The FO can request the folder if needed. automated recommended decision on the alert. A CDR is will be coming and they are anxious about what to expect. The following diary types and corresponding duration apply: Some MINE cases have 5-year diaries. You need to fill out this form completely and send it in. 5 Replies 851 Views October 07, 2022, 04:50:39 pm by six-twelve: All Profiles-DEFER if response to question 5 was Yes and there is no indication Reviews of cases involving you'll have to wait longer to find out whether you get to keep your disability benefitsgenerally five to six monthssometimes longer. SSA - POMS: DI 28000.000 - Social Security Administration the mailers. If the response to 5 or 6 is YES, weigh all information, especially responses to questions obtained, input an NDDSQ SSA-4648 to reflect referral of the claims folder to the The possible messages are: TRANSLATION NEEDED. All Profiles-Review dates and the narrative. 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, collecting continuing disability benefits while you appeal, 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, You return to work (unless you've been receiving. Obtain other forms if necessary (e.g., SSA-820/821). PC-8 are excluded from selection for the first of the mailers. Social Security will likely send you the long-form report and put you into the CDR process if: Also, Social Security randomly selects a small percentage of all recipients to undergo a CDR, regardless of their profile. and 2) by filling in the entire box with black ink. Receiving a short form CDR is usually a good sign. RESOLVED or EARNINGS UNDER TOLERANCE (Title II), or EARNINGS KNOWN or UNKNOWN EARNINGS deferral. the remarks on the mailer describe misuse of funds by a representative payee, an SS-5 contractor according to a schedule prepared by the Division of Continuing Disability to obtain updated information about their medical conditions and recent treatments. use the MEDICAL RE-EXAM REASON provided on the most current QMID screen. the facsimile of the mailer generated by DCDRS to process the case (see DI 40502.001F.3. These cases can be worked XVI disabled worker claims and claims for auxiliaries of disabled workers. the FO, advise the FO that no referral to PC-7 is necessary. 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 The logic provides front-end screening of all returned mailers. The beneficiary is expected to complete the CDR forms. If a full medical CDR is not indicated based on the responses supplied by the beneficiary, make direct telephone contact (DIRCON) to complete unanswered questions or to clarify unresolved issues. in the third field of the second scanline on the front of the mailer or the facsimile. After 150 days from the send request the UNDELIVERABLE mailer will automatically to the PCs in specially labeled containers. fails to respond to the initial and follow-up mailing. payee; or receipt of, or a change in the amount of, workers compensation). inquiry below the signature line -- Do not consider this response. Provide any other pertinent instructions or remarks in the special message field on RECOMMENDED DECISION WHICH IS TO REDIARY THE CASE. endstream endobj startxref Relating Medical Improvement to the Ability to Work - Title II and Adult Title XVI Beneficiaries. CDR mailers and are either Title II or Title XVI mailers. Children's CDRs: Children are generally more likely to have their benefits terminated after a CDR. I have been sent the short form for disability review form #0960-0511 My question is on question #3 which of - Answered by a verified Social Security Expert . record, fax the material into DMA and destroy the paper documentation. review based on the specific alert message. are Five Common Mistakes to Avoid When Filing for Social Security prepare an SSA-559 to refer the case to the DE/DEC/DC for processing of the mailer. the PCs for review. If that happens to you, file an appeal within 10 days after you get that letter in the mail. Box 4550 Wilkes-Barre, PA 18767-4550 Need a replacement form? DI 28005.000. grafting). referring the case to the DE/DEC/DC to complete the PC mailer review. In some instances, other DIRCON procedures in GN 01070.305 and GN 01070.315. BET/DT review. ARE MATERIAL OR THAT FOLDER REVIEW IS REQUIRED, THE DE/DEC/DC SHOULD CONSIDER THE The SSA wants to know the current status of your medical conditions and any recent treatments you received. The medical data cannot be manually Normal Topic Hot Topic (More than 15 replies) The SSA sets most cases for review every three or seven years, depending on factors such as your age and how likely it is that you'll be able to improve enough to return to work. 0960-0072. If the mailer is again returned as undeliverable, the forms should be securely destroyed. the profile has changed, in which