Field 6 Scanning Form Identification Code (SFIC) (describes if it is a first or Here are some bonus tips for making sure your Disability Update Report doesnt trigger a human review and medical exam: If your Disability Update Report answers arent clear or you mail it back late, youll likely have to undergo a medical exam. Only if you lose that hearing would you request an ALJ hearing. The long CDR form asks extensive questions about your disability, including: You'll need to provide your healthcare providers' names and contact information so that Social Security can request your medical records. A name change, a change of address to a foreign country, or fraudulent 6. All Profiles-Review dates and the narrative. 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. Most disability recipients receive a scannable short form, SSA-455the "mailer," as Social Security calls itwith just six questions. In both a cessation appeal and an initial denial, the reconsideration is essentially a review of your file by a different DDS staff member. Get A No-Obligation Evaluation With An Attorney or Advocate or call 855-475-1510. If the SSA finds that your condition has improved and you are no longer disabled or blind, then your benefits will terminate. I filled out counseling and prescriptions. Participating attorneys, advocates and other third-party service providers (collectively, Third-Party Service Providers) pay to advertise on the Site. the profile sheet, and any attachments in the right side of the claims folder. question 1 (work activity) is positive or if a code of 1 (or, in certain cases, At Cuddigan Law you have a team of professionals in your corner who know the system and will fight for your rights. 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). The PC's supply of the SSA-5526-U2-OP2 may not have pre-printed Continuing Disability profile cases. Document the results I am helping someone who was found disabled due to major depressive disorder and anxiety. in, print the appropriate CDT code in the CDT section of the SSA-5526-U2-OP2, http://policy.ssa.gov/poms.nsf/lnx/0440502001. The mailing address Box 4550 Wilkes-Barre, PA 18767-4550 Need a replacement form? 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. An optically scannable variation of the mailer, Form SSA-455-OCR-SM, is most frequently used. 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 . inquiry below the signature line -- Do not consider this response. as HIGHs or MEDIUMs, to differentiate between the scores of those who profile IF THE DE/DEC/DC FINDS THAT THE REMARKS/ATTACHMENTS WBDOC has procedures to attempt re-delivery. Alerts with the secondary title of PSC MAILER are generated when the actual mailer This process is called a continuing disability review (CDR) and is meant to identify recipients who might no longer qualify as disabled. activity may also be reported. DE/DEC/DC REVIEW NEEDED. They are identified as actionable mailers in the WBDOC. 3), was input in response to the Remarks and/or Attachments boxes in the ANY describe the local process. may be multiple QMID screens; typically, the most recent iteration is used. prevent user input in these situations. a foreign claim. They cannot stop your payments if you appeal within that 10-day window! If forms are not returned, send a follow-up notice. If the mailer is again returned as undeliverable, the forms should be securely destroyed. on the profile sheet or the mailer. on whether they are actionable or nonactionable. She dpssed the work test- she work several hrs . files from the WBDOC. Your attempts to start working again, if any. The seven messages are listed in this section at DI 40502.001F.3.c. All Profiles-DO CDR if question 5 is also answered No or there is no response to After yearly SGA amount (e.g., for 2008, more than $217 weekly, or $940 monthly, or $11,280 annually), develop is or is not indicated. If the alleged work is not already posted and the earnings reported are EQUAL TO OR If you make a DO CDR action, refer the case to the FO to notify the beneficiary and data, including folder location and date-in-location information; servicing FO, State and DDS codes, FO city and state name; and. After the work issue is resolved, refer to the DE/DEC/DC for completion of the PC . the case to the DE/DEC/DC to process the mailer. If the claimant or representative provides medical records to the FO, use the procedures Check the profile sheet for information about the prior decision. I recently had a social security disability claim that was becoming . stubs, copies of W-2's), and refer to the servicing FO to develop/adjust for the work If it can be processed under the MINE or MINE-equivalent procedures, refer it to the Do not use DIRCON if the responses or other information provided indicate that a full It is also important to consider the profile. High or Medium-DO CDR unless theDE/DEC/DC review raises doubt about the response (consider DIRCON to resolve). 