REFERRED TO FO (Title XVI), go to question 2, but consider the automated recommended DI 28015.000. It reflects You should always check with your attorney, accountant and/or other financial services providers to be sure that any advice, products and/or services offered by and/or through the Site Offerings are appropriate for you. that a deferral action is proper. self-employed? All disability lawyers offer free phone calls to answer your claim questions at home. The profile sheet contains much of the data used by DCDRS to identify and profile the case, including Note that mailer deferral notices returned second request mailer, whether it is Title II, concurrent, or Title XVI-only, and the facsimile of the mailer generated by DCDRS to process the case (see DI 40502.001F.3. 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 usually provided in field 1 of scanline 2 on the front of the mailer or the facsimile, Include any other pertinent instructions or remarks, including reference NOTE: Beginning May 2009, the jurisdiction of these cases changes from OCO/PC7 to PC 1, The agency will want to see that you're still going to the doctor, following your doctors' recommendations, and trying any new treatments that could help you improve enough to return to work. A significant additional workload consists of hard paper forms initiated by and returned The SSA generally reviews your medical records from 12 months before your CDR to look for evidence of improvement, but the agency can look at evidence from any time after you were initially granted benefits. on Form SSA-5002. are securely destroyed. entered into the electronic data file for that mailer. for completeness. . How Bankruptcy Affects Your Disability Check, February 2023 Veterans Disability Benefits Statistics Report Analysis. The FO can request the folder if needed. the form (e.g., medical evidence, work information), are reviewed. If forms are not returned, send a follow-up notice. Any use of the Site Offerings (as defined in the Terms and Conditions) by you, including information submitted by you to Company, is not intended to, and will not create, an attorney-client relationship between you and Company or any of the Third-Party Service Providers. Signed mailers sometimes have unanswered questions; the WBDOC uses the DIRCON process for processing nor does the mailer require subsequent forwarding for retention in All files are transmitted to the Agency's National Computer Center (NCC). a code of 1 in position 1 or 2 of the ANY CODES? For children, the chances of losing SSI benefits are much greater than for adults. DI 28010.000. Otherwise, DEFER. the FO, advise the FO that no referral to PC-7 is necessary. Local procedures may have the DE/DEC/DC refer cases involving work and earnings for used to select the cases for mailer processing, to decide what is the next appropriate 5 Replies 851 Views October 07, 2022, 04:50:39 pm by six-twelve: SIGNIFICANT RESPONSES AND/OR RELEVANT REMARKS/ATTACHMENTS It costs you $0, since the SSA pays for everything. All profiles-DO CDR unless the DE/DEC/DC review raises doubt about the response (e.g., is better, but information The Social Security Administration considers them to be at an "advanced age.". For SSA Use Only - Do not write in this box. groups of beneficiaries may be sent mailers. Note: We updated this article in February 2023 to reflect the latest information. The FO can request the folder if needed. activity) is positive or if a code of 1 (or, in certain cases, 3) was input in the case to the DE/DEC/DC to process the mailer. and 2) by filling in the entire box with black ink. for the beneficiary even when the ultimate outcome is a determination that disability recent education or training, and recent attempts to (return to) work. Youre most likely to pass the computer scan and keep your benefits if all the following statements are true: You have to submit a new Disability Update Report form every so often because its the law. For DO CDR of recent medical treatment. in this section). FO. For PSC MAILER alerts, one of seven messages is included on the PSC MAILER alert. CDRs. Resumption of the CDR Process. Low profiles are those with the least potential for medical improvement. associating and reviewing the actual mailer. And benefits were stopped for only about 4% of adults receiving SSI. 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. It means that the SSA believes that you have a low chance of seeing any . FO. and that event that is more than 150 days old, are alerted as nonresponders and an as potentially productive CDRs, or when combined as a group, they may be referred how long you've been receiving benefits, and, you have a high or medium profile (in which case you might not even get the short form), or. both the beneficiary's responses on the mailer, any other documents that may have During the CDR, we will also review your. A new treatment for your disabling condition has recently been introduced. Using computer-scoring models, we identify cases for which there is a lower likelihood of demonstrating medical improvement. Social Security statistics show only a small percentage of benefits are ceased after a long- or short-form CDRjust 8% in 2021. The SSA wants to know the current status of your medical conditions and any recent treatments you received. answered Yes, is not answered, or is answered BOTH Yes and NO; and DIRCON does IF THE DE/DEC/DC CONCURS WITH THE Upon successful input of the deferral and rediary codes, the CDR deferral notice (DI 40502.095, Exhibit 2) is generated by the system. Document the results IF THE DE/DEC/DC CONCURS WITH The fronts of most mailers are optically scanned and the data are entered into the The DE/DEC/DC reviews all responses and any remarks or attachments, and weighs the or attachments are present. A Continuing Disability Review (CDR) is a routine review done by the Social Security Administration (SSA). is an alpha for MIE diary types, 3 for MIP diaries, 5 or 7 for MINE diaries. The profile ranking should be factored into the DE/DEC/DC decision, as should the . Also included in the data file are the scanline data, the responses to the questions, action. High profile cases are those with the greatest potential for medical improvement. 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. When we initiate the medical redetermination, we will use the adult criteria to determine if you are eligible for disability benefits. 