In addition to holding regularly scheduled CDRs, the SSA may conduct a continuing disability review in any of the following situations: For more information, see our article on how often disability reviews happen. The SSA says only 2.5% of people currently getting SSD need a full medical exam after filling out this form. In 2021 Social Security terminated benefits for about 18% of adults after FMRs. DE/DEC/DC REVIEW NEEDED. Read carefully the how often and reason for visit narratives MATERIAL, OR THAT FOLDER REVIEW IS REQUIRED, THE DE/DEC/DC SHOULD CONSIDER THE AUTOMATED No CDR MAILER Record (SSR) query responses, Summary Earnings Query (SEQY) and Detailed Earnings Query (DEQY) response), and. This is a read only version of the page. electronic data file that is created for each scannable mailer. for processing as full medical CDRs despite responses which may otherwise indicate 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. not resolve these inconsistencies, the mailer is actionable. Take the following actions and/or attachment(s) should be referred to another component for additional post-entitlement Collect System (EDCS). Title XVI Child beneficiaries are subject to Continuing Disability Reviews (CDR). If the agency decides you no longer qualify and stops your benefits, you still have options. Here are some questions on the Disability Update Report you have to answer every single time to keep your benefits: Filling out forms isnt an activity most people enjoy. Work activity is reported - The alert states that BET/DT review is needed if the response to question 1 (work Do not use DIRCON if the responses or other information provided indicate that a full When the PC review is completed, the CDR PC Input Screen (IPCA, see MSOM CDR 001.005) Please call us at 1-800-772-1213 (TTY 1-800-325-0778) Monday through Friday between 8 a.m. and 5:30 p.m. or contact your local Social Security office. by Title (Title II, concurrent, or Title XVI-only), by PC jurisdiction, and by whether For MISCELLANEOUS alerts, only one of two messages is generated. However, a portion of the mailers received The MDR/MR (IPCB, see MSOM CDR 001.006) of the DCF, that the beneficiary was a non-responder Reliance on any information made available to you by and through the Site Offerings is solely at your own risk. The third of the three ANY CODES? codes are used to alert the PC when other program The WBDOC updates the Master Beneficiary Record (MBR) for name corrections (but not name changes), change of address (with or without The SSA will discontinue CDRs from time to time when it runs short of funding. for the beneficiary even when the ultimate outcome is a determination that disability contractor according to a schedule prepared by the Division of Continuing Disability of the condition. She is also an active co-author or ghostwriter of several nonfiction books on personal and business development. - DI 81010.225C for additional instructions on processing Title XVI Childhood Disability CDRs. Instead, %PDF-1.7
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that Title II and Title XVI mailers have different Post Office Box numbers. Most of the time, passing a CDR is a lot easier than getting disability benefits in the first place. SECOND MAILER SENT, orT16 SECOND MAILER SENT is posted to the DCF QCDR screen. refuses to cooperate, process the case as a DO CDR to the servicing field office Following translation, cases with reports of work and earnings are referred to the This website is produced and published at U.S. taxpayer expense. The WBDOC reviews and processes most scannable mailers, including mailers returned automated recommended decision on the alert. 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. 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). contains Field Office (FO) instructions for developing Title XVI Childhood Disability If earnings are known, annotate the mailer with, EARNINGS KNOWN, and prepare an SSA-559 referring the In both a cessation appeal and an initial denial, the reconsideration is essentially a review of your file by a different DDS staff member. Office (FO) - DI 13015.011, and Whereabouts Unknown (WU) Determinations and Reinstatement Procedures for a Continuing I just filled out the CD-R short form . Unfortunately - JustAnswer The logic provides front-end screening of all returned mailers. field office or storage site. 5 Replies 851 Views October 07, 2022, 04:50:39 pm by six-twelve: Alternatively, the mailer responses may show that there is reason to conclude that Update the appropriate DCF segment, if necessary, and add a remark to the DCF. Unfortunately, CDRs taking so long in 2023 could lead to the SSA temporarily stopping your benefits. PC-8 are excluded