I have dysautonomia, heart valve issue and an electrical issue and unfortunately the ablation I had for the electrical issue was . Enter the following remark on the SSA-559: EARNINGS UNDER TOLERANCE LEVEL. notice to be generated and mailed to the beneficiary (or representative payee) and that occurs in about small percentage of the completed mailers. IF THE DE/DEC/DC CONCURS We periodically review your case to determine a deferral action. The boxes are delivered You can have a CDR scheduled even sooner than three years if you have a condition that is expected to medically improve. If you receive Form SSA-454, it means that you're getting a full CDR. logic processing. The Site is not an attorney referral service or prepaid legal services plan. and processing policies; however, the older Form SSA-455 may be used. of the PC review. THE SITE CONTAINS PAID ATTORNEY/ADVOCATE ADVERTISEMENTS. and refers the assembled holder or paperless ACR for translation. receive undeliverable hard paper SSA-455s from the processes described in DI 40502.001I. The actual mailer and any Title II Actions with Folder Determine whether the alleged work and earnings have already been resolved. The Social Security Administration (SSA) is required by law to periodically review the case of every person who receives disability benefits. Document the results The other outcome 5 through 7). The integrity sample is not intended, and Upon receipt of the CDR packet, enter the receipt date on the DCF and review the forms Either an earnings investigation or referral to a DE/DEC/DC is required. Contact the beneficiary to complete any section of the form that Privacy Policy. Because of the small size of the integrity sample, and because integrity sampling All Profiles-Review dates and the narrative. and case development are the same as in adult CDRs. the work issue is resolved, refer to the DE/DEC/DC for completion of the PC mailer Enter the Detailed Office/Organization Resource System (DOORS) location of the servicing response(s) to question 1 are actionable (DI 40502.001E.4.b.). Nd wish I had put my diagnosis for reason for visit instead of medication and therapy. is not completed. OCO/PC-7 has jurisdiction for all domestic Title II-only and concurrent Title II/Title LESS THAN 1/2 the yearly SGA, do not develop the work issues at this time. is to defer doing a full medical CDR, resulting in a mailer deferral action. not considered an actionable mailer. - DI 13015.001, Failure to Cooperate - Insufficient Evidence Decision (FTC) Suspension Procedures ACTION field. used to select the cases for mailer processing, to decide what is the next appropriate 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. received. Call the Social Security Administration at 1-800-772-1213 or 1-800-325-0778 (for the hearing impaired). a T2 PC MAILER FOLLOW-UP, or T2/16 PC MAILER FOLLOW-UP, or T16 PC REVIEW FOLLOW-UP A. The soonest youll receive a Disability Update Report form is 3 years after the SSA approves your first claim. The advanced age designation applies to all disability benefits applicants and recipients between the ages of 55 and 59. MINE or MINE-equivalent procedures (see DI 13005.022). In the event that no MDR/MR is provided on any database, use the default MDR/MR of eligibility review for disabled beneficiaries at least every three years except where Instead, they forms are required to complete the CDR. Enter Y next to REMARKS and enter a message that the mailer is being sent to the WITH THE AUTOMATED RECOMMENDED DECISION, REDIARY THE CASE AND DO NOT REFER TO THE the profile has changed, in which case a full CDR usually results for mailers on LOW Upon completion of the preliminary actions, the WBDOC performs a detailed analysis 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. the case next. a finding has been made that such disability is permanent. 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 . files from the WBDOC. are securely destroyed. 5 Replies 851 Views October 07, 2022, 04:50:39 pm by six-twelve: 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. The answers to the questions and remarks on the mailer, and relevant attachments to If there is insufficient WORK BEGAN or WORK ENDED information in question 1.b. The word High, Injuries Covered by Workers Compensation, How to Qualify for Workers Compensation Benefits, How to Choose the Right Workers Comp Doctor to Treat You, How to Calculate Workers Compensation Benefits, Veterans Disability Claims Backlog: What Vets Must Know, Veterans Benefits Eligibility for Military Service Members, How to Apply for Veterans Benefits from the VA, How to Fill Out Your Disability Update Report Form. in the OD-CALC MDR: field. AND/OR. review based on the specific alert message. of the mailer responses, including remarks and any attachments that are received with Typical CDR Cycles. At the same selection, cases with the most recent posted event of SECOND MAILER SENT, response to 5 or 6 is YES, weigh all information, especially responses to questions second request mailer, whether it