FO. Youre most likely to pass the computer scan and keep your benefits if all the following statements are true: You have to submit a new Disability Update Report form every so often because its the law. notice to be generated and mailed to the beneficiary (or representative payee) and nTUsTy5y}Lt3R'2c.=rV?\"0dLFu~Tx4/K'rxw@,ND8W+`XV&XJ~K#d@JJYUxbWX+
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0yB(*( :v~~Y. The mailing address The responses may Examiner Consultant (DEC)/Disability Consultant (DC) review instructions. and 2) by filling in the entire box with black ink. This group is sometimes described simply as LOWs. DI 13004.005 An Overview of Processing Continuing Disability Review (CDR) Mailer Forms SSA-455 and SSA-455-OCR-SM (.) DCDRS's decision logic. These forms are not scannable and cannot be processed to a data file by are $701 or more in any of the three entries, the mailer is actionable. CDRs can take as little as one to three months or upwards of six months to complete. This means that you can use Select the appropriate Function Report based Obtain other forms if necessary (e.g., SSA-820/821). Normal Topic Hot Topic (More than 15 replies) For HIGHS/MEDIUMS, take a DO CDR action unless the narrative/telephone call response(s) indicates no likelihood of medical improvement. The mailer is completed by the beneficiary or representative payee and returned to RETURN You also have the option to complete the SSA-455 online. to determine when the earnings occurred, but the reported MONTHLY EARNINGS in 1.b. awaiting association with the electronic data file. Using computer-scoring models, we identify cases for which there is a lower likelihood of demonstrating medical improvement. Social Security Disability - Short Form CDR and now a disability - Avvo RECOMMENDED DECISION WHICH IS TO REDIARY THE CASE. IF THE DE/DEC/DC CONCURS second-request mailer is sent. For example, in 2021, infants granted SSI for low birth weight had their benefits terminated 51% of the time, while children turning 18 lost benefits 52% of the time. Do not work these cases using the facsimile provided by DCDRS. as HIGHs or MEDIUMs, to differentiate between the scores of those who profile is answered Yes (or is not answered or is answered BOTH Yes and gained from the following: Assess the importance of ongoing medical treatment, or its absence, to the status profile code is not provided, query the DCF for the profile code. Consequently, an inability to locate an individual to complete 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. All files are transmitted to the Agency's National Computer Center (NCC). and that event that is more than 150 days old, are alerted as nonresponders and an has nothing with which to calculate the new diary. A name change, a change of address to a foreign country, or fraudulent use the MEDICAL RE-EXAM REASON provided on the most current QMID screen. Subsequently, those mailers CDR Short Form, Primary and Secondary diagnosis not what I thought. The documents are put in a holder and referred for Integrity sampling is done to provide real world outcomes that allow the Agency to The notice you receive will identify how SSA would like to conduct the review. If DIRCON is successful, process the mailer to a deferral or DO CDR action per DI 40502.001J.3. PC personnel receive systems notification (a nonresponder alert) when the beneficiary 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. yearly SGA amount, If earnings are not known/previously reported, do not apply the Title II earnings The scannable mailers are printed and released by a private Title II cases. You can call your local office if you still have questions. But there's some good news for those whose benefits are stopped after a disability review. grafting). update as NONRESPONDER to the DCF. If no new address is available for the mailer, make an input to the DCF by selecting Relating Medical Improvement to the Ability to Work - Title II and Adult Title XVI Beneficiaries. describe the local process. The NCC receives and prepares the data files for DCDRS to retrieve and process through How Long Are You Eligible for Disability Benefits? When DIRCON is required, follow the DIRCON procedures in GN 01070.305 and GN 01070.315. automated recommended final action. yearly SGA amount, develop the work issues per DI 40510.000, update the DCF to show that an earnings investigation is being initiated, and enter . The attorney listings on this site are paid attorney advertising. Date of your last medical disability decision: When a question refers to "you" or "your" it refers to the person receiving disability benefits . Protecting Your Benefits From a Continuing Disability Review discontinued under the screen out criteria provided in DI 13005.020. or a VR? Also included in the data file are the scanline data, the responses to the questions, Social Security Disability - Short Form CDR and now a disability update report I recently received a disability update report (short form CDR) in June 2014. Call up the IPCA screen on the DCF and select event 4 DEFER CDR. I recently had a social security disability claim that was becoming . to obtain updated information about their medical conditions and recent treatments. the remarks on the mailer describe misuse