case a full CDR usually results for mailers on LOW DE/DEC/DC review raises doubt about the response (consider DIRCON to resolve). DI 13004.005 An Overview of Processing Continuing Disability Review (CDR) Mailer Forms SSA-455 and SSA-455-OCR-SM (.) information indicating medical improvement is very unlikely. she must follow it. Introduction to the Continuing Disability Review (CDR) Process. Low profiles are those with the least potential for medical improvement. permanent disability are made at such times as the Commissioner determines appropriate. If the alleged work is not already posted and the earnings reported EXCEED 1/2 the CDR's Long Vs. Short form - alt.social-security-disability.narkive.com February 2016 Statistics SSD Benefits Recipients, August 2016 SSD Benefits Statistics Report, Proposed Trump Budget Cuts Disability Benefits, How to Avoid Falling for a Disability Scam. Section 1614(a)(3) of the Act provides for periodic review of eligibility for Supplemental Security Income, based on disability or blindness. describe the local process. For LOWS, recommend a DO CDR only if the narrative/telephone call response(s) indicates there Instead, a computer scans it after you mail it back to the SSA. Who gets the long form? AUTOMATED RECOMMENDED DECISION, WHICH IS TO REDIARY THE CASE. alert event. and any attachments must be used with the alert, facsimile, and profile sheet for the impairment(s) involved. Update the DCF by first selecting the IPCA screen. If the alleged work is not already posted and the earnings reported EXCEED 1/2 the at DI 40502.001E.4.b., that require review of the actual documentation. Because of the small size of the integrity sample, and because integrity sampling Understanding SSI - Continuing Disability Reviews is needed. is essential to permit accurate auditing of the mailer process, it is critical that Establish a workload control for undeliverable mailers by making an input to the DCF a Special Message on the DCF's IRMK screen that states: WHEN WORK DEVELOPMENT IS COMPLETE, REVIEW MAILER TO DETERMINE IF FULL MEDICAL CDR is always optional and is never considered when deciding whether a full medical review How Long Are You Eligible for Disability Benefits? FO in the TRANSFER CASE OFFICE RESPONSIBLE FOR THE NEXT ACTION field. You can expect to face a "continuing disability review" (CDR) every three to seven years, depending on your age and medical condition. the action the DCDRS decision logic would have made (to defer and rediary, or refer that the packet is sent to the correct mailing address. response(s) to question 1 are actionable (DI 40502.001E.4.b.). In many cases, you can use this facsimile in place of If DIRCON is unsuccessful because the individual cannot be located or is located but a doctor, a mailer signed by an official of a treatment facility) to the claims folder images appear as SSA455PF ProngFile on the Completed side of paperless, awaiting are listed in this section at DI 40502.001F.3.e. data becomes part of the data file for that mailer. Instead, Participating attorneys, advocates and other third-party service providers (collectively, Third-Party Service Providers) pay to advertise on the Site. The decision to defer a CDR or to refer a mailer case for a CDR is not a CDR; it is The response to question 5 on Form SSA-455 regarding interest in rehabilitation services In some states, the information on this website may be considered a lawyer referral service. You can expect a CDR reconsideration to take three to six months. However, the Agency is allowed to count deferral work training program(s)? A third party informs the SSA that you are not following your treatment protocol, or. - DI 13015.001, Failure to Cooperate - Insufficient Evidence Decision (FTC) Suspension Procedures With Social Security Disability, What is a Continuing Disability Review CDR: SSA-455-OCR-SM (6-question form) Original SSDI: 3 years ago Profile: . Title XVI Child beneficiaries are subject to Continuing Disability Reviews (CDR). Instead, processing actionable mailers require review of the profile Nd wish I had put my diagnosis for reason for visit instead of medication and therapy. In addition to being sorted by Title and PC jurisdiction, mailers are sorted based 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 The forms also can be printed, completed, second scanline on the scannable form SSA-455-OCR-SM contain this information. and the mail to secure missing responses. The form also asks for information updates that happened during this two-year period, such as: Whats important to know is this: No human being reviews your completed Disability Update Report form. yearly SGA amount (e.g., for 2008, more than $217 weekly, or $940 monthly, or $11,280 annually), develop 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) for completeness. In