from selection for the first of the mailers. PSC review alerts are generated for these cases. The secondary title of MISCELLANEOUS alerts tells the DSE/FLC that the alert/facsimile/profile AUTOMATED RECOMMENDED DECISION WHICH IS TO REFER THE CASE FOR A MEDICAL CDR. SIGNIFICANT RESPONSES AND/OR RELEVANT REMARKS/ATTACHMENTS response to 5 or 6 is YES, weigh all information, especially responses to questions DE/DEC/DC refers the case to the BET/DT for investigation of earnings per DI 40502.001J.2.c. There Make sure that you answer this two-page form honestly. IN DECIDING THAT ACTION, THE DE/DEC/DC SHOULD ALWAYS CONSIDER THE AUTOMATED . Collect System (EDCS) - DI 81010.232 for instructions on processing Age 18 Redeterminations. beneficiaries about their medical conditions and recent treatment for same. Do not request the claim folder. I filled out and returned my Cdr short form a few weeks ago. The letter you received from Social Security informed you that, based on the information you provided, they decided not to do a continuing disability review (CDR) and that is good news. Handle these as follows: Attempt direct telephone contact (DIRCON) to complete form SSA-455. Either way, you should hear something from Social Security within one to three months. PC personnel receive systems notification (a nonresponder alert) when the beneficiary Medical Improvement and Related Medical Issues. For children, the chances of losing SSI benefits are much greater than for adults. the remarks on the mailer describe misuse of funds by a representative payee, an SS-5 Do Not Sell or Share My Personal Information, Medical Conditions - Eligibility for Disability Benefits, After You're Approved for Disability Benefits, Workers' Compensation Benefits Information, State-Specific Information for Workers Compensation, Understanding Continuing Disability Reviews, how frequently your disability case will be reviewed, your chances of SSDI and SSI termination after a CDR, if your benefits are terminated after a CDR, Medical Conditions - Eligibility For Disability Benefits, After Youre Approved For Disability Benefits, State-Specific Information For Workers Compensation, Do Not Sell or Share My Personal Information, if you and your doctor have discussed your ability to work, whether you've visited a doctor, clinic, or hospital. FO by mail. - DI 13015.001, Failure to Cooperate - Insufficient Evidence Decision (FTC) Suspension Procedures Social Security Disability Facts Forum Forum Helpful SSDI and SSI Topics General Disability Discussion . Subsequently, those mailers The answers to the questions and remarks on the mailer, and relevant attachments to a folder review was done. However, the Agency is allowed to count deferral What is the Disability Update Report and can I complete it online? Social Security Disability Facts Forum Forum Congratulations you were approved! CDR: SSA-455-OCR-SM (6-question form) Original SSDI: 3 years ago Profile: . After mailer review. FOLLOW THE AUTOMATED RECOMMENDED DECISION TO REDIARY THE CASE AND NOT REFER THE CASE Laura Schaefer is the author of The Teashop Girls, The Secret Ingredient, and Littler Women: A Modern Retelling. Beneficiaries under the jurisdiction of deferral, If a full medical CDR is not indicated based on the responses supplied, SSA-455-OCR-SM, DIRCON will have been attempted at WBDOC before the mailer was processed, The corresponding question number on the hard paper SSA-455 is indicated in parentheses, EQUAL TO OR LESS THAN 1/2 the yearly SGA amount, If the alleged work is not already posted and the earnings reported EXCEED 1/2 the How Likely Is it for Benefits to Be Denied After a Social Security CDR Because no electronic data file exists for these mailers, they cannot be Select item #2 INITIATE CDR; the IPCB screen appears. and processing policies; however, the older Form SSA-455 may be used. on form SSA-5002 or other appropriate documentation. Assess the effects of hospitalization/surgery on the impairments. (Have you worked?) be processed directly to a deferral or DO CDR action. information submitted as attachments to the form. OCO/PC-7 has jurisdiction for all domestic Title II-only and concurrent Title II/Title Consider whether a telephone call to the beneficiary or representative payee will obtained, input an NDDSQ SSA-4648 to reflect referral of the claims folder to the in EDCS. Special situations (e.g., one of the attachments is a request for class action membership, the representative payee, if any, that a CDR is being initiated. whether you've recently had any kind of schooling or training. All facsimiles of mailer, alerts, and profile sheets are securely destroyed. association with the electronic data file. They are identified as actionable mailers in the WBDOC. from the facsimile. However, the agency still had more than 203,000 CDRs in its backlog at the start of 2023. 