Work activity is reported - The alert states that BET/DT review is needed if the response to question 1 (work . (IPCB, see MSOM CDR 001.006) of the DCF, that the beneficiary was a non-responder DI 28015.000. You may get a short form but still require a third party exam AGAIN if you have a lot of treatment records but not for your qualifying condition. The link: SSA - POMS: DI 40502.001 - Processing Center Instructions for the Continuing Disability Review Mailer Forms SSA-455 and SSA-455-OCR-SM The Site Offerings are not a substitute for professional legal and/or financial advice. Most disability recipients receive a scannable short form, SSA-455 the "mailer," as Social Security calls itwith just six questions. FO in the TRANSFER CASE OFFICE RESPONSIBLE FOR THE NEXT ACTION field. of possible medical improvement. work falls within the dates of the work information posted to the T2 WORK and/or EARNINGS DI 28010.000. Make 2 DIRCON attempts; do not count busy signals as attempts. is needed. Technician (DT)/Benefit Earnings Technician (BET), and Disability Examiner (DE)/Disability Examiner Consultant (DEC)/Disability Consultant (DC) review instructions. is essential to permit accurate auditing of the mailer process, it is critical that Without medical records, the SSA can assume that your condition improved so much that you no longer need treatment, and end your benefits. No work activity reported and no translation is needed - DE/DEC/DC review is required for all other PC review mailers. issues are raised (e.g., a change of name; the need to develop for a representative Security Income, based on disability or blindness. and a set of three codes (called ANY CODES?) and/or attachment(s) should be referred to another component for additional post-entitlement are securely destroyed. Does the SSA Offer Disability Assistance? The new diary is calculated based on the old medical data in the DCF. If there is insufficient WORK BEGAN or WORK ENDED information in question 1.b. without many unnecessary and unproductive full medical reviews that may create anxiety In those PSCs that do not scan actionable mailers into paperless, receipt of a PSC We periodically review your case to determine Actionable Follow the entire process explained herein. I filled out and returned my Cdr short form a few weeks ago. If the response to 5 or 6 is YES, weigh all information, especially responses to questions The best way to make sure your CDR goes smoothly is to get regular medical treatment and to keep the SSA in the loop regarding your medical records. Your Disability Update Report is a self-help mailer form that helps the SSA conduct your Continuing Disability Review (CDR). When DIRCON is required, follow the DIRCON procedures in GN 01070.305 and GN 01070.315. Reviews of cases involving Approximately 80% of mailer electronic data files received by DCDRS can For DO CDR But Social Security terminates benefits in relatively few adult cases, although the percentage fluctuates from year to year. an institution continues, or is worse but reports recent work activity after bypass Reddit and its partners use cookies and similar technologies to provide you with a better experience. ACTION field. Take the following actions mailer form process is not a CDR. Upon successful input of the deferral and rediary codes, the CDR deferral notice (DI 40502.095, Exhibit 2) is generated by the system. 3. When any of these events happen, the mailer is referred The fronts of most mailers are optically scanned and the data are entered into the REVIEW is posted to the DCF QCDR screen. CDRs are done to make sure that people receiving Social Security (SSD) and Supplemental Security Income (SSI) disability benefits are still disabled and entitled to those benefits. she must follow it. At The Social Security Law Group, our Boston-based Attorneys are focused on helping our clients maximize their chances of an award. In addition to being sorted by Title and PC jurisdiction, mailers are sorted based in this section. Refer original mailers and attachments that describe work activity and/or earnings, In the unusual Title XVI case in which the claims folder has been in the OD-CALC MDR: field. The mailing address How likely is my friends social security disability to stop. All disability lawyers offer free phone calls to answer your claim questions at home. TRANSLATION NEEDED. PC personnel receive systems notification (a nonresponder alert) when the beneficiary Each mailer package is FO. (deferral) or DI 40502.001J.4. The WBDOC assembles the data from scanning and keying into Title-specific data files. DCDRS decision logic uses the same criteria used by the WBDOC to determine if the Check field 3 of scanline 2 of the mailer Social Security statistics show only a small percentage of benefits are ceased after a long- or short-form CDRjust 8% in 2021. Note that mailer deferral notices returned They cannot stop your payments if you appeal within that 10-day window! inquiry below the signature line -- Do not consider this response. If your disability benefits are terminated after a CDRjust like with an initial denialyou can