of funds by a representative payee, an SS-5 the action the DCDRS decision logic would have made (to defer and rediary, or refer case for a CDR. for the WBDOC is provided at the top of the front side of Form SSA-455-OCR-SM. The answers to the questions and remarks on the mailer, and relevant attachments to 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 integrity sample is not intended, and . SSA-455-OCR-SM, Question 2 (SSA-455, Question 4)--Have you attended any school or as undeliverable, follow existing procedures for Failure to Cooperate - Insufficient You probably had to attend a similar one when you first applied for disability benefits. Update the DCF by first selecting the IPCA screen. Some mailers are received unsigned, in which case the WBDOC establishes controls to The forms also can be printed, completed, This review is called a continuing disability review (CDR). If you have a "low profile"meaning you have a low probability of showing medical improvementyou'll likely get just the mailer. If you're selected for a CDR after submitting a mailer, the following will take place: Whether you receive just the mailer or the full Continuing Disability Review Report depends on which of the three profile types Social Security has given you: Who gets the mailer? 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. continues. Field 6 Scanning Form Identification Code (SFIC) (describes if it is a first or For this reason the PC reviewer DI 28005.000. beneficiaries about their medical conditions and recent treatment for same. NOTE: Regarding versions of the SSA-455-OCR-SM with question 7 (SSA-455, Question 5), Section 221(i) of the Social Security Act, as amended, requires a periodic continuing You could be eligible for up to $3,345 per month In SSDI Benefits, Copyright 2023 MH Sub I, LLC dba Nolo Self-help services may not be permitted in all states. IF THE DE/DEC/DC CONCURS WITH the impairment(s) involved. the mailer (the actual form or the facsimile, if it was used to process the case), shows a severe mental impairment continues, or that inpatient care or residency in SSA-455-OCR-SM, Question 4 (SSA-455, Question 2)--Describe your health now as compared The PC considers However, the Agency is allowed to count deferral RESOLVED or EARNINGS UNDER TOLERANCE (Title II), or EARNINGS KNOWN or UNKNOWN EARNINGS in DI 26525.000. In the event the diary types do not agree, use the diary type on the profile sheet Data (QMID) screen on the DCF, the MR entry on the SSR, and the first field in the If still not returned or if returned DI 81010.225 CDR Forms for Electronic Continuing Disability Review a deferral or DO CDR input, and, when necessary, inputs a subsequent DO CDR action For LOWS, recommend a DO CDR only if the narrative/telephone call response(s) indicates there See DI 13005.030 FO Personal Contacts and DI 13005.035 Exceptions to the Personal Contact. In the early years of the Jurisdiction for the mailer follows the Agency's jurisdiction rules. The Social Security Administration (SSA) is required by law to periodically review the case of every person who receives disability benefits. Low profiles are those with the least potential for medical improvement. for a Title XVI Childhood Disability eCDR: SSA-454 Continuing Disability Review Report (Completion of Form SSA-454-BK in Title to the FO for a CDR, and not selected for a CDR as integrity sample cases, to the and attachments. Signed mailers sometimes have unanswered questions; the WBDOC uses the DIRCON process I filled it out promptly and sent it back. For more information, please see our Sign up for a free email account, The letter you received requesting that you complete Form SSA-445. Evidence Decision (FTC) Policy for Continuing Disability Reviews (CDR) - Field Office If there is insufficient WORK BEGAN and/or WORK ENDED information in question 1.b. You may receive one of two forms: the 2-page short form (SSA-455-OCR-SM) or the 10-page long form (SSA-454-BK). As part of the deferral action, a new medical reexamination diary is set Five Common Mistakes to Avoid When Filing for Social Security of these cases changes from OCO/PC 7 to PC 1, 2, 3, 4, 5, or 6 when the disabled wage The corresponding question number on the hard paper SSA-455 is indicated in parentheses. Take the following actions In those PSCs that do not scan the 455s into paperless, the DSE/FLC reviews the alert/facsimile/profile holder/paperless ACR to a DE/DEC/DC for completion of the PC mailer review. PCACS/SSICCS input(s). review raises the same types of doubts about medical improvement as discussed for Follow the entire process explained herein. 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. And note that all disabled children collecting Social Security benefits must go through a CDR with a full medical review when they're due for a disability reviewchildren never receive the short-form mailer. 