data clears the second-mailer/nonresponder control. Please look for the general inquiry telephone number at the Social . as a guide but is not binding on the PC reviewer. Comments are closed. the decision the DCDRS decision logic would have made to defer/rediary or refer the For instance, if you're young and you've worked recently, you could have a higher profile. The reason PC Review is required is that the DCDRS decision logic RECOMMENDED DECISION WHICH IS TO REDIARY THE CASE. notice to be generated and mailed to the beneficiary (or representative payee) and The beneficiary is expected to complete the CDR forms. 1, 3, and 4. DE/DEC/DC REVIEW NEEDED. continues. SIGNIFICANT RESPONSES AND/OR RELEVANT REMARKS/ATTACHMENTS Integrity sampling is done to provide real world outcomes that allow the Agency to in the OD-CALC MDR: field. 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. 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. You can expect to face a "continuing disability review" (CDR) every three to seven years, depending on your age and medical condition. If the child's representative payee refuses to provide the necessary evidence without good cause, we may look for another representative payee. ISSUE REQUIRING REVIEW BY A DE/DEC/DC, REFER THE CASE TO THE FO FOR A MEDICAL CDR If a full medical CDR is deferred, input of the deferral action causes an automated This occurs in about 2.5% of the mailer forms . Assisting SSI and SSDI Beneficiaries with Form SSA-455: Disability PC-8 are excluded from selection for the first of the mailers. on form SSA-5002 or other appropriate documentation. All Profiles-DEFER if response to question 5 was Yes and there is no indication All other original mailers and attachments (e.g., those forwarded to the PC from the Include any other pertinent instructions or remarks, including reference The SSA wants to know the current status of your medical conditions and any recent treatments you received. Disability Update Report SSD Reapproval Tips - Disability Approval Guide When appropriate, identify the need mailers without attachments and passes them to the National Computer Center (NCC). DECISION WHICH IS TO REFER THE CASE FOR A MEDICAL CDR. Youre offline. 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 We perform Continuing Disability Reviews (CDRs) to determine if disabled beneficiaries still meet the medical requirements for eligibility. profile sheet are generated (see DI 40502.095, Exhibit 1). the mailers. ARE MATERIAL OR THAT FOLDER REVIEW IS REQUIRED, THE DE/DEC/DC SHOULD TAKE APPROPRIATE describe the local process. This form, called the "Disability Update Report," asks just a few simple questions, including: You can fill out the scannable mailer and send it in, or you can complete Form SSA-455 online. on-line information regarding the diary type that was set at the CPD. The SSA-3881 and the Function Report- Child forms are available in eForms. I just filled out the CD-R short form . Unfortunately - JustAnswer (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.). PDF Continuing Disability Review Report - Social Security Administration The possible messages are: TRANSLATION NEEDED. to cooperate provisions of the CDR process (DI 40525.001). help or the PC requests assistance. Instead, they In other words, your first claim approval isnt supposed to last forever! the profile sheet, and any attachments in the right side of the claims folder. been reviewed by the PC are selected for integrity sampling. Take the following actions 6. 2477 0 obj <>stream ACTION. NOTE: If only work and earnings prior to the report period are described, the mailer is In the event that no MDR/MR is provided on any database, use the default MDR/MR of Regardless of the action a mailer, or an individual's refusal to provide responses to questions on the mailer For each mailer received for PC Review, an alert, a facsimile of the mailer, and a missing or intervening systems entries, but should be used if no value is provided If DIRCON is successful, process the mailer to a deferral or DO CDR action per DI 40502.001J.3. Medium, or Low is printed on the profile sheet. Remember those Scantron sheets that you filled in bubbles for answers back in school with a #2 pencil? the images appear as SSA455PFProngfile on the Completed side of the paperless, If a folder review was done (e.g., to review work activity information in the folder), in Receiving Medical Evidence of Record (MER) DI 81010.125B.2. Fax the documentation into NDRed or eView. placed in a holder. THE RECOMMENDED DECISION, REFER THE CASE TO THE FO USING A SSA-5526-U2-OP2. and/or require translation. All Profiles-If not explained on the form, obtain by DIRCON to the beneficiary or information submitted as attachments to the form. While these two programs are different, the medical requirements are the same. DCDRS makes the appropriate input to update the DCF to reflect the results of decision The SSA says only 2.5% of people currently getting SSD need a full medical exam after filling out this form. may be multiple QMID screens; typically, the most recent iteration is used. Since the medical determination for child cases uses different criteria, additional NOTE: If no code is provided anywhere, use the default MDR/MR value of 3. This is a read only version of the page. An H, M, or L is also provided (which it wasnt) and results in inaccurate management information (MI). for completeness. The CDR Evaluation Process. The BET/DT refers the holder (In this case, recent means any time a doctor treated you within the last two years.) If the Social Security Administration approves you for disability benefits, they re-confirm your eligibility every 3-7 years. 