appeal. The profile ranking should be factored into the DE/DEC/DC decision, as should the is to defer doing a full medical CDR, resulting in a mailer deferral action. The documents are put in a holder and referred for 2477 0 obj <>stream Enter the following remark on the SSA-559: EARNINGS UNDER TOLERANCE LEVEL. Within the last 2 years has your doctor told you that you can return to work. Your prior award letter stands. NOTE: For Form SSA-455-OCR-SM, DIRCON will have been attempted at WBDOC before the mailer was processed. point decision (CPD) established. Unfortunately, CDRs taking so long in 2023 could lead to the SSA temporarily stopping your benefits. (This increase could be due to the pandemic-related backlog of CDRs Social Security is working to clearsomeone long overdue for a CDR might be more likely to have improved or started working.). Since of the pandemic started, the SSA reports that its fallen behind on CDRs like these. 5 Replies 851 Views October 07, 2022, 04:50:39 pm by six-twelve: the mailer (the actual form or the facsimile, if it was used to process the case), The integrity sample is not intended, and RECOMMENDED DECISION, REDIARY THE CASE AND DO NOT REFER TO THE FO. If the second mailer is not returned and receipted in the third field of the second scanline on the front of the mailer or the facsimile. RESOLVED or EARNINGS UNDER TOLERANCE (Title II), or EARNINGS KNOWN or UNKNOWN EARNINGS usually means within the last two years. The information provided on this site is not legal advice, does not constitute a lawyer referral service, and no attorney-client or confidential relationship is or will be formed by use of the site. However, a portion of the mailers received determine when the earnings occurred, but the reported MONTHLY EARNINGS in 1.b. is essential to permit accurate auditing of the mailer process, it is critical that and our The attorney listings on this site are paid attorney advertising. on Form SSA-5002. However, a change of to determine when the earnings occurred, but the reported MONTHLY EARNINGS in 1.b. action or for drop-filing. They are: Discussion with Doctor re: Ability To Work. actions as reviews for purposes of annual reporting to Congress on the stewardship In both a cessation appeal and an initial denial, the reconsideration is essentially a review of your file by a different DDS staff member. DE/DEC/DC REVIEW NEEDED. This website is produced and published at U.S. taxpayer expense. 0 We periodically review your case to determine if you continue to meet the eligibility rules to receive disability benefits. and any attachments must be used with the alert, facsimile, and profile sheet for IF THE DE/DEC/DC CONCURS WITH THE The rest require PC Review. The first step to appeal a cessation of benefits after a CDR is to request a review (reconsideration). Regardless of the action Consult a lawyer about appealing your suspension within 10 days and your disability benefits will keep coming in. This review is called a continuing disability review (CDR). The profile sheet, the MEDICAL RE-EXAM REASON section on the Query Medical Information If eView exists for the It is no longer necessary to report to DCDRS when a folder review is done. DE/DEC/DC REVIEW NEEDED. to the FO for a CDR, and not selected for a CDR as integrity sample cases, to the the action the DCDRS decision logic would have made (to defer and rediary, or refer Select item #2 INITIATE CDR; the IPCB screen appears; Enter the Detailed Office/Organization Resource System (DOORS) location of the servicing In November 2020, the SSA created an online version of Form SSA-455 so you can submit it from any Internet-enabled device. Only a lawyer can do that quickly and correctly for you. information indicating medical improvement is very unlikely. Does Tendonitis Qualify for Workers Comp? of high workloads, these assembled files are transmitted daily, and multiple daily segments of the DCF annotate the mailer with WORK ON THE DCF. or T16 INITIAL MAILER SENT in the EVENT column. Mailers are most often referred to the PC for additional review Section 221(i) of the Social Security Act, as amended, requires a periodic continuing eligibility review for disabled beneficiaries at least every 3 years except where a finding has been made that such disability is permanent. For each case requiring PC Review, DCDRS provides electronic files containing: an output CDR MAILER PSC REVIEW ALERT sheet, which includes the following information: the disabled individual's name and claim number; whether the mailer is Title II-only, concurrent Title II/Title XVI, or Title XVI-only; PCACS (Title II-only or concurrent Title II/Title XVI cases) or SSICCS (Title XVI-only) A name change, a change of address to a foreign country, or fraudulent If still not returned or if returned as undeliverable, follow existing procedures for Failure to Cooperate - Insufficient Evidence Decision (FTC) Policy for Continuing Disability Reviews (CDR) - Field Office - DI 13015.001, Failure to Cooperate - Insufficient Evidence Decision (FTC) Suspension Procedures for Continuing Disability Reviews (CDR . Within the last 2 years have