or attachments are present. NOTE: For Form SSA-455-OCR-SM, DIRCON will have been attempted at WBDOC before the mailer was processed. Most of the time, passing a CDR is a lot easier than getting disability benefits in the first place. CDR Survey age 50-59. . The FO can request the folder if needed. (CDR) First in 7 years. the mailers. The Social Security Administration considers them to be at an "advanced age.". by the USPS as undeliverable do not require further delivery attempts. CDRs can take as little as one to three months or upwards of six months to complete. NOTE: Review of the mailer, remarks on the form, and any attachments, and/or information and that event that is more than 150 days old, are alerted as nonresponders and an Field 6 Scanning Form Identification Code (SFIC) (describes if it is a first or The form you are looking for is not available online. DE/DEC/DC review raises doubt about the response (e.g., is better, but information 2477 0 obj <>stream significance of missing responses to determine if a deferral or a full CDR is appropriate. CONTINUING DISABILITY REVIEW REPORT. They cannot stop your payments if you appeal within that 10-day window! Beneficiaries under the jurisdiction of 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. 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. It is, however, a basis to refer the case to a FO to initiate a CDR. The NCC downloads the images into each PCs Paperless Processing Control system; the referring the case to the DE/DEC/DC to complete the PC mailer review. are securely destroyed. SSA-455-OCR-SM, Question 2 (SSA-455, Question 4)--Have you attended any school or The following instructions are designed for the sequence of the questions as they are listed in this section at DI 40502.001F.3.e. Your attempts to start working again, if any. a deferral action. For SSA Use Only - Do not write in this box. 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 . See our article on collecting continuing disability benefits while you appeal for information on when your disability benefit checks will stop. But if the SSA finds that your condition has improved to the point where you can return to work, the agency will notify you that your benefits will stop. If the medical and earnings information; signed by a doctor (or a nurse), or by a staff member of a nursing home, skilled nursing Youre offline. CONCURS WITH THE RECOMMENDED DECISION, REFER THE CASE TO THE FO USING A SSA-5526-U2-OP2. As part of the deferral action, a new medical reexamination diary is set Social Security will then do a full medical review (FMR) of your case, which could take three to five months. DIRCON procedures in GN 01070.305 and GN 01070.315. Without medical records, the SSA can assume that your condition improved so much that you no longer need treatment, and end your benefits. AUTOMATED RECOMMENDED DECISION, DO NOT REFER THE CASE FOR A CDR. 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 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. 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), When the next mailer selection is done (currently, every four months for Title II-only A Continuing Disability Review (CDR) is a routine review done by the Social Security Administration (SSA). You can expect a CDR reconsideration to take three to six months. 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 If question 1.b. Receiving a short form CDR is usually a good sign. Refer original mailers and attachments that describe work activity and/or earnings, I filled out and returned my Cdr short form a few weeks ago. Upon completion of the preliminary actions, the WBDOC performs a detailed analysis no one with access to the DCF take any action to change a flipped case back to a a foreign claim. The decision logic uses the mark sense responses (Yes/No, Same/Better/Worse, etc.) But most people over age 50 have a low profile and can expect to receive a mailer. Each message also includes a recommended final action. IF THE DE/DEC/DC FINDS THAT THE REMARKS/ATTACHMENTS ARE NOT The mailing address While these two programs are different, the medical requirements are the same. THE SITE CONTAINS PAID ATTORNEY/ADVOCATE ADVERTISEMENTS. IF THE DE/DEC/DC endstream endobj startxref Receipt of the confirmation WBDOC because translation was necessary) are securely destroyed. If the alleged work is not already posted and the earnings reported are EQUAL TO OR THE RECOMMENDED DECISION, REFER THE CASE TO THE FO USING A SSA-5526-U2-OP2. I am helping someone who was found disabled due to major depressive disorder and anxiety. response to question 5 or 6 (7 or 6 on SSA-455) is YES, or the reviewer has other of the relevant submissions (e.g., work, medical, both work and medical, or miscellaneous). images appear as SSA455PF ProngFile on the Completed side of paperless, awaiting ARE MATERIAL OR THAT FOLDER REVIEW IS REQUIRED, THE DE/DEC/DC SHOULD CONSIDER THE What Are Workers Compensation Benefits & Do You Qualify? Social Security statistics show only a small percentage of benefits are ceased after a long- or short-form CDRjust 8% in 2021. How Long Does It Take to Get Disability Benefits? may be multiple QMID screens; typically, the most recent iteration is used. transmissions are possible. The actionable mailers with attachments are boxed in special boxes that include a In these cases, the mailroom or DPB remails all undeliverables (see 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. Do not request the claim folder. 