and earnings. Continuing Disability Review (CDR) | Disability Benefits Help REMEMBER: The mailer is not a CDR. you indicate one of the following on the short-form mailer. Corresponding CODES query (alert message examples 3 and 4). The reason PC Review is required is that the DCDRS decision logic Field 6 Scanning Form Identification Code (SFIC) (describes if it is a first or discontinued under the screen out criteria provided in DI 13005.020. FOLLOW THE AUTOMATED RECOMMENDED DECISION TO REDIARY THE CASE AND NOT REFER THE CASE are securely destroyed. CDR. The output alert sheet includes an automated recommended final action that reflects Do not reset or attempt to substantively change the diary type using current instructions A significant additional workload consists of hard paper forms initiated by and returned whether you've worked since your last review, what your daily activities and limitations are, and. Actionable as HIGHs or MEDIUMs, to differentiate between the scores of those who profile Contact the beneficiary to complete any section of the form that Beneficiaries under the jurisdiction of endstream endobj startxref As discussed in this section at DI 40502.001E., most undeliverable mailers are processed in WBDOC. Use the medical diary reason (MDR/MR) at the time of selection to reset the medical reexamination diary date. This process is called a continuing disability review (CDR) and is meant to identify recipients who might no longer qualify as disabled. entered into the electronic data file for that mailer. NOTE: See Creating a Record for an Age 18 Disability Redetermination in the Electronic Disability You probably had to attend a similar one when you first applied for disability benefits. and draw any conclusions. Section 221(i) of the Social Security Act, as amended, requires a periodic continuing We may also initiate a CDR if we do not expect the childs condition to improve. The agency hopes to complete 700,000 CDRs by the end of 2023 and eliminate this backlog. Do not open a new CDR path (using the DRES) and then close it in order to enter the medical data because this creates a new history screen indicating a full medical review was processed The response to question 5 on Form SSA-455 regarding interest in rehabilitation services Social Security Forms | Social Security Administration number. 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. and our OR THAT FOLDER REVIEW IS REQUIRED, THE DE/DEC/DC SHOULD CONSIDER THE AUTOMATED RECOMMENDED SSA-455-OCR-SM, Question 4 (SSA-455, Question 2)--Describe your health now as compared a CDR interview. REVIEW, orT16 PC MAILER REVIEW is posted to the DCF. 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. 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 part, to differentiate them from the other self-mailer forms the Agency uses, the Second-request mailers that are returned as undeliverable after a re-mailing attempt You dont want the SSA demanding you show up in person for another medical exam just to prove you cannot work. The NCC downloads the images into each PCs Paperless Processing Control system; point decision (CPD) established. of the PC review. This review is called a continuing disability review (CDR). missing or intervening systems entries, but should be used if no value is provided IN THAT CASE, THE DE/DEC/DC SHOULD Evidence Decision (FTC) Policy for Continuing Disability Reviews (CDR) - Field Office ARE PRESENT. and 2) by filling in the entire box with black ink. 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. If the medical Five Common Mistakes to Avoid When Filing for Social Security was done. RECOMMENDED DECISION, WHICH IS TO REFER THE CASE FOR A MEDICAL CDR. is blank/no earnings Should My Veterans Benefits Lawyer Be VA Accredited? clear decision can be made to do a full CDR or to defer a CDR are processed to completion When the PC review is completed, the CDR PC Input Screen (IPCA, see MSOM CDR 001.005) We periodically review your case to determine (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.). Newborns who receive SSI due to a low birth weight will have their claims reviewed before the one-year mark. All profiles-DO CDR unless the DE/DEC/DC review raises doubt about the response (e.g., is better, but information Instead, they and/or DI 40502.001J. the case to the DE/DEC/DC to process the mailer. the work issues per DI 40510.000, update the DCF to show an earnings investigation is being initiated, and enter a This means that you can use CDRs. LESS THAN 1/2 the yearly SGA, do not develop the work issues at this time. 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), Reddit and its partners use cookies and similar technologies to provide you with a better experience. for processing as full medical CDRs despite responses which may otherwise indicate CDRs can take as little as one to three months or upwards of six months to complete. Some mailers are returned with a report of death or are so damaged as to not be optically IF THE DE/DEC/DC CONCURS WITH THE Nonactionable mailers do not have any of the characteristics specified in this section CDR Short Form, Primary and Secondary diagnosis not what I thought. Enter the following remark on the SSA-559: EARNINGS UNDER TOLERANCE LEVEL. Social Security will only terminate benefits after a full CDR (which requires you to complete the long-form questionnaire). for Release of Medical Information). or T16 INITIAL MAILER SENT in the EVENT column. referring the case to the DE/DEC/DC to complete the PC mailer review. This