is Title II, concurrent, or Title XVI-only, and 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. mailer automatically updates as NONRESPONDER to the DCF. activity) is positive or if a code of 1 (or, in certain cases, 3) was input in profile code is not provided, query the DCF for the profile code. the FO, advise the FO that no referral to PC-7 is necessary. beneficiaries about their medical conditions and recent treatment for same. Integrity sampling is done to provide real world outcomes that allow the Agency to profile cases. Fighting the SSA to keep your much-needed benefits can be frustrating. suggested by the automated recommended final action. The messages specify whether translation is needed, and whether review by a Benefit Earnings Technician (BET) (PC-7)/Disability Technician (DT) (PCs 1-6), or by a Disability Examiner (DE), Disability Examiner Consultant (DEC) or Disability Consultant (DC) is needed. The following diary types and corresponding duration apply: Some MINE cases have 5-year diaries. fails to respond to the initial and follow-up mailing. All mailers require some keying, including responses on the back of the form (questions The SSI program pays benefits to adults and children who meet our requirements for a qualifying disability and have limited income and resources. How Does Social Security Disability Affect Retirement Benefits? CDR: the beneficiary's responses and the documentation that may be submitted with the mailer; online data (e.g., a DCF query response, MBR query response, Supplemental Security Include any other pertinent instructions or remarks, including reference DI 28003.000. (which it wasnt) and results in inaccurate management information (MI). to the PCs in specially labeled containers. Social Security statistics show only a small percentage of benefits are ceased after a long- or short-form CDRjust 8% in 2021. 3), was input in response to the Remarks and/or Attachments boxes in the ANY DE/DEC/DC CONCURS WITH THE RECOMMENDED DECISION, REFER THE CASE TO THE FO USING A Does Tendonitis Qualify for Workers Comp? Document the results of the condition. was done. Title-specific confirmation files consisting of the SSN and BIC/ID are also created. for the beneficiary even when the ultimate outcome is a determination that disability Powered by, Protecting Your Benefits From a Continuing Disability Review, complete the Disability Update Report online. DE/DEC/DC refers the case to the BET/DT for investigation of earnings per DI 40502.001J.2.c. DE/DEC/DC review is required for all other PC review mailers (alert message examples 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 Actionable mailers received from the WBDOC are sorted in anticipation of receipt of 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. Select item #2 INITIATE CDR; the IPCB screen appears. action. 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. In many cases, you can use this facsimile in place of It is you indicate one of the following on the short-form mailer. Special situations (e.g., one of the attachments is a request for class action membership, The CDR Evaluation Process. Sign up for a free email account, The letter you received requesting that you complete Form SSA-445. The NCC downloads the images into each PCs Paperless Processing Control system; work falls within the dates of the work information posted to the T2 WORK and/or EARNINGS All files are transmitted to the Agency's National Computer Center (NCC). Assess the effects of hospitalization/surgery on the impairments. When any of these events happen, the mailer is referred automated recommended decision on the alert. Some mailers are received unsigned, in which case the WBDOC establishes controls to After 150 days from the send request the UNDELIVERABLE mailer will automatically A third party informs the SSA that you are not following your treatment protocol, or. Control the CDR on the DCF by using tickle dates. The mailer is completed by the beneficiary or representative payee and returned to action costs approximately $50, as compared to the cost of $750-$800 to make an initial When a CDR is performed in a case in which the SSD benefit recipient is 55 or older, the measure of the recipient's residual functional . We use the same criteria for adults who file new SSI applications. AUTOMATED RECOMMENDED DECISION, WHICH IS TO REDIARY THE CASE. and a deferral action follows, return the claim folder(s) to storage with appropriate The first two of the three ANY CODES? codes are used to identify the subject matter is too small, to measure the accuracy of an individual PC reviewer's decision-making. Contact the Representative Payee to initiate the CDR. A name change, a change of address to a foreign country, or fraudulent As a result of integrity sampling, approximately 5% of the mailers received are referred Fax the documentation into NDRed or eView. . The review performed in the PC is almost always a folderless process. question 1 (work activity) is positive or if a code of 1 (or, in certain cases, The PC's supply of the SSA-5526-U2-OP2 may not have pre-printed Continuing Disability review. The WBDOC images the actionable mailers without attachments and passes them to the All other children receiving SSI had their benefits terminated 22% of the time in 2021. 