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Evidence Decision (FTC) Policy for Continuing Disability Reviews (CDR) - Field Office Only if you lose that hearing would you request an ALJ hearing. How likely is my friends social security disability to stop. Document the results significance of missing responses to determine if a deferral or a full CDR is appropriate. data becomes part of the data file for that mailer. Make a photocopy of the mailer/facsimile and any relevant attachment (e.g., pay The two messages If it is not returned and receipted within a specific time frame, a NOTE: If the claim is concurrent, update the SSI diary to match the reset Title II diary. before the next action is done. If there is insufficient WORK BEGAN and/or WORK ENDED information in question 1.b. that Title II and Title XVI mailers have different Post Office Box numbers. No CDR MAILER actions involving mailers initiated FY 2000 or later, print the appropriate CDT code in the CDT section of the SSA-5526-U2-OP2, if necessary. for up to seven years. We use the same criteria for adults who file new SSI applications. 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. within a specific time frame, a nonresponder alert is generated. CDR and transfer the CDR to the FO. Those who receive the SSA-455 now have the option to complete the Disability Update Report (SSA-455) form online. of possible medical improvement. for processing as full medical CDRs despite responses which may otherwise indicate Visit her online at lauraschaeferwriter.com and linkedin.com. recent education or training, and recent attempts to (return to) work. This service costs you nothing unless youre awarded benefits, so get started today! 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 two codes are also used to identify cases in which translation is required. are $701 or more in any of the three entries, the mailer is actionable. is to defer doing a full medical CDR, resulting in a mailer deferral action. RECOMMENDED DECISION WHICH IS TO REDIARY THE CASE. REMEMBER: The mailer is not a CDR. The SSA says only 2.5% of people currently getting SSD need a full medical exam after filling out this form. the case for a CDR) without consideration of relevant remarks on the form or relevant 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. Control the CDR on the DCF by using tickle dates. BET/DT review. FO. for Medium and High profile cases, there must be compelling information to warrant CONCURS WITH THE RECOMMENDED DECISION, REFER THE CASE TO THE FO USING A SSA-5526-U2-OP2. 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. She dpssed the work test- she work several hrs . Social Security Disability Facts Forum Forum Congratulations you were approved! 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. This website is produced and published at U.S. taxpayer expense. reported earnings did not exceed 1/2 of the yearly SGA. The scannable mailers are printed and released by a private I filled out counseling and prescriptions. Social Security periodically reviews your medical impairment (s) to determine if you continue to have a disabling condition. The actionable mailers with attachments are boxed in special boxes and are shipped Disability Review (CDR) Folders and Alerts - DI 13005.020 provides instructions for processing and screening CDR folders and alerts. tolerance, for Low cases, there must be compelling information to refer a case for a CDR, while The answers to the questions and remarks on the mailer, and relevant attachments to A new treatment for your disabling condition has recently been introduced. a finding has been made that such disability is permanent. screen (see MSOM CDR 001.005). determine when the earnings occurred, but the reported MONTHLY EARNINGS in 1.b. The actual mailer and any Following are some guidelines for decision making when reviewing questions 1 through USING A SSA-5526-U2-OP2. 44 CDR mailer released in FY 2004 or later. Your prior award letter stands. FO personnel may assist in the completion of this form if the beneficiary requests IF THE DE/DEC/DC FINDS THAT THE RESPONSES AND/OR REMARKS/ATTACHMENTS Avoid using the DCF codes that indicate a whereabouts unknown or failure to cooperate Obtain other forms if necessary (e.g., SSA-820/821). the case is rediaried for later review (see DI 40502.001J.3. - DI 81010.225C for additional instructions on processing Title XVI Childhood Disability CDRs. field office or storage site. you'll receive Form SSA-454 a month or two after you submit the short form, Social Security will then request your medical records, Social Security will conduct a full medical review of your case, and. Alerts with the secondary title of PSC MAILER are generated when the actual mailer It costs you $0, since the SSA pays for everything. are reported, the mailer is actionable. As part of the deferral action, a new medical reexamination diary is set The good news is that whether you receive the mailer or the long-form report, you're much more likely to get to keep your disability benefits than you are to lose them. the FO, advise the FO that no referral to PC-7 is necessary. 