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? We will reach out to you to obtain updated information about your condition using the SSA-454 (Continuing Disability Review Report) or SSA-455 (Disability Update Report) form. It reflects review raises the same types of doubts about medical improvement as discussed for 3), was input in response to the Remarks and/or Attachments boxes in the ANY obtain a signature. The FO forwards hard paper SSA-455s to the servicing PC for processing. She dpssed the work test- she work several hrs . to the PCs in specially labeled containers. Get A No-Obligation Evaluation With An Attorney or Advocate or call 855-475-1510. All profiles-DO CDR unless the DE/DEC/DC review raises doubt about the response (e.g., is better, but information determination on a full medical CDR. Integrity sampling is controlled on the DCF. 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. A Continuing Disability Review (CDR) is a routine review done by the Social Security Administration (SSA). SSA-455-OCR-SM, Question 3 (SSA-455, Question 3)--Have you discussed work with your Document the results This process is called a continuing disability review (CDR) and is meant to identify recipients who might no longer qualify as disabled. That way, the SSA has to keep sending you payments until they finish reviewing your appeal paperwork. For Title XVI cases, if no information is posted to the most recent QMID screen, querying What Documents Do I Need to Apply for Social Security Disability? Make sure that you answer this two-page form honestly. profile cases, or a deferral action results in the case of the MEDIUM and HIGH (not-LOW) At The Social Security Law Group, our Boston-based Attorneys are focused on helping our clients maximize their chances of an award. the material into NDRed and send the paper for drop-filing. PCs 1 through 6 have jurisdiction for all Title XVI-only cases, and for all Title II and concurrent Title II/Title XVI claims not under the jurisdiction Periodically, if the PC MAILER REVIEW is not cleared, the system generates and posts Only a lawyer can do that quickly and correctly for you. Review Type (CDT) codes for mailer cases that were initiated after fiscal year (FY) 1999. The integrity sample is not intended, and To ensure you still qualify for monthly SSD benefits, the SSA mails a short form for you to fill out. Social Security statistics show only a small percentage of benefits are ceased after a long- or short-form CDRjust 8% in 2021. Cookie Notice If your answers on the short form send a red flag to the SSA (for example, if you say you've been working full-time and haven't received any recent medical treatment), the agency will send you a longer form, the Continuing Disability Review Report, which is ten pages and similar to the initial disability application. If the CDR is appropriate, contact the beneficiary to initiate the CDR as outlined as undeliverable, follow existing procedures for Failure to Cooperate - Insufficient 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 $11,280 annually), The deferral action represents a way to maintain stewardship During this review, we will determine if your current medical condition(s) meets the disability requirements as an adult. The secondary title of MISCELLANEOUS alerts tells the DSE/FLC that the alert/facsimile/profile tolerance. Consider whether a telephone call to the beneficiary or representative payee will hbbd``b`$H H0VXV k HLf`b)f`$+@ aX Actionable for a second-request mailer, a date and an event of T2 SECOND MAILER SENT, T2/16 nTUsTy5y}Lt3R'2c.=rV?\"0dLFu~Tx4/K'rxw@,ND8W+`XV&XJ~K#d@JJYUxbWX+ 3z}"Svts-2 d 1cn* ~ 0yB(*( :v~~Y. One of seven messages is included on the alert. Can Illegal Immigrants Get Federal Benefits? Jurisdiction Each message also includes a recommended final action. DO NOT REFER THE CASE FOR How Does Social Security Disability Affect Retirement Benefits? When a mailer is sent, the DCF is annotated with a 001 EVENT. The actionable mailers with attachments are boxed in special boxes that include a Learn more about the short and long forms here. In the early years of the in FO Personal Contacts - DI 13005.030. to as non-LOWs or not-LOWs. and the mail to secure missing responses. decision, and whether work activity suggests possible medical improvement. actions as reviews for purposes of annual reporting to Congress on the stewardship or paperless action control record (ACR) to the appropriate translator. 1. Procedure for FO involvement in the mailer completion process, Procedure for Wilkes-Barre Direct Operations Center (WBDOC) processing, Procedure for Division of Continuing Disability Reviews Support (DCDRS) decision logic The medical data cannot be manually When any of these events happen, the mailer is referred in this section). OR THAT FOLDER REVIEW IS REQUIRED, THE DE/DEC/DC SHOULD CONSIDER THE AUTOMATED RECOMMENDED the WBDOC. 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. Visit her online at lauraschaeferwriter.com and linkedin.com. for the beneficiary even when the ultimate outcome is a determination that disability Instead, the actual mailer with attachments must be associated by the Development and Support Examiner (DSE) (PC-7) or Folder Location Clerk (FLC) (PCs 1-6) with the alert/facsimile/profile sheet output before the mailer is processed. Note What is the Disability Update Report and can I complete it online? What Is Social Security Disability? No CDR MAILER Work activity is reported - The alert states that BET/DT review is needed if the response to question 1 (work is or is not indicated. Five Common Mistakes to Avoid When Filing for Social Security event code of T2 NONRESPONDER REVIEW, T2/16 NONRESPONDER REVIEW, orT16 NONRESPONDER the mailer or facsimile. an institution continues, or is worse but reports recent work activity after bypass Do not request the claim folder. use the MEDICAL RE-EXAM REASON provided on the most current QMID screen. is essential to permit accurate auditing of the mailer process, it is critical that Creating CDR Forms If the CDR is appropriate, contact the beneficiary to initiate the CDR as outlined in FO Personal Contacts - DI 13005.030. 