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 . discontinued under the screen out criteria provided in DI 13005.020. SSA-455-OCR-SM, Question 4 (SSA-455, Question 2)--Describe your health now as compared from the facsimile. 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). DI 28010.000. For a child, SSA initiates a CDR at least once every 3 years if we expect the childs medical condition may improve. Master Beneficiary Record (MBR) and the Supplemental Security Record (SSR) to ensure attachments are associated with PSC MAILER alert packages. The mailer process is also cost-efficient. Want free expert claim help without leaving your home? Record (SSR) query responses, Summary Earnings Query (SEQY) and Detailed Earnings Query (DEQY) response), and. The logic provides front-end screening of all returned mailers. NO, and DIRCON does not resolve these situations), but question 1.b. Second-request mailers that are returned as undeliverable after a re-mailing attempt In filling out the short form CDR, SSA-455-OCR-SM, I answered the first two boxes that ask for a Yes or No answer (1a. You could be eligible for up to $3,345 per month In SSDI Benefits Check Eligibility Office (FO) - DI 13015.011, and Whereabouts Unknown (WU) Determinations and Reinstatement Procedures for a Continuing When a case is pending PC Review, an event of T2 PC MAILER REVIEW, or T2/16 PC MAILER 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. shows a severe mental impairment continues, or that inpatient care or residency in If the CDR is appropriate, contact the beneficiary to initiate the CDR as outlined 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. 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 DE/DEC/DC review raises doubt about the response (consider DIRCON to resolve). review based on the specific alert message. When any of these events happen, the mailer is referred is essential to permit accurate auditing of the mailer process, it is critical that Within the last 2 years has your doctor told you that you can return to work. DE/DEC/DC CONCURS WITH THE RECOMMENDED DECISION, REFER THE CASE TO THE FO USING A This review is called a continuing disability review (CDR). DE/DEC/DC REVIEW NEEDED. 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. This occurs in about 2.5% of the mailer forms . A new treatment for your disabling condition has recently been introduced. 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. When we initiate the medical redetermination, we will use the adult criteria to determine if you are eligible for disability benefits. The medical data cannot be manually The sequence of questions on Form SSA-455-OCR-SM reflects the most current design The other outcome Update the appropriate DCF segment, if necessary, and add a remark to the DCF. The Social Security Administration (SSA) is required by law to periodically review the case of every person who receives disability benefits. IS NECESSARY, AND REPLACE WORK AND EARNINGS INVESTIGATION WITH APPROPRIATE IPCA EVENT a response of better. association with the electronic data file. Contacts - DI 13005.030C.2. eligibility review for disabled beneficiaries at least every three years except where and case development are the same as in adult CDRs. It's important for everyone receiving disability benefits to be aware of what to expect from the CDR process. action is made without consideration of what is in the relevant remarks and/or attachments. If we decided the child was disabled based on low birth weight, we will generally initiate a CDR by age 1. to any unresolved work and earnings (see DI 40502.001J.2.c.). The advanced age designation applies to all disability benefits applicants and recipients between the ages of 55 and 59. of the PC review. for Continuing Disability Reviews (CDR) - Field Office (FO) - DI 13015.005, Whereabouts Unknown (WU) Policy for a Continuing Disability Review (CDR) - Field The BET/DT develops the work on mailer alerts with a BET/DT remark/message, and the Send your completed disability update report to the following address within 30 days of receiving it: Social Security Administration P.O. For these mailers, a question(s) that remains unanswered at the time of PC review for processing nor does the mailer require subsequent forwarding for retention in Do not work these cases using the facsimile provided by DCDRS. We may also decide to pay the child directly, if he or she is old enough to receive their own benefits. mailers without attachments and passes them to the National Computer Center (NCC). Title II cases. Examiner Consultant (DEC)/Disability Consultant (DC) review instructions. IF THE BET/DT DETERMINES THERE IS NO WORK ISSUE, AND NO OTHER 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 0960-0072. must always consider the automated recommended final action but never think he or The WBDOC assembles the data from scanning and keying into Title-specific data files. DE/DEC/DC review is required for all other PC review mailers (alert message examples to as non-LOWs or not-LOWs. 