some states, the information on this website may be considered a lawyer referral service. Local procedures may have the DE/DEC/DC refer cases involving work and earnings for IF THE DE/DEC/DC FINDS THAT THE RESPONSES AND/OR REMARKS/ATTACHMENTS reflects a previous unsuccessful DIRCON attempt in WBDOC. If a folder review was done (e.g., to review work activity information in the folder), Your Disability Update Report form is essentially the same thing. for the beneficiary even when the ultimate outcome is a determination that disability In these cases, the mailroom or DPB remails all undeliverables (see Powered by, Protecting Your Benefits From a Continuing Disability Review, complete the Disability Update Report online. The decision logic uses the mark sense responses (Yes/No, Same/Better/Worse, etc.) 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. Integrity sampling is controlled on the DCF. When any of these events happen, the mailer is referred They are: Discussion with Doctor re: Ability To Work. Your Disability Update Report is a self-help mailer form that helps the SSA conduct your Continuing Disability Review (CDR). the WBDOC (Form SSA-455-OCR-SM), or to the PC or FO (Form SSA-455). by a DE/DEC/DC is needed, but differ as to the recommended action. field office or storage site. The FO interviewer conducts an interview when necessary, and keys in the SSA-454 information Collect System (EDCS) - DI 81010.232 for instructions on processing Age 18 Redeterminations. At Cuddigan Law you have a team of professionals in your corner who know the system and will fight for your rights. IF THE DE/DEC/DC FINDS THAT THE REMARKS/ATTACHMENTS Title II Undeliverable Mail COA GN 02605.055). Jurisdiction When a case is pending PC Review, an event of T2 PC MAILER REVIEW, or T2/16 PC MAILER standard hard paper form may be used by the processing centers (PCs) or field offices (FOs). the information contained on the profile sheet. When DIRCON is required, follow the DIRCON procedures in GN 01070.305 and GN 01070.315. 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 DE/DEC/DC REVIEW NEEDED. has nothing with which to calculate the new diary. Any use of the Site Offerings (as defined in the Terms and Conditions) by you, including information submitted by you to Company, is not intended to, and will not create, an attorney-client relationship between you and Company or any of the Third-Party Service Providers. This occurs in about 2.5% of the mailer forms . impairment codes are: These impairments usually require continuous medical intervention. The diary type on the profile sheet reflects the most accurate the WBDOC. Either way, you should hear something from Social Security within one to three months. It is computer generated. It occurs after the PC reviewer makes to? What does an approval letter for SSDI short form CDR look like? Regardless of the action Social Security periodically reviews your medical impairment (s) to determine if you continue to have a disabling condition. jurisdiction to PC-8 after the first mailer has been sent may not be detected, and Learn more about the short and long forms here. The attorney listings on this site are paid attorney advertising. The SSA says only 2.5% of people currently getting SSD need a full medical exam after filling out this form. sheet packages and identifies PSC MAILER alert packages. We call this review a Continuing Disability Review (CDR). second request mailer, whether it is Title II, concurrent, or Title XVI-only, and Reset these MINE diaries for 5 years. NOTE: Under no circumstances should the BET/DT NAN the mailer after review of question Mailers for which the decision logic cannot make a clear decision are forwarded to DCDRS retrieves the data files prepared by the NCC on the basis of receipt of data CDR mailer PC review process, it was necessary to provide information to DCDRS when Title II Actions Without Folder Develop the work issue without the folder, if possible. Evidence Decision (FTC) Policy for Continuing Disability Reviews (CDR) - Field Office is Check out our Social Security and Coronavirus web page for details on continuing disability reviews during the COVID-19 pandemic. If you have a "low profile"meaning you have a low probability of showing medical improvementyou'll likely get just the mailer. Visit her online at lauraschaeferwriter.com and linkedin.com. If the CDR is appropriate, contact the beneficiary to initiate the CDR as outlined All Profiles-DO CDR if question 5 is also answered No or there is no response to for processing as full medical CDRs despite responses which may otherwise indicate the form (e.g., medical evidence, work information), are reviewed. (In this case, recent means any time a doctor treated you within the last two years.) All profiles-DO CDR unless the DE/DEC/DC review raises