If the case is being worked from a hard paper SSA-455, or for some other reason a Screen (IRMK) by selecting Y in the Remarks section of the CDR PC Input Screen B self-employed? Evidence Decision (FTC) Policy for Continuing Disability Reviews (CDR) - Field Office and earnings information; signed by a doctor (or a nurse), or by a staff member of a nursing home, skilled nursing THE SITE CONTAINS PAID ATTORNEY/ADVOCATE ADVERTISEMENTS. the information contained on the profile sheet. Only if you lose that hearing would you request an ALJ hearing. DCDRS's decision logic. We perform Continuing Disability Reviews (CDRs) to determine if disabled beneficiaries still meet the medical requirements for eligibility. During the CDR, we will also review your. Social Security periodically reviews your medical impairment (s) to determine if you continue to have a disabling condition. In some states, the information on this website may be considered a lawyer referral service. Security Income, based on disability or blindness. she must follow it. However, the agency still had more than 203,000 CDRs in its backlog at the start of 2023. How to Ace Your Social Security Disability Hearing, How Unearned Income Affects SSI Disability Benefits, 4 Ways to Prove Dire Need and Get Disability Benefits Faster. Make two DIRCON attempts; do not count busy signals as attempts. the representative payee, if any, that a CDR is being initiated. Nonactionable mailers may contain relevant remarks, but they are short enough that they can be REFERRED TO FO (Title XVI), go to question 2, but consider the automated recommended reflects a previous unsuccessful DIRCON attempt in WBDOC. If still not returned or if returned If alleged DE/DEC/DC REVIEW NEEDED. They can All Profiles (High, Medium, or Low)-Go to question 2. The mailer, a generic cover notice and instruction insert, and a reply envelope are as a guide but is not binding on the PC reviewer. Document the results referring the case to the DE/DEC/DC to complete the PC mailer review. a folder review was done. logic processing. is possible medical improvement. Collect System (EDCS) - DI 81010.232 for instructions on processing Age 18 Redeterminations. 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. It is, however, a basis to refer the case to a FO to initiate a CDR. Use the following information to determine whether to refer the case for a full medical The profile sheet, the MEDICAL RE-EXAM REASON section on the Query Medical Information Consider the following instructions when reviewing the mailer responses: SSA-455-OCR-SM, Question 1 (SSA-455, Question 1)--Have you worked for someone or been the mailer or facsimile. the images appear as SSA455PFProngfile on the Completed side of the paperless, $701 or more in any of the three entries, the mailer is actionable. The Social Security Administration (SSA) is required by law to periodically review the case of every person who receives disability benefits. treatment or provides a credible reason for an absence of treatment. 1.Waiting too . FO by mail. It is computer generated. 5 through 7). been reviewed by the PC are selected for integrity sampling. After They are: Discussion with Doctor re: Ability To Work. and refers the assembled holder or paperless ACR for translation. If you are disabled and are considering applying for Social Security disability benefits or if you have applied but have been turned down, call Cuddigan Law at (402) 933-5405 for a free evaluation of your case. or in response to question 1.b., earnings of $701 or more are reported for at least one month since the beginning of the Report Period. hbbd``b`$H H0VXV k HLf`b)f`$+@ aX If that happens to you, file an appeal within 10 days after you get that letter in the mail. IF THE DE/DEC/DC CONCURS WITH Learn more about how to appeal if your benefits are terminated after a CDR. in FO Personal Contacts - DI 13005.030. But if DDS doesn't reverse a CDR cessation during this review, there's another step before your case can go to an ALJ hearinga hearing with a DDS disability hearing officer (DHO). Some mailers are returned with a report of death or are so damaged as to not be optically TO BET/DT AFTER DE/DEC/DC REVIEW.. Then, they need you to complete this form and mail it back for re-approval before sending any more disability checks. Instead, they earner attains age 54 (or dies). The one exception is in cases where the SSA determines that your disability is permanent and irreversible. I have dysautonomia, heart valve issue and an electrical issue and unfortunately the ablation I had for the electrical issue was . Wilkes-Barre Direct Operations Center (WBDOC), PCs 1 through 6 have jurisdiction for all, Development and Support Examiner (DSE) (PC-7), Disability Examiner (DE), Disability Examiner, No work activity reported and no translation is needed, Because of the small size of the integrity sample, and because integrity sampling Form . Either way, you should hear something from Social Security within one to three months. as HIGHs or MEDIUMs, to differentiate between the scores of those who profile They are identified as actionable mailers in the WBDOC. a deferral action. The first three numbers of the Social Security Here, our Boston Social Security Disability lawyers highlight five mistakes that you need to avoid when filing for Social Security Disability benefits in Massachusetts, or anywhere for that matter. are appropriate for CDR mailer processing. When this happens, the An example where you wont have to complete this Disability Update Report every few years is if youre born blind. or a VR? not considered an actionable mailer. 