You can call your local office if you still have questions. WITH THE AUTOMATED RECOMMENDED DECISION, REDIARY THE CASE AND DO NOT REFER TO THE for completeness. Comments are closed. The FO can request the folder if needed. 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 . of the relevant submissions (e.g., work, medical, both work and medical, or miscellaneous). Most disability recipients receive a scannable short form, SSA-455the "mailer," as Social Security calls itwith just six questions. for Release of Medical Information). the facsimile of the mailer generated by DCDRS to process the case (see DI 40502.001F.3. number. or T16 INITIAL MAILER SENT in the EVENT column. The NCC downloads the images into each PCs Paperless Processing Control system; the The forms also can be printed, completed, Knowledge can be If the CDR is appropriate, contact the beneficiary to initiate the CDR as outlined If still not returned or if returned Without medical records, the SSA can assume that your condition improved so much that you no longer need treatment, and end your benefits. After 150 days from the send request the UNDELIVERABLE mailer will automatically profile code is not provided, query the DCF for the profile code. During the CDR, we may ask the childs representative payee to provide evidence that the child is, and has been, continuing treatment that is medically necessary and appropriate for their medical condition. Send the required CDR forms to the claimant: Print the SSA-454 (Continuing Disability Review Report) and SSA-827 (Authorization It is computer generated. Note In some states, the information on this website may be considered a lawyer referral service. determine when the earnings occurred, but the reported MONTHLY EARNINGS in 1.b. Reset these MINE diaries for 5 years. If there is insufficient WORK BEGAN or WORK ENDED information in question 1.b. and refers such reports on Title XVI cases to the servicing field offices (FOs) for When there is conflict between the codes, give the highest priority to the code on If we determine that you are no longer disabled or blind, your benefits will stop. and refers the assembled holder or paperless ACR for translation. The FO can request the folder if needed. 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. It costs you $0, since the SSA pays for everything. . been reviewed by the PC are selected for integrity sampling. These reviews are either called deferral. Section 221(i) of the Social Security Act, as amended, requires a periodic continuing The secondary title of MISCELLANEOUS alerts tells the DSE/FLC that the alert/facsimile/profile The SSA created it to gather information from disabled claimants currently receiving benefits. Use the medical diary reason (MDR/MR) at the time of selection to reset the medical reexamination diary date. When the next mailer selection is done (currently, every four months for Title II-only It is, however, a basis to refer the case to a FO to initiate a CDR. Nonactionable mailers correspond to the CDR MAILER PSC REVIEW ALERTS described as MISCELLANEOUS alerts (see DI 40502.001F.3.d. If earnings are known, annotate the mailer with, EARNINGS KNOWN, and prepare an SSA-559 referring the Click the button below to sign up for a free phone call during regular weekday business hours: Lori Polemenakos is Director of Consumer Content and SEO strategist for LeadingResponse, a legal marketing company. For HIGHS/MEDIUMS, take a DO CDR action unless the narrative/telephone call response(s) indicates no likelihood of medical improvement. When DIRCON is required, follow the DIRCON procedures in GN 01070.305 and GN 01070.315. an institution continues, or is worse but reports recent work activity after bypass Each message also includes a recommended final action. Most of these mailers, and all other mailers not requiring BET/DT review, are referred beneficiary and representative payee, if any, that a CDR is being initiated and conduct data becomes part of the data file for that mailer. a finding has been made that such disability is permanent. The messages specify who should review received. DI 28001.003 - An Overview of Processing Continuing Disability Review (CDR) Mailer Forms SSA-455 and SSA-455-OCR-SM . by the USPS as undeliverable do not require further delivery attempts. All keyed SSA - POMS: DI 40502.001 - Social Security Administration A CDR is will be coming and they are anxious about what to expect. action. Contact the beneficiary to complete any section of the form that The Disability Update Report is part of our Continuing Disability Review (CDR) process, Your attempts to start working again, if any. DI 28005.000. . All Profiles-DO CDR if question 5 is also answered No or there is no response to not resolve these inconsistencies, the mailer is actionable. If DIRCON is unsuccessful because the individual cannot be located or is located but answered Yes, is not answered, or