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. SSA-455-OCR-SM, Question 3 (SSA-455, Question 3)--Have you discussed work with your If the medical Control the CDR on the DCF by using tickle dates. Note and processing policies; however, the older Form SSA-455 may be used. Field 8 Servicing State Agency/DDS code, Field 9 Servicing Field Office (FO) Code. ISSUE REQUIRING REVIEW BY A DE/DEC/DC, REDIARY THE CASE. This website is produced and published at U.S. taxpayer expense. BET/DT REVIEW NEEDED. payee, or a request to waive recovery of an overpayment); with a YES response to question 1.a. to the PC. And Social Security will reset your periodic review interval, which it calls your "medical reexamination diary," at the same interval it was before you received the mailer. of possible medical improvement. in FO Personal Contacts - DI 13005.030. High or Medium-DO CDR unless the response to question 5 or 6 (7 or 6 on SSA-455) is YES, or the reviewer has other Processing a mailer for a deferral The medical data cannot be manually FOLLOW THE AUTOMATED RECOMMENDED DECISION TO REDIARY THE CASE AND NOT REFER THE CASE Integrity sampling is controlled on the DCF. a code of 1 in position 1 or 2 of the ANY CODES? IF THE DE/DEC/DC CONCURS WITH THE prepare an SSA-559 to refer the case to the DE/DEC/DC for processing of the mailer. The SSA wants to know the current status of your medical conditions and any recent treatments you received. The reason PC Review is required is that the DCDRS decision logic DIRCON procedures in GN 01070.305 and GN 01070.315. 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. Those who receive the SSA-455 now have the option to complete the Disability Update Report (SSA-455) form online. Take the following actions Follow the entire process explained herein. answered Yes, is not answered, or is answered BOTH Yes and NO; and DIRCON does following WBDOC and Central Office processing. and/or attachment(s) should be referred to another component for additional post-entitlement One outcome is a DO CDR (mailer to be referred for a full medical CDR) that results in a full medical CDR Contact the beneficiary to complete any section of the form that 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. Some mailers are received unsigned, in which case the WBDOC establishes controls to decision, and whether work activity suggests possible medical improvement. FO personnel may assist in the completion of this form if the beneficiary requests DE/DEC/DC review is required for all other PC review mailers (alert message examples BET/DT to complete the development of the unposted earnings in accordance with DI 40510.000. If the response to 5 or 6 is YES, weigh all information, especially responses to questions CDR mailer PC review process, it was necessary to provide information to DCDRS when You inform the SSA that your condition has improved. The form you are looking for is not available online. The SSA will discontinue CDRs from time to time when it runs short of funding. However, the Agency is allowed to count deferral The following instructions are designed for the sequence of the questions as they The PC considers Collect System (EDCS). And I was actually due every year. 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. The DE/DEC/DC may find it efficient to consider the responses Start your application through a personal disability advocate or attorney and potentially improve your chances of approval. for Release of Medical Information). of high workloads, these assembled files are transmitted daily, and multiple daily profile cases, or a full CDR is initiated for MEDIUM or HIGH (not-LOW) profile cases. facility, or residential care facility; with a code of Y in position 3 of the Any Codes? the suggested outcome; however, profiling has been shown to be accurate in assessing Since the medical determination for child cases uses different criteria, additional As part of the deferral action, a new medical reexamination diary is set automated recommended final action. (Have you worked?) Actually, the SSA is required to review every individual receiving Social Security Disability (SSD,) or Supplemental Security Income (SSI.) 5 Replies 851 Views October 07, 2022, 04:50:39 pm by six-twelve: Receipt of the confirmation We mail the Disability Update Report, or Form SSA-455, to disabled beneficiaries A complete list of CDT codes is in SM 06001.120B.11. to the PCs in specially labeled containers. How Bankruptcy Affects Your Disability Check, February 2023 Veterans Disability Benefits Statistics Report Analysis. information submitted as attachments to the form. (Learn more about how frequently your disability case will be reviewed.). two codes are also used to identify cases in which translation is required. DE/DEC/DC refers the case to the BET/DT for investigation of earnings per DI 40502.001J.2.c. Typical CDR Cycles. If the folder is paper (e.g., Megasite, Caves, WBFSO, DDS, FO, ODAR), fax provide further details. 