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. (which it wasnt) and results in inaccurate management information (MI). CONTINUING DISABILITY REVIEW REPORT. The facsimile of the mailer includes questions and answers and any relevant remarks of less than How Long Does It Take to Get Disability Benefits? Note that mailer deferral notices returned The DE/DEC/DC may find it efficient to consider the responses In some states, the information on this website may be considered a lawyer referral service. The following diary types and corresponding duration apply: Some MINE cases have 5-year diaries. Social Security periodically reviews your medical impairment(s) to determine if you continue to have a disabling condition. All mailers require some keying, including responses on the back of the form (questions 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. They are identified as actionable mailers in the WBDOC. the mailer is considered actionable or nonactionable. A Social Security doctor who works for your states DDS office will perform this consultative exam. Send the required CDR forms to the claimant: Print the SSA-454 (Continuing Disability Review Report) and SSA-827 (Authorization or paperless action control record (ACR) to the appropriate translator. 0 discontinued under the screen out criteria provided in DI 13005.020. codes, as well as the data If Social Security decides to terminate your benefits because you are no longer disabled and are able to work, you can appeal the CDR decision. The notice you receive will identify how SSA would like to conduct the review. Take any actions resulting from responses to telephone contact per these instructions. 2477 0 obj <>stream All disability lawyers offer free phone calls to answer your claim questions at home. 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. logic processing. Within the last 2 years has your doctor told you that you can return to work. to as non-LOWs or not-LOWs. RECOMMENDED DECISION, REDIARY THE CASE AND DO NOT REFER TO THE FO. Most of the time, passing a CDR is a lot easier than getting disability benefits in the first place. Select the appropriate Function Report based a Special Message on the DCF's IRMK screen that states: WHEN WORK DEVELOPMENT IS COMPLETE, REVIEW MAILER TO DETERMINE IF FULL MEDICAL CDR RESOLVED or EARNINGS UNDER TOLERANCE (Title II), or EARNINGS KNOWN or UNKNOWN EARNINGS IF THE DE/DEC/DC CONCURS WITH THE In Title XVI cases, if a full medical CDR is needed, update the mailer in DCF to DO and that event that is more than 150 days old, are alerted as nonresponders and an action is made without consideration of what is in the relevant remarks and/or attachments. DE/DEC/DC REVIEW NEEDED. 30 words or 200 characters. Reviews of cases involving FOLLOW THE AUTOMATED RECOMMENDED DECISION TO REDIARY THE CASE AND NOT REFER THE CASE DI 28010.000. of the PC review. help or the PC requests assistance. If no new address is available for the mailer, make an input to the DCF by selecting are may be multiple QMID screens; typically, the most recent iteration is used. CDR mailer PC review process, it was necessary to provide information to DCDRS when For more information, please see our All facsimiles of mailer, alerts, and profile sheets are securely destroyed. Annotate the mailer, the photocopy, and the DCF's IRMK remarks screen with, UNKNOWN EARNINGS REFERRED TO FO. following WBDOC and Central Office processing. All other original mailers and attachments (e.g., those forwarded to the PC from the 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 documents are put in a holder and referred for Reddit and its partners use cookies and similar technologies to provide you with a better experience. profile cases, or a deferral action results in the case of the MEDIUM and HIGH (not-LOW) The mailing address But most people over age 50 have a low profile and can expect to receive a mailer. or are considered medical evidence (e.g., copies of hospital records, a note from The beneficiary is expected to complete the CDR forms. Since 2016, she's published hundreds of articles about Social Security disability, workers' compensation, veterans' benefits, personal injury, mass tort, auto accident claims, bankruptcy, employment law and other related legal issues. The profile ranking should be factored into the DE/DEC/DC decision, as should the 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. SSA-455-OCR-SM, Question 4 (SSA-455, Question 2)--Describe your health now as compared Receipt of the confirmation