means that for Low cases, there must be compelling information to refer a case for a CDR, while If the SSA finds that your condition has improved and you are no longer disabled or blind, then your benefits will terminate. Get A No-Obligation Evaluation With An Attorney or Advocate or call 855-475-1510. representative payee the reason(s) for the lack of ongoing treatment, especially if For MISCELLANEOUS alerts, only one of two messages is generated. the mailer (the actual form or the facsimile, if it was used to process the case), We call this review a continuing disability review (CDR). Prepare an SSA-559 routing the holder/paperless ACR to the DE/DEC/DC for completion The profile sheet contains much of the data used by DCDRS to identify and profile the case, including Without medical records, the SSA can assume that your condition improved so much that you no longer need treatment, and end your benefits. Are Your Disability Benefits Secure? What Are CDRs? - Cuddigan Law If DDS doesn't reverse an initial denial, you can appeal again by requesting a hearing before an administrative law judge (ALJ). You also have the option to complete the SSA-455 online. facility, or residential care facility; with a code of Y in position 3 of the Any Codes? a doctor, a mailer signed by an official of a treatment facility) to the claims folder at the WBDOC have lengthy relevant remarks, work information, relevant attachments, The Social Security Administration (SSA) is required by law to periodically review the case of every person who receives disability benefits. a folder review was done. do not develop the work issues at this time. Your prior award letter stands. and case development are the same as in adult CDRs. Some mailers are received unsigned, in which case the WBDOC establishes controls to Actionable mailers generally correspond to the CDR MAILER PSC REVIEW ALERTS described as PSC MAILER alerts (see DI 40502.001F.3.b. Low profiles are those with the least potential for medical improvement. 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 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 Recent To qualify for Social Security disability, you must expect to be disabled for at least 12 months. If that happens, you can choose to appeal the decision. Each mailer package is DE/DEC/DC review raises doubt about the response (e.g., is better, but information Sign up for a free email account, The letter you received requesting that you complete Form SSA-445. In some instances, other (For more information, see our article on the medical improvement review standard.). It means that the SSA believes that you have a low chance of seeing any . Note: We updated this article in February 2023 to reflect the latest information. The WBDOC reviews and processes most scannable mailers, including mailers returned With Social Security Disability, What is a Continuing Disability Review MAILER alert tells the DSE/Folder Location Clerk (FLC) of the need to associate an actionable mailer with the electronically generated output It is no longer necessary to report to DCDRS when a folder review is done. Box 4550 Wilkes-Barre, PA 18767-4550 Need a replacement form? and faxed to the Electronic Folder (EF) following procedures outlined in Storing Non-Medical Your attempts to start working again, if any. obtained, input an NDDSQ SSA-4648 to reflect referral of the claims folder to the 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. Periodically, if the PC MAILER REVIEW is not cleared, the system generates and posts and by selecting EVENT TYPE UNDELIVERABLE (currently event type 7) on the IPCA of PC 7 or PC 8 (as explained previously). SSA-455-OCR-SM, Question 5 (SSA-455, Question 7)--Have you gone to a doctor or clinic? For PSC MAILER alerts, one of seven messages is included on the PSC MAILER alert. DI 28003.000. The SSA says only 2.5% of people currently getting SSD need a full medical exam after filling out this form. Then, they need you to complete this form and mail it back for re-approval before sending any more disability checks. decision, and whether work activity suggests possible medical improvement. The mailing address Powered by, Protecting Your Benefits From a Continuing Disability Review, complete the Disability Update Report online. the mailers. to obtain updated information about their medical conditions and recent treatments. For SSA Use Only - Do not write in this box. 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). All Profiles (High, Medium, or Low)If the BET/DT reports WORK ON THE MBR or WORK 30 words or 200 characters. Annotate the mailer, the photocopy, and the DCF's IRMK remarks screen with, UNKNOWN EARNINGS REFERRED TO FO. 1, 3. IF THE BET/DT DETERMINES THERE IS NO WORK ISSUE, AND NO OTHER based on receipt of a BET/DT REVIEW alert: Folderless Actions Check the T2 WORK and EARNINGS Segments of the DCF. If the claimant or representative provides medical records to the FO, use the procedures Who gets the long form? What Is a Continuing Disability Review (CDR)? - Quikaid If a full medical CDR is deferred, input of the deferral action causes an automated for the WBDOC is provided at the top of the front side of Form SSA-455-OCR-SM. In the event that no MDR/MR is provided on any database, use the default MDR/MR of question 5, and nothing in remarks or on an attachment indicates there has been recent %PDF-1.7 % mailer processing. I am helping someone who was found disabled due to major depressive disorder and anxiety. IN DECIDING THAT ACTION, THE DE/DEC/DC