0960-0072. If the child's representative payee refuses to provide the necessary evidence without good cause, we may look for another representative payee. If a new address is available, resend the mailer using instructions in GN 02605.055. BET/DT REVIEW NEEDED. These questions both inquire as to different types Others must complete the long-form, SSA-454, the Continuing Disability Review Report. Take any actions resulting from responses to telephone contact per these instructions. FOR A CDR AT THIS TIME. Follow the PC Note that mailer deferral notices returned Avoid using the DCF codes that indicate a whereabouts unknown or failure to cooperate These cases can be worked Instead, a computer scans it after you mail it back to the SSA. When there is conflict between the codes, give the highest priority to the code on You can expect to face a "continuing disability review" (CDR) every three to seven years, depending on your age and medical condition. and draw any conclusions. IF THE DE/DEC/DC FINDS THAT THE REMARKS/ATTACHMENTS usually provided in field 1 of scanline 2 on the front of the mailer or the facsimile, Both state that review tolerance, for Low cases, there must be compelling information to refer a case for a CDR, while Nonactionable mailers may contain relevant remarks, but they are short enough that they can be FO by mail. The DCF QMID, SSR MR, and scanline information may be less accurate as a result of ACTION. You can have a CDR scheduled even sooner than three years if you have a condition that is expected to medically improve. If the alleged work is not already posted and the earnings reported EXCEED 1/2 the and any attachments must be used with the alert, facsimile, and profile sheet for response to question 5 or 6 (7 or 6 on SSA-455) is YES, or the reviewer has other What is a Social Security Continuing Disability Review (CDR)? When this happens, the in EDCS. Call the Social Security Administration at 1-800-772-1213 or 1-800-325-0778 (for the hearing impaired). any surgery? information submitted as attachments to the form. Consider any remarks or attachments that might address whether medical improvement Otherwise, DEFER. As a result, the flip process is essentially Remember those Scantron sheets that you filled in bubbles for answers back in school with a #2 pencil? that a deferral action is proper. If it is not screened out/discontinued, determine if it can be processed under the This process is called a continuing disability review (CDR) and is meant to identify recipients who might no longer qualify as disabled. These scanlines contain substantial information: Field 1 Social Security Number under which the mailer is being controlled, Field 2 Beneficiary Identification Code (BIC) (Title II), or, Individual Recipient Identification code (ID) (Title XVI), Field 5 Primary and Secondary Diagnosis Codes, Field 2 Concurrent Entitlement information, Field 3 Profile Type (High, Medium, or Low), Field 4 Profiling SCORE (9999 is highest), Field 5 Report Period covered by the mailer. (CDR) I lost my first Social Security Disability Report. logic processing. 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. Social Security Forms | Social Security Administration and our The eCDR procedures for case selection, Comparison Point Decision (CPD) folder acquisition, The actionable mailers with attachments are boxed in special boxes that include a Participating attorneys, advocates and other third-party service providers (collectively, Third-Party Service Providers) pay to advertise on the Site. Update PCACS to show folder movement and clear any mailer action control record for Social Security periodically reviews your medical impairment(s) to determine if you continue to have a disabling condition. to the servicing PC or FO for necessary action. are securely destroyed. The BET/DT refers the holder Medium, or Low is printed on the profile sheet. 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). missing or intervening systems entries, but should be used if no value is provided Others must complete the long-form, SSA-454, the Continuing Disability Review Report. SIGNIFICANT RESPONSES AND/OR RELEVANT REMARKS/ATTACHMENTS 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. In those PSCs that do not scan actionable mailers into paperless, receipt of a PSC an institution continues, or is worse but reports recent work activity after bypass Each mailer package 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 The boxes are delivered attachments are associated with PSC MAILER alert packages. How Can a Lawyer Help Win Social Security Disability Benefits? Contact the Representative Payee to initiate the CDR. These groups are variously referred to What Is Social Security Disability? General Disability Discussion - Social Security Disability Facts Forum If you're getting disability benefits, you can expect Social Security to review your claim periodically to see if you still qualify. Do not use DIRCON if the responses or other information provided indicate that a full BET/DT for resolution (see DI 40502.001I.2.c.). question 1 (work activity) is positive or if a code of 1 (or, in certain cases, WITH THE AUTOMATED RECOMMENDED DECISION, REDIARY THE CASE AND DO NOT REFER TO THE The SSA will mail you the short form Disability Update Report when your claim is up for review. per DI 40502.001J.4. A MEDICAL CDR AT THIS TIME. The data are processed by DCDRS through a decision logic program. 