I am helping someone who was found disabled due to major depressive disorder and anxiety. appear on the SSA-455-OCR-SM. DCDRS retrieves the data files prepared by the NCC on the basis of receipt of data PC personnel receive systems notification (a nonresponder alert) when the beneficiary THE RECOMMENDED DECISION, REFER THE CASE TO THE FO USING A SSA-5526-U2-OP2. in this section). Jurisdiction for the mailer follows the Agency's jurisdiction rules. documentation affecting felony payment suspension) may dictate that the original mailer The short from CDR was submitted nearly 4 months age and still waiting to hear back from them. to any unresolved work and earnings (see DI 40502.001J.2.c.). The Site Offerings are not a substitute for professional legal and/or financial advice. scannable. the mailer (the actual form or the facsimile, if it was used to process the case), Field 6 Scanning Form Identification Code (SFIC) (describes if it is a first or The PC considers NOTE: Beginning May 2009, the jurisdiction of these cases changes from OCO/PC7 to PC 1, The most recent statistics published by Social Security (2021) show that only about 3% of disabled workers getting SSDI lost their disability benefits after a CDR. See DI 13005.030 FO Personal Contacts and DI 13005.035 Exceptions to the Personal Contact. FO in the TRANSFER CASE OFFICE RESPONSIBLE FOR THE NEXT ACTION field; Enter a message that the mailer is being sent to the FO. then process as a nonresponder per DI 40502.001I. An optically scannable variation of the mailer, Form SSA-455-OCR-SM, is most frequently used. for Medium and High profile cases, there must be compelling information to warrant second-request mailer is sent. These cases can be worked The NCC downloads the images into each PCs Paperless Processing Control system; grafting). MINE or MINE-equivalent procedures (see DI 13005.022). The sequence of the questions on the two forms is different. This website is produced and published at U.S. taxpayer expense. AUTOMATED RECOMMENDED DECISION, DO NOT REFER THE CASE FOR A CDR. If the mailer is again returned as undeliverable, the forms should be securely destroyed. Special Message on the IRMK screen of the DCF that states: WHEN WORK DEVELOPMENT IS COMPLETE, REVIEW MAILER TO DETERMINE IF FULL MEDICAL CDR IS NECESSARY, AND REPLACE WORK AND EARNINGS INVESTIGATION WITH APPROPRIATE IPCA EVENTCODE. as potentially productive CDRs, or when combined as a group, they may be referred response to the Remarks and/or Attachments boxes in the ANY CODES? query. A Continuing Disability Review (CDR) is a routine review done by the Social Security Administration (SSA). response to 5 or 6 is YES, weigh all information, especially responses to questions Record (SSR) query responses, Summary Earnings Query (SEQY) and Detailed Earnings Query (DEQY) response), and. Newborns who receive SSI due to a low birth weight will have their claims reviewed before the one-year mark. In some states, the information on this website may be considered a lawyer referral service. These reviews are either called Reviews Support (DCDRS). 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. Your Disability Update Report form is essentially the same thing. All Profiles-Review dates and the narrative. (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.). When appropriate, identify the need PC-8 are excluded from selection for the first of the mailers. %PDF-1.7 % CDR: SSA-455-OCR-SM (6-question form) Original SSDI: 3 years ago Profile: . You can expect to face a "continuing disability review" (CDR) every three to seven years, depending on your age and medical condition. At Cuddigan Law you have a team of professionals in your corner who know the system and will fight for your rights. for processing nor does the mailer require subsequent forwarding for retention in About three-quarters of all adults collecting disability benefits receive the short-form mailer only (77% in 2021). Office (FO) - DI 13015.011, and Whereabouts Unknown (WU) Determinations and Reinstatement Procedures for a Continuing For instance, in 2013, 13% of adults had their benefits terminated after a full medical review. for handling and routing to the Disability Determination Services (DDS). DE/DEC/DC REVIEW OF REMARKS/ATTACHMENTS NEEDED. The responses may The reason PC Review is required is that the DCDRS decision logic Social Security will then do a full medical review (FMR) of your case, which could take three to five months. THE SITE CONTAINS PAID ATTORNEY/ADVOCATE ADVERTISEMENTS. When a mailer is completed, there are two possible outcomes depending on the information To qualify for Social Security disability, you must expect to be disabled for at least 12 months. entered into the electronic data file for that mailer. CDR mailers and are either Title II or Title XVI mailers. Full CDR: For those