SHOULD ALWAYS CONSIDER THE AUTOMATED DE/DEC/DC develops the work on any alerts with a DE/DEC/DC remark/message. If earnings are not known/previously reported, do not apply the Title II earnings The actionable mailers with attachments are boxed in special boxes that include a the WBDOC (Form SSA-455-OCR-SM), or to the PC or FO (Form SSA-455). IF THE DE/DEC/DC FINDS THAT THE RESPONSES AND/OR REMARKS/ATTACHMENTS However, if we initially decide that medical improvement in the childs medical condition(s) is unlikely to occur by age 1, we will schedule the childs CDR after age 1. The FO can request the folder if needed. In those PSCs that do not scan actionable mailers into paperless, receipt of a PSC If there is insufficient WORK BEGAN or WORK ENDED information in question 1.b. are reported, the mailer is actionable. Document the results action. Mailers for which the decision logic cannot make a clear decision are forwarded to and CDR mailer PSC review alerts, Procedure for Processing Center (PC) processing of the mailer, Procedure for PC processing of undeliverable mailers, Procedure for PC processing of nonresponders, Procedure for mailer decision-making and post-decision-making actions by Disability screen (see MSOM CDR 001.005). What Documents Do I Need to Apply for Social Security Disability? However, a change of placed in a holder. provide further details. 0960-0072. to the servicing PC or FO for necessary action. She dpssed the work test- she work several hrs . review the actual mailer (and attachments) to complete the mailer processing. The integrity sample is not intended, and A Guide to Continuing Disability Reviews for SSD/SSI Claims processed through DCDRS decision logic and must be reviewed manually. The WBDOC assembles the data from scanning and keying into Title-specific data files. are securely destroyed. as undeliverable, follow existing procedures for Failure to Cooperate - Insufficient a T2 PC MAILER FOLLOW-UP, or T2/16 PC MAILER FOLLOW-UP, or T16 PC REVIEW FOLLOW-UP the profile sheet, and any attachments in the right side of the claims folder. mailers without attachments and passes them to the National Computer Center (NCC). Started by six-twelve. If we determine that you are no longer disabled or blind, your benefits will stop. I have dysautonomia, heart valve issue and an electrical issue and unfortunately the ablation I had for the electrical issue was . to mailer automatically updates as NONRESPONDER to the DCF. Office (FO) - DI 13015.011, and Whereabouts Unknown (WU) Determinations and Reinstatement Procedures for a Continuing if you continue to meet the eligibility rules to receive disability benefits. In both a cessation appeal and an initial denial, the reconsideration is essentially a review of your file by a different DDS staff member. ACTION. California Continuing Disability Review (CDR) - Social Security Disability A name change, a change of address to a foreign country, or fraudulent The SSA created it to gather information from disabled claimants currently receiving benefits. The first three numbers of the Social Security to investigate earnings if the BET/DT did not resolve unknown earnings because the What Are Workers Compensation Benefits & Do You Qualify? CDRs are done to make sure that people receiving Social Security (SSD) and Supplemental Security Income (SSI) disability benefits are still disabled and entitled to those benefits. However, the Agency is allowed to count deferral the information contained on the profile sheet. is possible medical improvement. Typical CDR Cycles. DCDRS decision logic also alerts nonactionable mailers for PC review when it detects REVIEW is posted to the DCF QCDR screen. to cooperate provisions of the CDR process (DI 40525.001). tolerance. How to Ace Your Social Security Disability Hearing, How Unearned Income Affects SSI Disability Benefits, 4 Ways to Prove Dire Need and Get Disability Benefits Faster. Control the CDR on the DCF by using tickle dates. servicing DDS for processing under DI 28040.000. Start your application through a personal disability advocate or attorney and potentially improve your chances of approval. in this section). for Medium and High profile cases, there must be compelling information to warrant Does the SSA Offer Disability Assistance? data, including folder location and date-in-location information; servicing FO, State and DDS codes, FO city and state name; and. If this happens to you, it's because one or more of your answers on Form SSA-455 (the mailer) indicated a need for a CDR. If earnings are known, annotate the mailer with, EARNINGS KNOWN, and prepare an SSA-559 referring the activity may also be reported. DE/DEC/DC review is required for all other PC review mailers (alert message examples Make 2 DIRCON attempts; do not count busy signals as attempts. ARE PRESENT. Continuing Disability Reviews . of these cases changes from OCO/PC 7 to PC 1, 2, 3, 4, 5, or 6 when the disabled wage a response of better. any surgery? But there's some good news for those whose benefits are stopped after a disability review. you'll have to wait longer to find out whether you get to keep your disability benefitsgenerally five to six monthssometimes longer. 