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 An H, M, or L is also provided 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. (deferral) or DI 40502.001J.4. See CDR Forms for eCDR Review Note: We updated this article in February 2023 to reflect the latest information. CDR. Actionable mailers are those that always require PC review. The NCC receives and prepares the data files for DCDRS to retrieve and process through These forms are not scannable and cannot be processed to a data file by 0960-0072. 1. The PC reviewer always needs to In some states, the information on this website may be considered a lawyer referral service. Enter Y next to REMARKS and enter a message that the mailer is being sent to the are $701 or more in any of the three entries, the mailer is actionable. electronic data file that is created for each scannable mailer. All Profiles-If not explained on the form, obtain by DIRCON to the beneficiary or a Special Message on the DCF's IRMK screen that states: WHEN WORK DEVELOPMENT IS COMPLETE, REVIEW MAILER TO DETERMINE IF FULL MEDICAL CDR to cooperate provisions of the CDR process (DI 40525.001). $701 or more in any of the three entries, the mailer is actionable. of the condition. On the copy of the mailer referred to If DIRCON is successful, process the mailer to a deferral or DO CDR action per DI 40502.001J.3. Mailers in which a Privacy Policy. Signed mailers sometimes have unanswered questions; the WBDOC uses the DIRCON process The WBDOC reviews and processes most scannable mailers, including mailers returned is answered Yes (or is not answered or is answered BOTH Yes and Follow the PC Title-specific confirmation files consisting of the SSN and BIC/ID are also created. If Social Security believes you have a high probability of medical improvement, you'll likely receive the longer Form SSA-454, the Continuing Disability Review Report, rather than the mailer. . to (For more information, see our article on the medical improvement review standard.). The third of the three ANY CODES? codes are used to alert the PC when other program The word High, The scannable mailers are printed and released by a private Nonactionable mailers do not have any of the characteristics specified in this section is blank or if no earnings are reported; and if question 1.a. 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? data clears the second-mailer/nonresponder control. are reported, the mailer is actionable. 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. DCDRS's decision logic. 2464 0 obj <>/Encrypt 2456 0 R/Filter/FlateDecode/ID[<0E53796FDE8F714F84C7B5E38030F59A>]/Index[2455 23]/Info 2454 0 R/Length 63/Prev 272370/Root 2457 0 R/Size 2478/Type/XRef/W[1 2 1]>>stream Your Disability Update Report form is essentially the same thing. CDR is needed. beneficiary and representative payee, if any, that a CDR is being initiated and conduct action. second-request mailer is sent. Nonactionable mailers are held in the WBDOC for a specified period of time and are on form SSA-5002 or other appropriate documentation. point decision (CPD) established. SSA-455-OCR-SM, Question 2 (SSA-455, Question 4)--Have you attended any school or If still not returned or if returned as undeliverable, follow existing procedures for Failure to Cooperate - Insufficient Evidence Decision (FTC) Policy for Continuing Disability Reviews (CDR) - Field Office - DI 13015.001, Failure to Cooperate - Insufficient Evidence Decision (FTC) Suspension Procedures for Continuing Disability Reviews (CDR . After sorting by PC jurisdiction and Title (II or XVI), WBDOC images the actionable CDRs. Reliance on any information made available to you by and through the Site Offerings is solely at your own risk. It is no longer necessary to report to DCDRS when a folder review is done. FO in the TRANSFER CASE OFFICE RESPONSIBLE FOR THE NEXT ACTION field; Enter a message that the mailer is being sent to the FO. 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. FO. The fronts of most mailers are optically scanned and the data are entered into the Instead, a computer scans it after you mail it back to the SSA. By rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform. At The Social Security Law Group, our Boston-based Attorneys are focused on helping our clients maximize their chances of an award. a deferral action. If you're getting disability benefits, you can expect Social Security to review your claim periodically to see if you still qualify. The answers to the questions and remarks on the mailer, and relevant attachments to If question 1.a. Actionable mailers received from the WBDOC are sorted in anticipation of receipt of 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 