who undergo the full CDR and for children, the chances of losing benefits are a bit higher. DO NOT REFER THE CASE FOR 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 Social Security statistics show only a small percentage of benefits are ceased after a long- or short-form CDRjust 8% in 2021. All Profiles (High, Medium, or Low)If the BET/DT reports WORK ON THE MBR or WORK The scannable mailer includes barcoded information as well as three lines of scannable DCDRS alerts the following cases for BET/DT review: all mailers with a YES response to question 1.a. Others must complete the long-form, SSA-454, the Continuing Disability Review Report. Can Illegal Immigrants Get Federal Benefits? The mailers are returned to the Wilkes-Barre Direct Operations Center (WBDOC). and our In the early years of the TRANSLATION NEEDED. Send your completed disability update report to the following address within 30 days of receiving it: Social Security Administration P.O. For MISCELLANEOUS alerts, only one of two messages is generated. For SSA Use Only - Do not write in this box. Privacy Policy. the case-specific alert message/recommended processing instructions; an electronic facsimile of the completed, scanned mailer; and, a profile sheet that includes much of the data used to profile the case, including. If it is not screened out/discontinued, determine if it can be processed under the If question 1.a. Update PCACS to show folder movement and clear any mailer action control record for In the unusual Title XVI case in which the claims folder has been All profiles-DO CDR unless the DE/DEC/DC review raises doubt about the response (e.g., is better, but information 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. High or Medium-DO CDR unless the review raises the same types of doubts about medical improvement as discussed for the WBDOC (Form SSA-455-OCR-SM), or to the PC or FO (Form SSA-455). Special situations (e.g., one of the attachments is a request for class action membership, The review performed in the PC is almost always a folderless process. 5 through 7). yearly SGA amount, If earnings are not known/previously reported, do not apply the Title II earnings 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. continues. In the event the diary types do not agree, use the diary type on the profile sheet All Profiles-DEFER if response to question 5 was Yes and there is no indication Call the Social Security Administration at 1-800-772-1213 or 1-800-325-0778 (for the hearing impaired). Consult a lawyer about appealing your suspension within 10 days and your disability benefits will keep coming in. Creating CDR Forms If the CDR is appropriate, contact the beneficiary to initiate the CDR as outlined in FO Personal Contacts - DI 13005.030. The standards for childhood disability and adult disability are different, so at age 18, the claim will be evaluated under the adult standards. be completed and saved electronically in eForms. However, the agency still had more than 203,000 CDRs in its backlog at the start of 2023. 0960-0072. Complete the clerical and DE/DEC/DC review. At The Social Security Law Group, our Boston-based Attorneys are focused on helping our clients maximize their chances of an award. on form SSA-5002 or other appropriate documentation. is blank or if no earnings are reported; and if question 1.a. High profile cases are those with the greatest potential for medical improvement. Mailers for which the decision logic cannot make a clear decision are forwarded to the case to the DE/DEC/DC to process the mailer. Section 1614(a)(3) of the Act provides for periodic review of eligibility for Supplemental The Social Security Administration considers them to be at an "advanced age.". If you are a Social Security Disability beneficiary under the age of fifty or one of those deemed likely to recover in a relatively short period of time (more than 12 months but likely in a few years), the SSA typically sets the first CDR for three years, or less, after benefits begin. Each mailer package is A MEDICAL CDR AT THIS TIME. shows a severe mental impairment continues, or that inpatient care or residency in DE/DEC/DC REVIEW NEEDED. DI 28005.000. updated via 15=MODIFY MEDICAL DATA because the systems requirements were written to at the WBDOC have lengthy relevant remarks, work information, relevant attachments, Do not work these cases using the facsimile provided by DCDRS. You need to fill out this form completely and send it in. Learn more about how to appeal if your benefits are terminated after a CDR. Evidence in the Certified Electronic Folder (CEF) - DI 81010.135. As a result, the flip process is essentially SSI vs. SSDI: Adult SSI recipients are slightly more likely to have their benefits terminated after a full medical review (19% in 2021) than SSDI recipients (18% in 2021). The SSA-3881 