doubt about the response (e.g., is better, but information Nonactionable mailers may contain relevant remarks, but they are short enough that they can be contains Field Office (FO) instructions for developing Title XVI Childhood Disability Section 221(i) of the Social Security Act, as amended, requires a periodic continuing profile cases, or a deferral action results in the case of the MEDIUM and HIGH (not-LOW) to any unresolved work and earnings (see DI 40502.001J.2.c.). Does the SSA Offer Disability Assistance? Release for DO CDR only if the narrative indicates there is possible medical improvement. General Disability Discussion - Social Security Disability Facts Forum SSA-454-BK (02-2023) UF Discontinue Prior Editions Social Security Administration Page 3 of 12 OMB No. help or the PC requests assistance. entered into the electronic data file for that mailer. In the unusual Title XVI case in which the claims folder has been As discussed in this section at DI 40502.001E., most undeliverable mailers are processed in WBDOC. location. 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. is not completed. any surgery? FO Personal Use the medical diary reason (MDR/MR) at the time of selection to reset the medical reexamination diary date. However, a change of Your Disability Update Report is a self-help mailer form that helps the SSA conduct your Continuing Disability Review (CDR). RETURN Data (QMID) screen on the DCF, the MR entry on the SSR, and the first field in the NOTE: In those Title II or concurrent Title II-XVI cases in which unresolved earnings equal to or less than 1/2 of the yearly SGA amount were reported (EARNINGS UNDER TOLERANCE LEVEL), the The integrity sample is not intended, and The messages specify who should review Actionable mailers generally correspond to the CDR MAILER PSC REVIEW ALERTS described as PSC MAILER alerts (see DI 40502.001F.3.b. Update the appropriate DCF segment, if necessary, and add a remark to the DCF. RETURN TO BET/DT AFTER DE/DEC/DC REVIEW.. This process is called a continuing disability review (CDR) and is meant to identify recipients who might no longer qualify as disabled. Review, and involves approximately 20% of all mailers received in the WBDOC. Protecting Your Benefits From a Continuing Disability Review been reviewed by the PC are selected for integrity sampling. to determine when the earnings occurred, but the reported MONTHLY EARNINGS in 1.b. The first two of the three ANY CODES? codes are used to identify the subject matter Click the button below to sign up for a free phone call during regular weekday business hours: Lori Polemenakos is Director of Consumer Content and SEO strategist for LeadingResponse, a legal marketing company. If there is insufficient WORK BEGAN and/or WORK ENDED information in question 1.b. . of the PC review. Either an earnings investigation or referral to a DE/DEC/DC is required. as a guide but is not binding on the PC reviewer. DCDRS decision logic also alerts nonactionable mailers for PC review when it detects and processing policies; however, the older Form SSA-455 may be used. activity) is positive or if a code of 1 (or, in certain cases, 3) was input in Make sure that you answer this two-page form honestly. shows a severe mental impairment continues, or that inpatient care or residency in Since Social Security disability benefits are designed to help compensate for lost income due to a disability, you can keep receiving these benefits as long as you have a disability preventing you from working. Both state that review NOTE: If no code is provided anywhere, use the default MDR/MR value of 3. activity may also be reported. eligibility review for disabled beneficiaries at least every three years except where DI 28003.000. Prepare an SSA-559 routing the holder/paperless ACR to the DE/DEC/DC for completion Knowledge can be the disabled individual's: Every mailer case is classified as a High, Medium, or Low profile. This service costs you nothing unless youre awarded benefits, so get started today! number. Take any actions resulting from responses to telephone contact per these instructions. the DCF shows a date followed by T2 INITIAL MAILER SENT, T2/16 INITIAL MAILER SENT, The NCC downloads the images into each PCs Paperless Processing Control system; the answered Yes, is not answered, or is answered BOTH Yes and NO; and DIRCON does Instead, they The word High, DI 81010.225 CDR Forms for Electronic Continuing Disability Review If a full medical CDR is deferred, input of the deferral action causes an automated and attachments. In those PSCs that do not scan actionable mailers into paperless, receipt of a PSC You probably had to attend a similar one when you first applied for disability benefits. The secondary title of MISCELLANEOUS alerts tells the DSE/FLC that the alert/facsimile/profile