Describe in detail how your condition affects daily activities — cooking, cleaning, dressing, etc.

If your condition has worsened, provide specific examples and new medical evidence

Return this form on time — failure to cooperate can result in benefit cessation

Social Security Disabilityhard

Continuing Disability Review Report

SSA-454-BK · SSA

Required review for current SSDI/SSI recipients. 10-page form documenting current medical conditions, treatment changes, and functional status over the past 12 months.

Form Details

Total fields: 85
Auto-fillable: 60 (71%)
Time without BeneFill: 60 minutes
Time with BeneFill: 15 minutes
Time saved: 45 minutes
Filled by: patient
Frequency: annual

Fill this form with BeneFill

Auto-fill 71% of fields from your profile. Save 45 minutes. Download a real PDF.

60 of 85 fields71% auto-filled

Start Filling Upload Your Copy Instead Download blank official form

Where to Submit This Form

📬

Return to the address provided on the form

SSA sends this as part of a Continuing Disability Review.

🏢

In person at local SSA office

https://secure.ssa.gov/ICON/main.jsp

Filing Deadline

Within 30 days of receipt. Request an extension if needed by calling 1-800-772-1213.

Processing Time

Part of the Continuing Disability Review process — 3-6 months total.

What Happens Next

SSA will compare your current functional abilities with your prior assessment to determine if medical improvement has occurred.

Tips for This Form

✓ Describe in detail how your condition affects daily activities — cooking, cleaning, dressing, etc.
✓ If your condition has worsened, provide specific examples and new medical evidence
✓ Return this form on time — failure to cooperate can result in benefit cessation

More Social Security Disability Forms

SSDI Application

SSA-16-BK · SSA

Application for Social Security Disability Insurance Benefits. Requires detailed work history, earnings record, and medical condition documentation.

SSI Application

SSA-8000-BK · SSA

Application for Supplemental Security Income for aged, blind, and disabled individuals with limited income and resources. Must be completed via SSA interview.

Adult Disability Report

SSA-3368-BK · SSA

The most complex patient-facing disability form. 15 pages requiring complete medical history, all diagnoses, medications, treating providers, hospitalizations, and work history.

Work History Report

SSA-3369-BK · SSA

10-page report requiring detailed descriptions of all jobs held in the past 15 years including physical demands, tools used, supervision, and lifting requirements.

Function Report

SSA-3373-BK · SSA

10-page functional assessment covering ADL capacity, daily routines, social functioning, cognitive abilities, and physical limitations.

Authorization to Disclose Information

SSA-827 · SSA

Authorization allowing SSA to collect medical and other information from providers, hospitals, and other sources for disability determination.

Not sure which forms you need?

Tell our assistant about your situation and we'll find the right forms for you.

Chat with Form Assistant

Disclaimer: BeneFill™ provides form-filling assistance and informational guidance only. It is not affiliated with, endorsed by, or sponsored by the SSA or any government agency. The information provided is for general informational purposes and does not constitute legal, medical, financial, or tax advice. Always verify form requirements and submission details directly with the issuing agency.