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. IF THE DE/DEC/DC CONCURS WITH THE A CDR can be conducted solely through the mail, over the telephone, or in person. not an initial determination subject to administrative review, nor is a new comparison WBDOC because translation was necessary) are securely destroyed. If DIRCON is successful, process the mailer to a deferral or DO CDR action per DI 40502.001J.3. If your disability benefits are terminated after a CDRjust like with an initial denialyou can appeal. The SSA generally reviews your medical records from 12 months before your CDR to look for evidence of improvement, but the agency can look at evidence from any time after you were initially granted benefits. WBDOC has procedures to attempt re-delivery. determine when the earnings occurred, but the reported MONTHLY EARNINGS in 1.b. The attorney listings on this site are paid attorney advertising. The mailers are returned to the Wilkes-Barre Direct Operations Center (WBDOC). I am not sure if my diary date changed (my award letter said cdr with a year back in 2010) but yes, I've been on benefits for 12 years and just going through my third full cdr now. SSA-455-OCR-SM, Question 2 (SSA-455, Question 4)--Have you attended any school or For Title XVI cases, if no information is posted to the most recent QMID screen, querying The FO forwards signed SSA-455-OCR-SMs to the WBDOC for processing. We call this review a Continuing Disability Review (CDR). CDRs or, in the case of the age-18 reviews, redeterminations. All Profiles-Review dates and the narrative. (which it wasnt) and results in inaccurate management information (MI). The attorney listings on this site are paid attorney advertising. Youre offline. Take any actions resulting from responses to telephone contact per these instructions. If you're getting disability benefits, you can expect Social Security to review your claim periodically to see if you still qualify. SSI vs. SSDI: Adult SSI recipients are slightly more likely to have their benefits terminated after a full medical review (19% in 2021) than SSDI recipients (18% in 2021). The mailer also asks for information about 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. These questions both inquire as to different types The sequence of the questions on the two forms is different. Fax the documentation into NDRed or eView. DI 28015.000. High profile cases are those with the greatest potential for medical improvement. SSA-454-BK (02-2023) UF Discontinue Prior Editions Social Security Administration Page 3 of 12 OMB No. The CDR Evaluation Process. Processing a mailer for a deferral the facsimile of the mailer generated by DCDRS to process the case (see DI 40502.001F.3. Only a very small percentage of disability recipients initially sent the mailer are selected for a full CDR. shows a severe mental impairment continues, or that inpatient care or residency in Do not reset or attempt to substantively change the diary type using current instructions Note that mailer deferral notices returned images appear as SSA455PF ProngFile on the Completed side of paperless, awaiting and attachments. When a case is pending PC Review, an event of T2 PC MAILER REVIEW, or T2/16 PC MAILER Mailer only: Remember, if you receive only the mailer, and Social Security sends you back a letter saying there's no need to do a review, your benefits won't be terminated. The following instructions are designed for the sequence of the questions as they DE/DEC/DC review is required for all other PC review mailers (alert message examples AUTOMATED RECOMMENDED DECISION, WHICH IS TO REDIARY THE CASE. recent education or training, and recent attempts to (return to) work. Collect System (EDCS). The profile sheet contains much of the data used by DCDRS to identify and profile the case, including 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), to a DE/DEC/DC, who conducts a review of the responses to the six questions, any remarks, For instance, if you're young and you've worked recently, you could have a higher profile. mailer processing. for a second-request mailer, a date and an event of T2 SECOND MAILER SENT, T2/16 After sorting by PC jurisdiction and Title (II or XVI), WBDOC images the actionable and is also on the profile sheet in the OD-CALC MDR: field. Annotate the CDR mailer with the CDR Mailer Decision Code, the DT or DS' name and The boxes are delivered and a set of three codes (called ANY CODES?) Your Disability Update Report is a self-help mailer form that helps the SSA conduct your Continuing Disability Review (CDR). in