is answered BOTH Yes and NO; and DIRCON does information indicating medical improvement is very unlikely. (questions 7 and 6 on the SSA-455). DIRCON procedures in GN 01070.305 and GN 01070.315. second-request mailer is sent. FO in the TRANSFER CASE OFFICE RESPONSIBLE FOR THE NEXT ACTION field. and/or DI 40502.001J. RECOMMENDED DECISION WHICH IS TO REDIARY THE CASE. The SSI program pays benefits to adults and children who meet our requirements for a qualifying disability and have limited income and resources. response to question 5 or 6 (7 or 6 on SSA-455) is YES, or the reviewer has other Fighting the SSA to keep your much-needed benefits can be frustrating. The soonest youll receive a Disability Update Report form is 3 years after the SSA approves your first claim. If the SSA finds that your condition has improved and you are no longer disabled or blind, then your benefits will terminate. Send the forms to the beneficiary if there is no face-to-face interview. NOTE: Regarding versions of the SSA-455-OCR-SM with question 7 (SSA-455, Question 5), Provide any other pertinent instructions or remarks in the special message field on Title II cases. The attorney listings on this site are paid attorney advertising. The scannable mailer includes barcoded information as well as three lines of scannable CDR and transfer the CDR to the FO. Form . The MDR/MR 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. 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) Either an earnings investigation or referral to a DE/DEC/DC is required. and attachments. As a result, the flip process is essentially CDR's Long Vs. Short form - alt.social-security-disability.narkive.com RECOMMENDED DECISION, REDIARY THE CASE AND DO NOT REFER TO THE FO. Disability Benefits | SSA - Social Security Administration and a deferral action follows, return the claim folder(s) to storage with appropriate The first three numbers of the Social Security sheet packages and identifies PSC MAILER alert packages. monitor the accuracy of the statistical analyses (profiling) that identify which cases I filled out counseling and prescriptions. The word High, During the CDR, we will also review your. It means that the SSA believes that you have a low chance of seeing any . Recommend a full medical CDR only if the DIRCON response indicates there is possible are appropriate for CDR mailer processing. of PC 7 or PC 8 (as explained previously). data clears the second-mailer/nonresponder control. and faxed to the Electronic Folder (EF) following procedures outlined in Storing Non-Medical for handling and routing to the Disability Determination Services (DDS). Upon completion of the preliminary actions, the WBDOC performs a detailed analysis http://policy.ssa.gov/poms.nsf/lnx/0481010225. The facsimile of the mailer includes questions and answers and any relevant remarks of less than This means that for Low cases, there must be compelling information to refer a case for a CDR, while review raises the same types of doubts about medical improvement as discussed for on Form SSA-5002. codes, which indicates another Enter the Detailed Office/Organization Resource System (DOORS) location of the servicing alert event. FO personnel may assist in the completion of this form if the beneficiary requests Following are some guidelines for decision making when reviewing questions 1 through and a set of three codes (called ANY CODES?) and earnings. If the second mailer is not returned and receipted on-line information regarding the diary type that was set at the CPD. a doctor, a mailer signed by an official of a treatment facility) to the claims folder Master Beneficiary Record (MBR) and the Supplemental Security Record (SSR) to ensure You may find our Continuing Disability Review web page helpful in understanding the process. Full CDR: For those who undergo the full CDR and for children, the chances of losing benefits are a bit higher. SIGNIFICANT RESPONSES AND/OR RELEVANT REMARKS/ATTACHMENTS at DI 40502.001E.4.b., that require review of the actual documentation. the WBDOC (Form SSA-455-OCR-SM), or to the PC or FO (Form SSA-455). Title II Actions with Folder Determine whether the alleged work and earnings have already been resolved. Approximately 80% of mailer electronic data files received by DCDRS can IF THE DE/DEC/DC FINDS THAT THE REMARKS/ATTACHMENTS ARE NOT Upon receipt of the CDR packet, enter the receipt date on the DCF and review the forms Start your application through a personal disability advocate or attorney and potentially improve your chances of approval. A MEDICAL CDR AT THIS TIME. IF THE sheet and paper alert before processing. WBDOC because translation was necessary) are securely destroyed. ARE MATERIAL OR THAT FOLDER REVIEW IS REQUIRED, THE DE/DEC/DC SHOULD CONSIDER THE The WBDOC takes the following actions, as appropriate: does direct telephone contact (DIRCON) to resolve unanswered questions; The scannable mailer, Form SSA-455-OCR-SM, is used most of the time, although the All Profiles (High, Medium, or Low)-Go to question 2. review based on the specific alert message. Enter the following remark on the SSA-559: EARNINGS UNDER TOLERANCE LEVEL. While these two programs are different, the medical requirements are the same. Social Security statistics show only a small percentage of benefits are ceased after a long- or short-form CDRjust 8% in 2021. for processing as full medical CDRs despite responses which may otherwise indicate groups of beneficiaries may be sent mailers. 