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. the mailer is considered actionable or nonactionable. PCACS/SSICCS input(s). When the PC review is completed, the CDR PC Input Screen (IPCA, see MSOM CDR 001.005) 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. suggested by the automated recommended final action. Using computer-scoring models, we identify cases for which there is a lower likelihood of demonstrating medical improvement. are reported, the mailer is actionable. Contact the beneficiary to complete any section of the form that called profiling, indicate a low probability of medical improvement where a full CDR receive undeliverable hard paper SSA-455s from the processes described in DI 40502.001I. 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. The FO will obtain it. OR THAT FOLDER REVIEW IS REQUIRED, THE DE/DEC/DC SHOULD CONSIDER THE AUTOMATED RECOMMENDED All Profiles-DEFER if response to question 5 was Yes and there is no indication a response of , indicates no likelihood of medical improvement, Do not open a new CDR path (using the DRES) and then close it in, Do not reset or attempt to substantively change the diary type using current instructions processed through DCDRS decision logic and must be reviewed manually. The diary type on the profile sheet reflects the most accurate The letter you received from Social Security informed you that, based on the information you provided, they decided not to do a continuing disability review (CDR) and that is good news. the disabled individual's: Every mailer case is classified as a High, Medium, or Low profile. the PCs may encounter second mailers or nonresponder alerts involving what has become Special Message on the IRMK screen of the DCF that states: WHEN WORK DEVELOPMENT IS COMPLETE, REVIEW MAILER TO DETERMINE IF FULL MEDICAL CDR in FO Personal Contacts - DI 13005.030. deferral, If a full medical CDR is not indicated based on the responses supplied, SSA-455-OCR-SM, DIRCON will have been attempted at WBDOC before the mailer was processed, The corresponding question number on the hard paper SSA-455 is indicated in parentheses, EQUAL TO OR LESS THAN 1/2 the yearly SGA amount, If the alleged work is not already posted and the earnings reported EXCEED 1/2 the Subsequently, those mailers Instead, When selected AFTER TRANSLATION AND REVIEW, THE DE/DEC/DC SHOULD CONSIDER THE The SSA created it to gather information from disabled claimants currently receiving benefits. The messages specify who should review If you undergo a full medical review and the claims examiner finds that your condition has improved since you were approved for disability, your benefits will likely be terminated. the mailer (the actual form or the facsimile, if it was used to process the case), Alerts with the secondary title of PSC MAILER are generated when the actual mailer 0 Review Type (CDT) codes for mailer cases that were initiated after fiscal year (FY) 1999. The SSA will mail you the short form Disability Update Report when your claim is up for review. As a result of integrity sampling, approximately 5% of the mailers received are referred Evidence in the Certified Electronic Folder (CEF) - DI 81010.135. In the event the diary types do not agree, use the diary type on the profile sheet Security Income, based on disability or blindness. DCDRS makes the appropriate input to update the DCF to reflect the results of decision 5 through 7). In the event that no MDR/MR is provided on any database, use the default MDR/MR of The eCDR procedures for case selection, Comparison Point Decision (CPD) folder acquisition, Jurisdiction for the mailer follows the Agency's jurisdiction rules. See DI 13005.030 FO Personal Contacts and DI 13005.035 Exceptions to the Personal Contact. If you receive Form SSA-454, it means that you're getting a full CDR. Following translation, cases with reports of work and earnings are referred to the Social Security periodically reviews your medical impairment (s) to determine if you continue to have a disabling condition. Make sure that you answer this two-page form honestly. Please reference the Terms of Use and the Supplemental Terms for specific information related to your state. within a specific time frame, a nonresponder alert is generated. files from the WBDOC. The one exception is in cases where the SSA determines that your disability is permanent and irreversible.