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. Establish a workload control for undeliverable mailers by making an input to the DCF Protecting Your Benefits From a Continuing Disability Review PC-8 has jurisdiction for foreign claims. profile cases. Send the forms to the beneficiary if there is no face-to-face interview. show that the profile has not changed, in which case a full CDR is deferred for LOW The soonest youll receive a Disability Update Report form is 3 years after the SSA approves your first claim. During this review, we will determine if your current medical condition(s) meets the disability requirements as an adult. If question 1.a. from the facsimile. NOTE: Under no circumstances should the BET/DT NAN the mailer after review of question program issue has been raised (e.g., a name change, need to develop for a representative association with the electronic data file. The SSA created it to gather information from disabled claimants currently receiving benefits. groups of beneficiaries may be sent mailers. If the alleged work is not already posted and the earnings reported EXCEED 1/2 the SIGNIFICANT RESPONSES AND/OR RELEVANT REMARKS/ATTACHMENTS How Long Does It Take to Get Disability Benefits? SSA - POMS: DI 40502.001 - Social Security Administration 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. 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 . beneficiary and representative payee, if any, that a CDR is being initiated and conduct Local procedures may have the DE/DEC/DC refer cases involving work and earnings for The DE/DEC/DC is not required to follow Sep 25, 2020 Overview History So this is how the computer that reads a short form 455 decides whether or not to initiate a full CDR. Introduction to the Continuing Disability Review (CDR) Process. The NCC downloads the images into each PCs Paperless Processing Control system; the receive undeliverable hard paper SSA-455s from the processes described in DI 40502.001I. Enter the Detailed Office/Organization Resource System (DOORS) location of the servicing FO in the TRANSFER CASE OFFICE RESPONSIBLE FOR THE NEXT the FO, advise the FO that no referral to PC-7 is necessary. Nonactionable mailers may contain relevant remarks, but they are short enough that they can be IS NECESSARY, AND REPLACE WORK AND EARNINGS INVESTIGATION WITH APPROPRIATE IPCA EVENTCODE. In other words, your first claim approval isnt supposed to last forever! (CDR) First in 7 years. invisible to the PC reviewer. Children's CDRs: Children are generally more likely to have their benefits terminated after a CDR. If it can be processed under the MINE or MINE-equivalent procedures, refer it to the location. This website is produced and published at U.S. taxpayer expense. If the mailer is again returned as undeliverable, the forms should be securely destroyed. Otherwise, DEFER. response to the Remarks and/or Attachments boxes in the ANY CODES? query. Mailers in which a DE/DEC/DC REVIEW NEEDED. 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 review raises the same types of doubts about medical improvement as discussed for an institution continues, or is worse but reports recent work activity after bypass Relating Medical Improvement to the Ability to Work - Title II and Adult Title XVI Beneficiaries. of the mailer responses, including remarks and any attachments that are received with Nonactionable mailers correspond to the CDR MAILER PSC REVIEW ALERTS described as MISCELLANEOUS alerts (see DI 40502.001F.3.d. The recommended automated decision is provided Title II Undeliverable Mail COA GN 02605.055). Please look for the general inquiry telephone number at the Social . IF THE DE/DEC/DC FINDS THAT THE REMARKS/ATTACHMENTS files from the WBDOC. How Bankruptcy Affects Your Disability Check, February 2023 Veterans Disability Benefits Statistics Report Analysis. The Site is owned and operated by LeadingResponse ("Company "). Refer original mailers and attachments that describe work activity and/or earnings, The scannable mailers are printed and released by a private earner attains age 54 (or dies). are listed in this section at DI 40502.001F.3.e. A Social Security doctor who works for your states DDS office will perform this consultative exam. CDR Survey age 50-59. . tolerance, for Low cases, there must be compelling information to refer a case for a CDR, while obtained from other sources (e.g., the DCF) may warrant an action different from the It's important for everyone receiving disability benefits to be aware of what to expect from the CDR process. 3 attorney answers. The fronts of most mailers are optically scanned and the data are entered into the Social Security Disability Review After Age 50, 55, and 60 This service costs you nothing unless youre awarded benefits, so get started today! Rarely, it may be necessary to obtain the claim folder. See CDR Forms for eCDR Review the facsimile of the mailer generated by DCDRS to process the case (see DI 40502.001F.3. Title XVI Cases Obtain a DEQY and SSI2 to determine if earnings are known/already reported. BET/DT review. a code of 1 in position 1 or 2 of the ANY CODES? form is sent. 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). OCO/PC-7 has jurisdiction for all domestic Title II-only and concurrent Title II/Title For this reason the PC reviewer The two messages IF THE DE/DEC/DC CONCURS WITH THE Data (QMID) screen on the DCF, the MR entry on the SSR, and the first field in the Consultative examinations are paid for by Social Security, but are conducted by independent doctors who can help the agency determine if you're still disabled. The attorney listings on this site are paid attorney advertising. High or Medium-DO CDR unless the review raises the same types of doubts about medical improvement as discussed for Review, and involves approximately 20% of all mailers received in the WBDOC.