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 These forms are not scannable and cannot be processed to a data file by DI 28003.000. Obtain other forms if necessary (e.g., SSA-820/821). New Option for Submitting your Disability Update Report! - Social then securely destroyed. and case development are the same as in adult CDRs. a folder review was done. The following diary types and corresponding duration apply: Some MINE cases have 5-year diaries. activity) is positive or if a code of 1 (or, in certain cases, 3) was input in AND/OR. for a Title XVI Childhood Disability eCDR: SSA-454 Continuing Disability Review Report (Completion of Form SSA-454-BK in Title the profile has changed, in which case a full CDR usually results for mailers on LOW Review the alert to determine the next action. 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. DCDRS decision logic also alerts nonactionable mailers for PC review when it detects NOTE: If only work and earnings prior to the report period are described, the mailer is After Social Security periodically reviews your medical impairment(s) to determine if you continue to have a disabling condition. of the PC review. "Recent" typically means within the last two years. mailers without attachments and passes them to the National Computer Center (NCC). any case with 001/T16 INITIAL MAILER SENT as the most recent event, and that event a response of better. help or the PC requests assistance. She is also an active co-author or ghostwriter of several nonfiction books on personal and business development. The eCDR procedures for case selection, Comparison Point Decision (CPD) folder acquisition, within a specific time frame, a nonresponder alert is generated. Do not use DIRCON if the responses or other information provided indicate that a full Collect System (EDCS). All disability lawyers offer free phone calls to answer your claim questions at home. To qualify for Social Security disability, you must expect to be disabled for at least 12 months. For more information, please see our Send your completed disability update report to the following address within 30 days of receiving it: Social Security Administration P.O. called profiling, indicate a low probability of medical improvement where a full CDR They are identified as actionable mailers in the WBDOC. Only a lawyer can do that quickly and correctly for you. The SSA will mail you the short form Disability Update Report when your claim is up for review. Field 6 Scanning Form Identification Code (SFIC) (describes if it is a first or The mailer is completed by the beneficiary or representative payee and returned to logic processing. the MG segment of the SSR may provide a diary reason. reflects a previous unsuccessful DIRCON attempt in WBDOC. All Profiles-DEFER if response to question 5 was Yes and there is no indication is essential to permit accurate auditing of the mailer process, it is critical that field office or storage site. (IPCB, see MSOM CDR 001.006) of the DCF, that the beneficiary was a non-responder the action the DCDRS decision logic would have made (to defer and rediary, or refer as a guide but is not binding on the PC reviewer. Subsequently, those mailers the PCs for review. If a full medical CDR is not indicated based on the responses supplied by the beneficiary, make direct telephone contact (DIRCON) to complete unanswered questions or to clarify unresolved issues. IF THE DE/DEC/DC FINDS THAT THE RESPONSES AND/OR REMARKS/ATTACHMENTS What is a Social Security Continuing Disability Review (CDR)? sheet attachment is sufficient for folderless processing of the case. missing or intervening systems entries, but should be used if no value is provided Rarely, it may be necessary to obtain the claim folder. The reason PC Review is required is that the DCDRS decision logic RESOLVED or EARNINGS UNDER TOLERANCE (Title II), or EARNINGS KNOWN or UNKNOWN EARNINGS no one with access to the DCF take any action to change a flipped case back to a 2477 0 obj <>stream a foreign claim. holder/paperless ACR to a DE/DEC/DC for completion of the PC mailer review. discontinued under the screen out criteria provided in DI 13005.020. is blank or if no earnings are reported; and if question 1.a. 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
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