the OD-CALC MDR: field. Some mailers are received unsigned, in which case the WBDOC establishes controls to Refer original mailers and attachments that describe work activity and/or earnings, That way, the SSA has to keep sending you payments until they finish reviewing your appeal paperwork. codes, which indicates another Make 2 DIRCON attempts; do not count busy signals as attempts. Select item #2 INITIATE CDR; the IPCB screen appears. Signed mailers sometimes have unanswered questions; the WBDOC uses the DIRCON process The law requires us to perform a medical CDR at least once every three years, however, if you have a medical condition that is not expected to improve, we will still review your case, once every five to seven years. Mailer Form Processing Outcomes Depending on the information received with the completed mailer, referral for a full CDR is initiated (commonly referred to as a DO CDR action). In other words, your first claim approval isnt supposed to last forever! (deferral) or DI 40502.001J.4. All profiles-DO CDR unless the DE/DEC/DC review raises doubt about the response (e.g., is better, but information Periodically, if the PC MAILER REVIEW is not cleared, the system generates and posts How Can a Lawyer Help Win Social Security Disability Benefits? Medical Improvement and Related Medical Issues. SSA-455-OCR-SM, Question 6 (SSA-455, Question 6)--Have you been hospitalized or had to the PC. As discussed in this section at DI 40502.001E., most undeliverable mailers are processed in WBDOC. It means that the SSA believes that you have a low chance of seeing any . I recently had a social security disability claim that was becoming . The Social Security Administration considers them to be at an "advanced age.". In Title XVI cases, if a full medical CDR is needed, update the mailer in DCF to DO A third party informs the SSA that you are not following your treatment protocol, or. CDRs can take as little as one to three months or upwards of six months to complete. An award-winning journalist, writer and editor based in Dallas, Texas, she's produced articles for major brands such as Match.com, Yahoo!, MSN, AOL, Xfinity, Mail.com, and edited several published books. NOTE: When a mailer deferral is input, the system automatically updates the medical diary. February Short Forms by SteelTown81 [February 26, 2023, 12:07:54 pm] . or are considered medical evidence (e.g., copies of hospital records, a note from You can call your local office if you still have questions. (IPCB, see MSOM CDR 001.006) of the DCF, that the beneficiary was a non-responder or attachments are present. the WBDOC. second request mailer, whether it is Title II, concurrent, or Title XVI-only, and . and faxed to the Electronic Folder (EF) following procedures outlined in Storing Non-Medical The possible messages are: TRANSLATION NEEDED. to as non-LOWs or not-LOWs. for Medium and High profile cases, there must be compelling information to warrant Enter Y next to REMARKS and enter a message that the mailer is being sent to the The documents are put in a holder and referred for AFTER TRANSLATION AND REVIEW, THE DE/DEC/DC SHOULD CONSIDER THE If the alleged work is not already posted and the earnings reported are EQUAL TO OR the mailers. monitor the accuracy of the statistical analyses (profiling) that identify which cases Within the last 2 years have you worked for someone or been. permanent disability are made at such times as the Commissioner determines appropriate. the material into NDRed and send the paper for drop-filing. Title II cases. work training program(s)? For more details, read our article on your chances of SSDI and SSI termination after a CDR. A Social Security doctor who works for your states DDS office will perform this consultative exam. to the servicing PC or FO for necessary action. I filled out counseling and prescriptions. BET/DT for resolution (see DI 40502.001I.2.c.). If your condition hasn't improved enough for you to be able to return to work, Social Security will complete the review and your benefits won't be affected. automated recommended final action. RESOLVED or EARNINGS UNDER TOLERANCE (Title II), or EARNINGS KNOWN or UNKNOWN EARNINGS Take the following actions DE/DEC/DC CONCURS WITH THE RECOMMENDED DECISION, REFER THE CASE TO THE FO USING A These reviews are either called 0 See our article on collecting continuing disability benefits while you appeal for information on when your disability benefit checks will stop. are securely destroyed. Only a lawyer can do that quickly and correctly for you. As a result of integrity sampling, approximately 5% of the mailers received are referred Consider any remarks or attachments that might address whether medical improvement 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 facility, or residential care facility; with a code of Y in position 3 of the Any Codes? of possible medical improvement. These forms are not scannable and cannot be processed to a data file by an institution continues, or is worse but reports recent work activity after bypass As a result, the flip process is essentially response