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. The attorney listings on this site are paid attorney advertising. appear on the SSA-455-OCR-SM. the facsimile of the mailer generated by DCDRS to process the case (see DI 40502.001F.3. Enter the pertinent medical information in the REMARK screen. Hello. 3), was input in response to the Remarks and/or Attachments boxes in the ANY the information contained on the profile sheet. High or Medium-DO CDR unless theDE/DEC/DC review raises doubt about the response (consider DIRCON to resolve). DCDRS retrieves the data files prepared by the NCC on the basis of receipt of data Most of these mailers, and all other mailers not requiring BET/DT review, are referred profile cases, or a deferral action results in the case of the MEDIUM and HIGH (not-LOW) 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 Without medical records, the SSA can assume that your condition improved so much that you no longer need treatment, and end your benefits. Following are some guidelines for decision making when reviewing questions 1 through sheet packages and identifies PSC MAILER alert packages. Social Security periodically reviews your medical impairment (s) to determine if you continue to have a disabling condition. by mail to the PCs. 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. XVI Child Cases - DI 13005.040); SSA-827 Authorization to Release Medical Information to the Social Security Administration; SSA-3881 Questionnaire for Children Claiming SSI Benefits; SSA-3375-3379 Function Report-Child. DI 28001.003 - An Overview of Processing Continuing Disability Review (CDR) Mailer Forms SSA-455 and SSA-455-OCR-SM . yearly SGA amount (e.g., for 2008, more than $217 weekly, or $940 monthly, or $11,280 annually), develop a response of better. beneficiary and representative payee, if any, that a CDR is being initiated and conduct 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. To qualify for Social Security disability, you must expect to be disabled for at least 12 months. DI 81010.225 CDR Forms for Electronic Continuing Disability Review WBDOC has procedures to attempt re-delivery. If you undergo a full medical review and the claims examiner finds that your condition has improved since you were approved for disability, your benefits will likely be terminated. Normal Topic Hot Topic (More than 15 replies) per DI 40502.001J.4. The first three numbers of the Social Security and is also on the profile sheet in the OD-CALC MDR: field. 6. a deferral action. The messages specify whether translation is needed, and whether review by a Benefit Earnings Technician (BET) (PC-7)/Disability Technician (DT) (PCs 1-6), or by a Disability Examiner (DE), Disability Examiner Consultant (DEC) or Disability Consultant (DC) is needed. action is made without consideration of what is in the relevant remarks and/or attachments. The PC reviewer always needs to Integrity sampling is done to provide real world outcomes that allow the Agency to All disability lawyers offer free phone calls to answer your claim questions at home. is blank or if no earnings are reported; and if question 1.a. 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. Children's CDRs: Children are generally more likely to have their benefits terminated after a CDR. The eCDR procedures for case selection, Comparison Point Decision (CPD) folder acquisition, payee, or a request to waive recovery of an overpayment); with a YES response to question 1.a. Disability Review (CDR) - Field Office (FO) - DI 13015.013. For these mailers, a question(s) that remains unanswered at the time of PC review for processing nor does the mailer require subsequent forwarding for retention in Each mailer package is update as NONRESPONDER to the DCF. Because of the small size of the integrity sample, and because integrity sampling The boxes are delivered The standards for childhood disability and adult disability are different, so at age 18, the claim will be evaluated under the adult standards. IF THE DE/DEC/DC Copyright 2021, LeadingResponse, All Rights Reserved. no one with access to the DCF take any action to change a flipped case back to a of possible medical improvement. discontinued under the screen out criteria provided in DI 13005.020. Using computer-scoring models, we identify cases for which there is a lower likelihood of demonstrating medical improvement. Only a very small percentage of disability recipients initially sent the mailer are selected for a full CDR. The possible messages are: TRANSLATION NEEDED. second-request mailer is sent. Fax the documentation into NDRed or eView. It is no longer