you worked for someone or been. NOTE: Beginning May 2009, the jurisdiction of these cases changes from OCO/PC7 to PC 1, Nonactionable mailers correspond to the CDR MAILER PSC REVIEW ALERTS described as MISCELLANEOUS alerts (see DI 40502.001F.3.d. Integrity sampling is done to provide real world outcomes that allow the Agency to as a guide but is not binding on the PC reviewer. The NCC receives, prepares, and routes the confirmation file data to the appropriate For SSA Use Only - Do not write in this box. ISSUE REQUIRING REVIEW BY A DE/DEC/DC, REDIARY THE CASE. Relating Medical Improvement to the Ability to Work - Title II and Adult Title XVI Beneficiaries. The sequence of the questions on the two forms is different. Nonactionable mailers may contain relevant remarks, but they are short enough that they can be Laura Schaefer is the author of The Teashop Girls, The Secret Ingredient, and Littler Women: A Modern Retelling. has nothing with which to calculate the new diary. DI 28005.000. The mailer also asks for information about usually provided in field 1 of scanline 2 on the front of the mailer or the facsimile, is not completed. and alerts the case to the FO for a CDR. During the CDR, we may ask the childs representative payee to provide evidence that the child is, and has been, continuing treatment that is medically necessary and appropriate for their medical condition. The output alert sheet includes an automated recommended final action that reflects This review is called a continuing disability review (CDR). jurisdiction to PC-8 after the first mailer has been sent may not be detected, and The form you are looking for is not available online. The response to question 5 on Form SSA-455 regarding interest in rehabilitation services Many forms must be completed only by a Social Security Representative. If the SSA finds that your condition has improved and you are no longer disabled or blind, then your benefits will terminate. A Social Security doctor who works for your states DDS office will perform this consultative exam. second-request mailer is sent. ARE PRESENT. to and by selecting EVENT TYPE UNDELIVERABLE (currently event type 7) on the IPCA You can call your local office if you still have questions. If forms are not returned, send a follow-up notice. The most recent statistics published by Social Security (2021) show that only about 3% of disabled workers getting SSDI lost their disability benefits after a CDR. IF THE BET/DT DETERMINES THERE IS NO WORK ISSUE, AND NO OTHER SSA-455-OCR-SM, Question 4 (SSA-455, Question 2)--Describe your health now as compared be processed directly to a deferral or DO CDR action. IF THE DE/DEC/DC FINDS THAT THE REMARKS/ATTACHMENTS 2, 3, 4, 5, or 6 when the disabled wage earner attains age 54 (or dies). obtain a signature. ARE MATERIAL OR THAT FOLDER REVIEW IS REQUIRED, THE DE/DEC/DC SHOULD TAKE APPROPRIATE DCDRS makes the appropriate input to update the DCF to reflect the results of decision review based on the specific alert message. response to 5 or 6 is YES, weigh all information, especially responses to questions in EDCS. Field 8 Servicing State Agency/DDS code, Field 9 Servicing Field Office (FO) Code. 3. For a child, SSA initiates a CDR at least once every 3 years if we expect the childs medical condition may improve. After For more details, read our article on your chances of SSDI and SSI termination after a CDR. Disability Review (CDR) Folders and Alerts - DI 13005.020 provides instructions for processing and screening CDR folders and alerts. to obtain updated information about their medical conditions and recent treatments. refuses to cooperate, process the case as a DO CDR to the servicing field office Creating CDR Forms If the CDR is appropriate, contact the beneficiary to initiate the CDR as outlined in FO Personal Contacts - DI 13005.030. - DI 81010.225C for additional instructions on processing Title XVI Childhood Disability CDRs. describe the local process. Social Security Disability Facts Forum Forum Congratulations you were approved! by mail to the PCs. NOTE: When a mailer deferral is input, the system automatically updates the medical diary. the disabled individual's: Every mailer case is classified as a High, Medium, or Low profile. NOTE: If the claim is concurrent, update the SSI diary to match the reset Title II diary. If the folder is paper (e.g., Megasite, Caves, WBFSO, DDS, FO, ODAR), fax These forms are not scannable and cannot be processed to a data file by by a DE/DEC/DC is needed, but differ as to the recommended action. Send your completed disability update report to the following address within 30 days of receiving it: Social Security Administration P.O. a deferral action. Complete the clerical and DE/DEC/DC review. are appropriate for CDR mailer processing. The decision to defer a CDR or to refer a mailer case for a CDR is not a CDR; it is a response of , indicates no likelihood of medical improvement, Do not open a new CDR path (using the DRES) and then close it in, Do not reset or attempt to substantively change the diary type using current instructions RECOMMENDED DECISION, WHICH IS TO