Most disability recipients receive a scannable short form, SSA-455 the "mailer," as Social Security calls itwith just six questions. The Site is not an attorney referral service or prepaid legal services plan. The BET/DT develops the work on mailer alerts with a BET/DT remark/message, and the 44 CDR mailer released in FY 2004 or later. Introduction to the Continuing Disability Review (CDR) Process. Enter the following remark on the SSA-559: EARNINGS UNDER TOLERANCE LEVEL. DCDRS makes the appropriate input to update the DCF to reflect the results of decision tolerance, for Low cases, there must be compelling information to refer a case for a CDR, while Review Type (CDT) codes for mailer cases that were initiated after fiscal year (FY) 1999. are securely destroyed. no one with access to the DCF take any action to change a flipped case back to a that Title II and Title XVI mailers have different Post Office Box numbers. If that happens to you, file an appeal within 10 days after you get that letter in the mail. Your prior award letter stands. DE/DEC/DC REVIEW NEEDED. If it cannot be processed under the MINE or MINE-equivalent procedures, notify the The decision to defer a CDR or to refer a mailer case for a CDR is not a CDR; it is IF THE DE/DEC/DC FINDS THAT THE REMARKS/ATTACHMENTS ARE MATERIAL Make sure that you answer this two-page form honestly. for a Title XVI Childhood Disability eCDR: SSA-454 Continuing Disability Review Report (Completion of Form SSA-454-BK in Title If a folder review was done (e.g., to review work activity information in the folder), Call up the IPCA screen on the DCF and select event 4 DEFER CDR. It reflects A CDR is a process by which the SSA analyzes your medical impairment (s) to determine if you continue to have a disabling condition that qualifies you for disability benefits. In some instances, other Next in priority, the alert states that BET/DT review is needed if the response to she must follow it. The decision logic uses the mark sense responses (Yes/No, Same/Better/Worse, etc.) Handle these as follows: Attempt direct telephone contact (DIRCON) to complete form SSA-455. 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. 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. a corresponding change of telephone number), and reports of death for Title II cases, For Title XVI cases, if no information is posted to the most recent QMID screen, querying If you have a "low profile"meaning you have a low probability of showing medical improvementyou'll likely get just the mailer. To ensure you still qualify for monthly SSD benefits, the SSA mails a short form for you to fill out. IF THE BET/DT DETERMINES THERE IS NO WORK ISSUE, AND NO OTHER the WBDOC (Form SSA-455-OCR-SM), or to the PC or FO (Form SSA-455). sent to the beneficiary or representative payee. These cases can be worked PCACS/SSICCS input(s). The profile sheet contains much of the data used by DCDRS to identify and profile the case, including We periodically review your case to determine if you continue to meet the eligibility rules to receive disability benefits. Newborns who receive SSI due to a low birth weight will have their claims reviewed before the one-year mark. Contacts - DI 13005.030C.2. The FO forwards signed SSA-455-OCR-SMs to the WBDOC for processing. and earnings. Although sometimes referred to as CDR mailers, in Evidence Decision (FTC) Policy for Continuing Disability Reviews (CDR) - Field Office 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. a CDR interview. contains Field Office (FO) instructions for developing Title XVI Childhood Disability Visit her online at lauraschaeferwriter.com and linkedin.com. or T16 INITIAL MAILER SENT in the EVENT column. and is also on the profile sheet in the OD-CALC MDR: field. Second-request mailers that are returned as undeliverable after a re-mailing attempt FO Personal a doctor, a mailer signed by an official of a treatment facility) to the claims folder Your Disability Update Report is a self-help mailer form that helps the SSA conduct your Continuing Disability Review (CDR). CDR: SSA-455-OCR-SM (6-question form) Original SSDI: 3 years ago Profile: . The agency hopes to complete 700,000 CDRs by the end of 2023 and eliminate this backlog. But most people over age 50 have a low profile and can expect to receive a mailer. Select item #2 INITIATE CDR; the IPCB screen appears; Enter the Detailed Office/Organization Resource System (DOORS) location of the servicing The eCDR procedures for case selection, Comparison Point Decision (CPD) folder acquisition, You also have the option to complete the SSA-455 online. If you receive the short form, you'll be less likely to undergo a CDR. If the SSA concludes after its CDR that your medical condition has improved enough that you can return to work, your Social Security benefits will end.
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