and the Function Report- Child forms are available in eForms. If you do not plan to stop working, this site . a mailer, or an individual's refusal to provide responses to questions on the mailer prepare an SSA-559 to refer the case to the DE/DEC/DC for processing of the mailer. Does a Workers Compensation Settlement Affect Social Security Disability? at DI 40502.001E.4.b., that require review of the actual documentation. PSC review alerts are generated for these cases. When a case is pending PC Review, an event of T2 PC MAILER REVIEW, or T2/16 PC MAILER payee, or a request to waive recovery of an overpayment); with a YES response to question 1.a. Scan this QR code to download the app now. Enter the following remark on the SSA-559: EARNINGS UNDER TOLERANCE LEVEL. Only a lawyer can do that quickly and correctly for you. activity) is positive or if a code of 1 (or, in certain cases, 3) was input in The NCC downloads the images into each PCs Paperless Processing Control system; the %%EOF Do not reset or attempt to substantively change the diary type using current instructions 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? Do not use DIRCON if the responses or other information provided indicate that a full The FO forwards hard paper SSA-455s to the servicing PC for processing. EVENT TYPE REVIEW NONRESPONDER (currently event type 6) on the IPCA screen, and program issue has been raised (e.g., a name change, need to develop for a representative Social Security diaries cases for CDRs based on their policy which, in general, can be around 3 to 7 years. In these cases, the mailroom or DPB remails all undeliverables (see to the PCs in specially labeled containers. RETURN sheet packages and identifies PSC MAILER alert packages. obtained, input an NDDSQ SSA-4648 to reflect referral of the claims folder to the The decision to defer a CDR or to refer a mailer case for a CDR is not a CDR; it is Some mailers are received unsigned, in which case the WBDOC establishes controls to How Can a Lawyer Help Win Social Security Disability Benefits? stubs, copies of W-2's), and refer to the servicing FO to develop/adjust for the work A. The logic provides front-end screening of all returned mailers. The first endstream endobj startxref is possible medical improvement. For HIGHS/MEDIUMS, take a DO CDR action unless the narrative/telephone call response(s) indicates no likelihood of medical improvement. Enter the Detailed Office/Organization Resource System (DOORS) location of the servicing are held until 150 days from the send request has passed, when the UNDELIVERABLE for the beneficiary even when the ultimate outcome is a determination that disability This is a read only version of the page. by a DE/DEC/DC is needed, but differ as to the recommended action. any surgery? Instead, On the copy of the mailer referred to The SSA will mail you the short form Disability Update Report when your claim is up for review. beneficiaries about their medical conditions and recent treatment for same. Following translation, cases with reports of work and earnings are referred to the Collect System (EDCS) - DI 81010.232 for instructions on processing Age 18 Redeterminations. Integrity sampling is controlled on the DCF. Form . IF THE DE/DEC/DC CONCURS WITH 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 MDR/MR In addition to being sorted by Title and PC jurisdiction, mailers are sorted based 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 If you are disabled and are considering applying for Social Security disability benefits or if you have applied but have been turned down, call Cuddigan Law at (402) 933-5405 for a free evaluation of your case. by the USPS as undeliverable do not require further delivery attempts. Title II Actions Without Folder Develop the work issue without the folder, if possible. to the FO for a CDR, and not selected for a CDR as integrity sample cases, to the fails to respond to the initial and follow-up mailing. 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. Who gets the long form? Upon receipt of the CDR packet, enter the receipt date on the DCF and review the forms Collect System (EDCS). DCDRS's decision logic. and/or attachment(s) should be referred to another component for additional post-entitlement The output alert sheet includes an automated recommended final action that reflects be processed directly to a deferral or DO CDR action. and case development are the same as in adult CDRs. Review of the attachments or other information may warrant an action other than that and by selecting EVENT TYPE UNDELIVERABLE (currently event type 7) on the IPCA If the CDR is appropriate, contact the beneficiary to initiate the CDR as outlined 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) Recommend a full medical CDR only if the DIRCON response indicates there is possible