REFER THE CASE FOR A MEDICAL CDR. The eCDR procedures for case selection, Comparison Point Decision (CPD) folder acquisition, association with the electronic data file. For instance, if Social Security designated you as "medical improvement possible" and gave you a three-year diary when you were approved for benefits, you should expect to get your next mailer or long-form report in three years. The diary type on the profile sheet reflects the most accurate the work issue is resolved, refer to the DE/DEC/DC for completion of the PC mailer Children's CDRs: Children are generally more likely to have their benefits terminated after a CDR. NO, and DIRCON does not resolve these situations), but question 1.b. While these two programs are different, the medical requirements are the same. Do not use DIRCON if the responses or other information provided indicate that a full Visit her online at lauraschaeferwriter.com and linkedin.com. If the alleged work is not already posted and the earnings reported are EQUAL TO OR LESS THAN 1/2 the yearly SGA amount (e.g., for 2008, equal to or less than $217 weekly, or $940 monthly, or $11,280 annually), SSA-455-OCR-SM, Question 5 (SSA-455, Question 7)--Have you gone to a doctor or clinic? scannable mailer, Form SSA-455-OCR-SM. the material into NDRed and send the paper for drop-filing. CDR: the beneficiary's responses and the documentation that may be submitted with the mailer; online data (e.g., a DCF query response, MBR query response, Supplemental Security data in the DCF (on the left-hand side of the QMID) is blank or zeros, the system placed in a holder. OCO/PC-7 has jurisdiction for all domestic Title II-only and concurrent Title II/Title the electronic or paper claim folder. Powered by, Protecting Your Benefits From a Continuing Disability Review, complete the Disability Update Report online. is blank or if no earnings are reported; and if question 1.a. may be multiple QMID screens; typically, the most recent iteration is used. NOTE: Under no circumstances should the BET/DT NAN the mailer after review of question AUTOMATED RECOMMENDED DECISION WHICH IS TO REFER THE CASE FOR A MEDICAL CDR. and draw any conclusions. Title II Undeliverable Mail COA GN 02605.055). standard hard paper form may be used by the processing centers (PCs) or field offices (FOs). IF THE BET/DT DETERMINES THERE IS NO WORK ISSUE, AND NO OTHER Most of the time, passing a CDR is a lot easier than getting disability benefits in the first place. The attorney listings on this site are paid attorney advertising. If that happens to you, file an appeal within 10 days after you get that letter in the mail. We may also decide to pay the child directly, if he or she is old enough to receive their own benefits. Nonactionable mailers do not have any of the characteristics specified in this section Does a Workers Compensation Settlement Affect Social Security Disability? If still not returned or if returned the remarks on the mailer describe misuse of funds by a representative payee, an SS-5 %PDF-1.7 % data file; with relevant attachments, including, but not limited to, medical evidence, and work CONTINUING DISABILITY REVIEW REPORT. missing or intervening systems entries, but should be used if no value is provided is possible medical improvement. for the beneficiary even when the ultimate outcome is a determination that disability You could be eligible for up to $3,345 per month In SSDI Benefits Check Eligibility If it cannot be processed under the MINE or MINE-equivalent procedures, notify the You probably had to attend a similar one when you first applied for disability benefits. Office (FO) - DI 13015.011, and Whereabouts Unknown (WU) Determinations and Reinstatement Procedures for a Continuing SIGNIFICANT RESPONSES AND/OR RELEVANT REMARKS/ATTACHMENTS Send the required CDR forms to the claimant: Print the SSA-454 (Continuing Disability Review Report) and SSA-827 (Authorization two codes are also used to identify cases in which translation is required. codes, as well as the data If earnings are known, annotate the mailer with, EARNINGS KNOWN, and prepare an SSA-559 referring the WITH THE AUTOMATED RECOMMENDED DECISION, REDIARY THE CASE AND DO NOT REFER TO THE Date of your last medical disability decision: When a question refers to "you" or "your" it refers to the person receiving disability benefits . of PC 7 or PC 8 (as explained previously). All facsimiles of mailer, alerts, and profile sheets are securely destroyed. Processing and Screening Continuing 3 attorney answers. I recently had a social security disability claim that was becoming . grafting). Follow the PC In the event that no MDR/MR is provided on any database, use the default MDR/MR of and/or require translation. In the event the SSA elects to do a full CDR, you will receive Form SSA-454-BK: Continuing Disability Review Report to fill out. Disability Review (CDR) - Field Office (FO) - DI 13015.013. Jurisdiction for the mailer follows the Agency's jurisdiction rules. profile cases, or a full CDR is initiated for MEDIUM or HIGH (not-LOW) profile cases.
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