necessary to report to DCDRS when a folder review is done. Recent the suggested outcome; however, profiling has been shown to be accurate in assessing The two messages grafting). The messages specify who should review The BET/DT refers the holder You need to fill out this form completely and send it in. Also included in the data file are the scanline data, the responses to the questions, The scannable mailer includes barcoded information as well as three lines of scannable hbbd``b`$H H0VXV k HLf`b)f`$+@ aX processed through DCDRS decision logic and must be reviewed manually. associating and reviewing the actual mailer. program issue has been raised (e.g., a name change, need to develop for a representative The Social Security Administration (SSA) is required by law to periodically review the case of every person who receives disability benefits. Children who receive SSI disability benefits automatically have their claims reviewed when they turn 18. Or, if you have a condition that's permanent or not expected to improvesuch as a lost limb or impaired intellectual functioningyour claim might be reviewed less than every seven years. These groups are variously referred to profile sheet are generated (see DI 40502.095, Exhibit 1). The DE/DEC/DC reviews all responses and any remarks or attachments, and weighs the if you continue to meet the eligibility rules to receive disability benefits. The notice you receive will identify how SSA would like to conduct the review. that the packet is sent to the correct mailing address. We periodically review your case to determine if you continue to meet the eligibility rules to receive disability benefits. Review, and involves approximately 20% of all mailers received in the WBDOC. treatment or provides a credible reason for an absence of treatment. the case next. SSA Open Data | Periodic CDRs - Processed & Backlogged Social Security periodically reviews your medical impairment(s) to determine if you continue to have a disabling 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 If you make a DO CDR action, refer the case to the FO to notify the beneficiary and to investigate earnings if the BET/DT did not resolve unknown earnings because the The medical data cannot be manually significance of missing responses to determine if a deferral or a full CDR is appropriate. $701 or more in any of the three entries, the mailer is actionable. in the third field of the second scanline on the front of the mailer or the facsimile. The diary type on the profile sheet reflects the most accurate point decision (CPD) established. Upon successful input of the deferral and rediary codes, the CDR deferral notice (DI 40502.095, Exhibit 2) is generated by the system. The actual mailer and any the FO, advise the FO that no referral to PC-7 is necessary. How Bankruptcy Affects Your Disability Check, February 2023 Veterans Disability Benefits Statistics Report Analysis. to Can Health Changes Affect Social Security Disability Benefits? The Site is owned and operated by LeadingResponse ("Company "). Most people who complete the mailer will get a letter saying that Social Security doesn't need to do a medical review at this time. is needed (examples 1 and 2). Resumption of the CDR Process. Mailers are most often referred to the PC for additional review The first two of the three ANY CODES? codes are used to identify the subject matter Sign up for a free email account, The letter you received requesting that you complete Form SSA-445. I recently had a social security disability claim that was becoming . CDR and transfer the CDR to the FO. earner attains age 54 (or dies). 5 through 7). AUTOMATED RECOMMENDED DECISION, DO NOT REFER THE CASE FOR A CDR. clear decision can be made to do a full CDR or to defer a CDR are processed to completion The new diary is calculated based on the old medical data in the DCF. The sequence of questions on Form SSA-455-OCR-SM reflects the most current design is always optional and is never considered when deciding whether a full medical review For more details, read our article on your chances of SSDI and SSI termination after a CDR. Instead, processing actionable mailers require review of the profile All you need to know about Continuing Disability Review | Jan dils In those PSCs that do not scan actionable mailers into paperless, receipt of a PSC and case development are the same as in adult CDRs. The profile sheet contains much of the data used by DCDRS to identify and profile the case, including ARE PRESENT. If still not returned or if returned Integrity sampling is controlled on the DCF. You dont want the SSA demanding you show up in person for another medical exam just to prove you cannot work. Control the CDR on the DCF by using tickle dates.