultimately successful - benefits continued with no issues. The "medical improvement expected" notation ended up being much less scary than it initially seemed. You've already proven your disability to a judge, which puts you in a much stronger position than initial applicants. Stay consistent with treatment, document thoroughly, and don't panic!

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This is such valuable advice, especially the point about starting documentation well before the CDR arrives! I wish I had known to begin tracking symptoms 6 months in advance - I only started my symptom diary recently after reading suggestions in this thread. Your distinction between "Are you still in pain?" versus "Can you sustain competitive employment?" really clarifies what the reviewers are actually evaluating. That's exactly the kind of insight that helps frame how to approach the whole process. I'm definitely going to schedule those proactive appointments with my doctors to discuss functional capacity specifically. The idea of saving parking receipts and other proof of ongoing treatment is brilliant too - it shows the continuous effort required just to manage the condition. Thank you for sharing such practical, actionable advice. It's incredibly reassuring to hear from another person who successfully navigated this process with similar circumstances!

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