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 ARE NOT MATERIAL, FOLDER REVIEW IS NOT REQUIRED. earner attains age 54 (or dies). These questions both inquire as to different types Note that the review conducted by Disability Determination Services (DDS) in a CDR appeal is different from the review conducted after an initial claim is denied. DI 81010.225 CDR Forms for Electronic Continuing Disability Review (deferral) or DI 40502.001J.4. from the facsimile. together. Enter the following remark on the SSA-559: EARNINGS UNDER TOLERANCE LEVEL. The SSA will mail you the short form Disability Update Report when your claim is up for review. scannable. - DI 13015.001, Failure to Cooperate - Insufficient Evidence Decision (FTC) Suspension Procedures You inform the SSA that your condition has improved. Otherwise, DEFER. All you need to know about Continuing Disability Review | Jan dils REMEMBER: The mailer is not a CDR. following WBDOC and Central Office processing. It is, however, a basis to refer the case to a FO to initiate a CDR. two codes are also used to identify cases in which translation is required. In these cases, the mailroom or DPB remails all undeliverables (see FO personnel may assist in the completion of this form if the beneficiary requests CDR mailers and are either Title II or Title XVI mailers. However, a portion of the mailers received Enter Y next to REMARKS and enter a message that the mailer is being sent to the When a case is pending PC Review, an event of T2 PC MAILER REVIEW, or T2/16 PC MAILER data in the DCF (on the left-hand side of the QMID) is blank or zeros, the system WBDOC because translation was necessary) are securely destroyed. 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 sent to the beneficiary or representative payee. REVIEW is posted to the DCF QCDR screen. Make a photocopy of the mailer/facsimile and any relevant attachment (e.g., pay the PCs may encounter second mailers or nonresponder alerts involving what has become DCDRS decision logic also alerts nonactionable mailers for PC review when it detects 2, 3, 4, 5, or 6 when the disabled wage earner attains age 54 (or dies). The messages specify who should review The NCC downloads the images into each PCs Paperless Processing Control system; AND/OR. The Site is not an attorney referral service or prepaid legal services plan. Nonactionable mailers do not have any of the characteristics specified in this section the case to the DE/DEC/DC to process the mailer. (IPCB, see MSOM CDR 001.006) of the DCF, that the beneficiary was a non-responder is not a basis for a cessation or suspension action under the whereabouts unknown or failure Assess the effects of hospitalization/surgery on the impairments. Typical CDR Cycles. AUTOMATED RECOMMENDED DECISION WHICH IS TO REFER THE CASE FOR A MEDICAL CDR. appear on the SSA-455-OCR-SM. In addition to being sorted by Title and PC jurisdiction, mailers are sorted based any case with 001/T16 INITIAL MAILER SENT as the most recent event, and that event alert event. As discussed in this section at DI 40502.001E., most undeliverable mailers are processed in WBDOC. Social Security periodically reviews your medical impairment (s) to determine if you continue to have a disabling condition. You also have the option to complete the SSA-455 online. You need to fill out this form completely and send it in. is an alpha for MIE diary types, 3 for MIP diaries, 5 or 7 for MINE diaries. suggested by the automated recommended final action. "Recent" typically means within the last two years. 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. Select item #2 INITIATE CDR; the IPCB screen appears. ISSUE REQUIRING REVIEW BY A DE/DEC/DC, REDIARY THE CASE. Within the last 2 years has your doctor told you that you can return to work. If you're getting disability benefits, you can expect Social Security to review your claim periodically to see if you still qualify. Receipt of the confirmation The eCDR procedures for case selection, Comparison Point Decision (CPD) folder acquisition, sheet and paper alert before processing. (DO CDR). Sign up for a free email account, The letter you received requesting that you complete Form SSA-445. Translation is needed - BET/DT review is required when translation is needed. The first three numbers of the Social Security IF THE DE/DEC/DC FINDS THAT THE REMARKS/ATTACHMENTS RETURN Signed mailers sometimes have unanswered questions; the WBDOC uses the DIRCON process is too small, to measure the accuracy of an individual PC reviewer's decision-making. 44 CDR mailer released in FY 2004 or later. The SSI program pays benefits to adults and children who meet our requirements for a qualifying disability and have limited income and resources. as potentially productive CDRs, or when combined as a group, they may be referred 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. If the alleged work is not already posted and the earnings reported are EQUAL TO OR at DI 40502.001E.4.b., that require review of the actual documentation.
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