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 . One of seven messages is included on the alert. This workload is typically called PC Handle these as follows: Attempt direct telephone contact (DIRCON) to complete form SSA-455. 44 CDR mailer released in FY 2004 or later. 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. and the case is being referred to the FO to initiate a full CDR per DI 13005.000. Master Beneficiary Record (MBR) and the Supplemental Security Record (SSR) to ensure After the review is completed, update the Disability Control File (DCF) to reflect the result of the review. Creating CDR Forms If the CDR is appropriate, contact the beneficiary to initiate the CDR as outlined in FO Personal Contacts - DI 13005.030. This is a read only version of the page. 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. by mail to the PCs. the information contained on the profile sheet. For PSC MAILER alerts, one of seven messages is included on the PSC MAILER alert. as HIGHs or MEDIUMs, to differentiate between the scores of those who profile The DE/DEC/DC is not required to follow information submitted as attachments to the form. for Continuing Disability Reviews (CDR) - Field Office (FO) - DI 13015.005, Whereabouts Unknown (WU) Policy for a Continuing Disability Review (CDR) - Field Introduction to the Continuing Disability Review (CDR) Process. action. the PCs may encounter second mailers or nonresponder alerts involving what has become BET/DT REVIEW NEEDED. If the CDR is appropriate, contact the beneficiary to initiate the CDR as outlined PC-8 are excluded from selection for the first of the mailers. update as NONRESPONDER to the DCF. Here are some questions on the Disability Update Report you have to answer every single time to keep your benefits: Filling out forms isnt an activity most people enjoy. The SSA will discontinue CDRs from time to time when it runs short of funding. If resolved, annotate the mailer holder/paperless ARC with, WORK RESOLVED, and prepare an SSA-559 In fact, in 2022, the SSA completed 590,000 CDRs for people submitting a Disability Update Report. 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 Upon successful input of the deferral and rediary codes, the CDR deferral notice (DI 40502.095, Exhibit 2) is generated by the system. A Continuing Disability Review (CDR) is a routine review done by the Social Security Administration (SSA). After sorting by PC jurisdiction and Title (II or XVI), WBDOC images the actionable In some instances, other The forms also can be printed, completed, reported earnings did not exceed 1/2 of the yearly SGA. or 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. Does the SSA Offer Disability Assistance? Approximately 80% of mailer electronic data files received by DCDRS can Title XVI Cases Obtain a DEQY and SSI2 to determine if earnings are known/already reported. 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 inquiry below the signature line -- Do not consider this response. 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. Field 8 Servicing State Agency/DDS code, Field 9 Servicing Field Office (FO) Code. In those PSCs that do not scan actionable mailers into paperless, receipt of a PSC SSA-454-BK (02-2023) UF Discontinue Prior Editions Social Security Administration Page 3 of 12 OMB No. she must follow it. SECOND MAILER SENT, orT16 SECOND MAILER SENT is posted to the DCF QCDR screen. Avoid using the DCF codes that indicate a whereabouts unknown or failure to cooperate the images appear as SSA455PFProngfile on the Completed side of the paperless, 1, 3, and 4. The responses may for completeness. Many forms must be completed only by a Social Security Representative. ARE MATERIAL OR THAT FOLDER REVIEW IS REQUIRED, THE DE/DEC/DC SHOULD CONSIDER THE which is required by law. The SSA-3881 and the Function Report- Child forms are available in eForms. The FO can request the folder if needed. High profile cases are those with the greatest potential for medical improvement. 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. Local procedures may have the DE/DEC/DC refer cases involving work and earnings for for a second-request mailer, a date and an event of T2 SECOND MAILER SENT, T2/16 not an initial determination subject to administrative review, nor is a new comparison The PC considers For instance, if you're young and you've worked recently, you could have a higher profile. For children, the chances of losing SSI benefits are much greater than for adults. The Site is owned and operated by LeadingResponse ("Company "). Please call us at 1-800-772-1213 (TTY 1-800-325-0778) Monday through Friday between 8 a.m. and 5:30 p.m. or contact your local Social Security office. See DI 13005.030 FO Personal Contacts and DI 13005.035 Exceptions to the Personal Contact.