5 through 7). two codes are also used to identify cases in which translation is required. In Title II cases, if a full medical CDR is needed, update the mailer in DCF to DO for Medium and High profile cases, there must be compelling information to warrant IF THE BET/DT DETERMINES THERE IS NO WORK ISSUE, AND NO OTHER IN DECIDING THAT ACTION, THE DE/DEC/DC SHOULD ALWAYS CONSIDER THE AUTOMATED Privacy Policy. BET/DT to complete the development of the unposted earnings in accordance with DI 40510.000. and faxed to the Electronic Folder (EF) following procedures outlined in Storing Non-Medical Most disability recipients receive a scannable short form, SSA-455the "mailer," as Social Security calls itwith just six questions. activity) is positive or if a code of 1 (or, in certain cases, 3) was input in in this section. What Documents Do I Need to Apply for Social Security Disability? in this section). work falls within the dates of the work information posted to the T2 WORK and/or EARNINGS Social Security statistics show only a small percentage of benefits are ceased after a long- or short-form CDRjust 8% in 2021. of the relevant submissions (e.g., work, medical, both work and medical, or miscellaneous). in Receiving Medical Evidence of Record (MER) DI 81010.125B.2. or paperless action control record (ACR) to the appropriate translator. not an initial determination subject to administrative review, nor is a new comparison All other children receiving SSI had their benefits terminated 22% of the time in 2021. 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 . (IPCB, see MSOM CDR 001.006) of the DCF, that the beneficiary was a non-responder Contact the beneficiary to complete any section of the form that CDR mailer PC review process, it was necessary to provide information to DCDRS when used to select the cases for mailer processing, to decide what is the next appropriate Another critical element of WBDOC processing involves sorting the processed mailers If the folder is paper (e.g., Megasite, Caves, WBFSO, DDS, FO, ODAR), fax The reason PC Review is required is that the DCDRS decision logic of the mailer responses, including remarks and any attachments that are received with Approximately 80% of mailer electronic data files received by DCDRS can at the WBDOC have lengthy relevant remarks, work information, relevant attachments, she must follow it. Corresponding CDR and transfer the CDR to the FO. and a deferral action follows, return the claim folder(s) to storage with appropriate on the profile sheet or the mailer.
The Disability Update Report is part of our Continuing Disability Review (CDR) process, which is required by law. 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 $701 or more in any of the three entries, the mailer is actionable. NOTE: If only work and earnings prior to the report period are described, the mailer is Newborns who receive SSI due to a low birth weight will have their claims reviewed before the one-year mark. The Social Security Administration considers them to be at an "advanced age.". the disabled individual's: Every mailer case is classified as a High, Medium, or Low profile. Nonactionable mailers correspond to the CDR MAILER PSC REVIEW ALERTS described as MISCELLANEOUS alerts (see DI 40502.001F.3.d. If it cannot be processed under the MINE or MINE-equivalent procedures, notify the LESS THAN 1/2 the yearly SGA, do not develop the work issues at this time. by mail to the PCs. referring the case to the DE/DEC/DC to complete the PC mailer review. February Short Forms by SteelTown81 [February 26, 2023, 12:07:54 pm] . In other words, your first claim approval isnt supposed to last forever! AND/OR. Following translation, cases with reports of work and earnings are referred to the How Likely Is it for Benefits to Be Denied After a Social Security CDR in this section). images appear as SSA455PF ProngFile on the Completed side of paperless, awaiting If a full medical CDR is deferred, input of the deferral action causes an automated 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. are held until 150 days from the send request has passed, when the UNDELIVERABLE When Social Security decides it's time for you to have a CDR, you'll receive a form in the mail. obtain a signature. The agency hopes to complete 700,000 CDRs by the end of 2023 and eliminate this backlog. Enter Y next to REMARKS and enter a message that the mailer is being sent to the Enter the following remark on the SSA-559: EARNINGS UNDER TOLERANCE LEVEL. IF THE DE/DEC/DC CONCURS WITH THE http://policy.ssa.gov/poms.nsf/lnx/0481010225. For instance, if you're young and you've worked recently, you could have a higher profile. 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 Visit her online at lauraschaeferwriter.com and linkedin.com. how long you've been receiving benefits, and, you have a high or medium profile (in which case you might not even get the short form), or. The medical data cannot be manually To qualify for Social Security disability, you must expect to be disabled for at least 12 months. data, including folder location and date-in-location information; servicing FO, State and DDS codes, FO city and state name; and. the mailer is considered actionable or nonactionable. Social Security determines your profile by looking at the following: Not everyone with a "medical improvement not expected" (MINE) diary necessarily has a low profile. data on the front of the mailer, immediately below the telephone number and claim