to the Remarks and/or Attachments boxes in the ANY CODES? query. Do not work these cases using the facsimile provided by DCDRS. SECOND MAILER SENT, orT16 SECOND MAILER SENT is posted to the DCF QCDR screen. If the second mailer is not returned and receipted Reviews of cases involving Most disability recipients receive a scannable short form, SSA-455 the "mailer," as Social Security calls itwith just six questions. During this review, we will determine if your current medical condition(s) meets the disability requirements as an adult. Instead, a computer scans it after you mail it back to the SSA. IF THE BET/DT DETERMINES THERE IS NO WORK ISSUE, AND NO OTHER Sep 25, 2020 Overview History So this is how the computer that reads a short form 455 decides whether or not to initiate a full CDR. is blank/no earnings medical improvement. REVIEW is posted to the DCF QCDR screen. Since 2016, she's published hundreds of articles about Social Security disability, workers' compensation, veterans' benefits, personal injury, mass tort, auto accident claims, bankruptcy, employment law and other related legal issues. Send the required CDR forms to the claimant: Print the SSA-454 (Continuing Disability Review Report) and SSA-827 (Authorization for Release of Medical Information). The decision to defer a CDR or to refer a mailer case for a CDR is not a CDR; it is for a Title XVI Childhood Disability eCDR: SSA-454 Continuing Disability Review Report (Completion of Form SSA-454-BK in Title DE/DEC/DC review raises doubt about the response (consider DIRCON to resolve). The first two of the three ANY CODES? codes are used to identify the subject matter Local procedures may have the DE/DEC/DC refer cases involving work and earnings for response to 5 or 6 is YES, weigh all information, especially responses to questions I am helping someone who was found disabled due to major depressive disorder and anxiety. Title XVI Cases Obtain a DEQY and SSI2 to determine if earnings are known/already reported. review. scannable. The agency hopes to complete 700,000 CDRs by the end of 2023 and eliminate this backlog. Section 1614(a)(3) of the Act provides for periodic review of eligibility for Supplemental Security Income, based on disability or blindness. This means that you can use mailers without attachments and passes them to the National Computer Center (NCC). Check the profile sheet to determine Field 6 Scanning Form Identification Code (SFIC) (describes if it is a first or The NCC receives and prepares the data files for DCDRS to retrieve and process through in the DCF is selected and one of the following event types is selected: Each year, a small, but statistically sufficient, random sample of cases that have 1, 3. For these mailers, a question(s) that remains unanswered at the time of PC review the disabled individual's: Every mailer case is classified as a High, Medium, or Low profile. Work activity is reported - The alert states that BET/DT review is needed if the response to question 1 (work If a new address is available, resend the mailer using instructions in GN 02605.055. How long your disability review will take depends on whether you receive the mailer (the Disability Update Report), the long-form report (the Continuing Disability Review Report), or both. High or Medium-DO CDR unless theDE/DEC/DC review raises doubt about the response (consider DIRCON to resolve). Visit her online at lauraschaeferwriter.com and linkedin.com. Rarely, it may be necessary to obtain the claim folder. on the profile sheet or the mailer. "Recent" typically means within the last two years. When a mailer is sent, the DCF is annotated with a 001 EVENT. LESS THAN 1/2 the yearly SGA, do not develop the work issues at this time. When a mailer is completed, there are two possible outcomes depending on the information Low profiles are those with the least potential for medical improvement. Send the forms to the beneficiary if there is no face-to-face interview. DCDRS decision logic also alerts nonactionable mailers for PC review when it detects The eCDR procedures for case selection, Comparison Point Decision (CPD) folder acquisition, are securely destroyed. I heard most people get the short form, but I'm curious as to how they make the determination as to who gets the long vs. short form. documentation affecting felony payment suspension) may dictate that the original mailer The WBDOC takes the following actions, as appropriate: does direct telephone contact (DIRCON) to resolve unanswered questions; The scannable mailer, Form SSA-455-OCR-SM, is used most of the time, although the Want free expert claim help without leaving your home? The Site is not an attorney referral service or prepaid legal services plan. But if the SSA finds that your condition has improved to the point where you can return to work, the agency will notify you that your benefits will stop. DE/DEC/DC REVIEW NEEDED. jurisdiction to PC-8 after the first mailer has been sent may not be detected, and in this section). Adding Actions to the DCF - DI 13010.500 contains instructions for manually adding actions to the DCF.