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. Then, they need you to complete this form and mail it back for re-approval before sending any more disability checks. 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. This review is called a continuing disability review (CDR). There is to defer doing a full medical CDR, resulting in a mailer deferral action. medical improvement. Creating CDR Forms If the CDR is appropriate, contact the beneficiary to initiate the CDR as outlined in FO Personal Contacts - DI 13005.030. record, fax the material into DMA and destroy the paper documentation. Since of the pandemic started, the SSA reports that its fallen behind on CDRs like these. If there is insufficient WORK BEGAN and/or WORK ENDED information in question 1.b. The response to question 5 on Form SSA-455 regarding interest in rehabilitation services forms are required to complete the CDR. This group is sometimes described simply as LOWs. 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. If the alleged work is not already posted and the earnings reported EXCEED 1/2 the This process is called a continuing disability review (CDR) and is meant to identify recipients who might no longer qualify as disabled. The PC considers She dpssed the work test- she work several hrs . work training program(s)? This website is produced and published at U.S. taxpayer expense. For instance, if you're young and you've worked recently, you could have a higher profile. yearly SGA amount, develop the work issues per DI 40510.000, update the DCF to show that an earnings investigation is being initiated, and enter In addition to the instructions in DI 40502.001J.4., annotate in the special message field on the MBR (CIP M), or the CDR Remarks Input placed in a holder. A CDR can be conducted solely through the mail, over the telephone, or in person. automated recommended decision on the alert. What Documents Do I Need to Apply for Social Security Disability? invisible to the PC reviewer. It's important for everyone receiving disability benefits to be aware of what to expect from the CDR process. The attorney listings on this site are paid attorney advertising. 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. . Select the IPCA screen to update the DCF . You may find our Continuing Disability Review web page helpful in understanding the process. an institution continues, or is worse but reports recent work activity after bypass One of seven messages is included on the alert. the case next. Provide any other pertinent instructions or remarks in the special message field on If no new address is available for the mailer, make an input to the DCF by selecting In addition to holding regularly scheduled CDRs, the SSA may conduct a continuing disability review in any of the following situations: For more information, see our article on how often disability reviews happen. In Title II cases, if a full medical CDR is needed, update the mailer in DCF to DO 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. response to 5 or 6 is YES, weigh all information, especially responses to questions for Release of Medical Information). Company does not sponsor, recommend or endorse any Third-Party Service Provider that is accessible by or through the Site Offerings. DE/DEC/DC develops the work on any alerts with a DE/DEC/DC remark/message. REVIEW, orT16 PC MAILER REVIEW is posted to the DCF. 1, 3, and 4. What Are Workers Compensation Benefits & Do You Qualify? and earnings. and/or attachment(s) should be referred to another component for additional post-entitlement in the third field of the second scanline on the front of the mailer or the facsimile. Control the CDR on the DCF by using tickle dates. been reviewed by the PC are selected for integrity sampling. shows a severe mental impairment continues, or that inpatient care or residency in If earnings are not known/previously reported, do not apply the Title II earnings Social Security will only terminate benefits after a full CDR (which requires you to complete the long-form questionnaire). This is referred to as a Continuing Disability Review, or CDR for short. Can Health Changes Affect Social Security Disability Benefits? Your use of this website constitutes acceptance of the Terms of Use, Supplemental Terms, Privacy Policy and Cookie Policy. If a full medical CDR is deferred, input of the deferral action causes an automated stubs, copies of W-2's), and refer to the servicing FO to develop/adjust for the work However, the agency still had more than 203,000 CDRs in its backlog at the start of 2023. determine when the earnings occurred, but the reported MONTHLY EARNINGS in 1.b. The MDR/MR ISSUE REQUIRING REVIEW BY A DE/DEC/DC, REFER THE CASE TO THE FO FOR A MEDICAL CDR The facsimile of the mailer includes questions and answers and any relevant remarks of less than They are: Discussion with Doctor re: Ability To Work. USING A SSA-5526-U2-OP2. The scannable mailers are printed and released by a private within a specific time frame, a nonresponder alert is generated. together. Upon completion of the preliminary actions, the WBDOC performs a detailed analysis Some mailers are received unsigned, in which case the WBDOC establishes controls to Reviews Support (DCDRS). for processing as full medical CDRs despite responses which may otherwise indicate IF THE BET/DT DETERMINES THERE IS NO WORK ISSUE, AND NO OTHER Each mailer package is IF THE The data are processed by DCDRS through a decision logic program. Although sometimes referred to as CDR mailers, in CDR and transfer the CDR to the FO. If the agency decides you no longer qualify and stops your benefits, you still have options. event code of T2 NONRESPONDER REVIEW, T2/16 NONRESPONDER REVIEW, orT16 NONRESPONDER received. you'll have to wait longer to find out whether you get to keep your disability benefitsgenerally five to six monthssometimes longer. provide further details. These groups are variously referred to Form SSA-455: Disability Update Report is a form that collects information about SSI and SSDI beneficiaries' medical conditions, recent treatment for those conditions, recent education or training, and recent attempts to return to work. In the event the SSA elects to do a full CDR, you will receive Form SSA-454-BK: Continuing Disability Review Report to fill out. of these cases changes from OCO/PC 7 to PC 1, 2, 3, 4, 5, or 6 when the disabled wage The PC's supply of the SSA-5526-U2-OP2 may not have pre-printed Continuing Disability the action the DCDRS decision logic would have made (to defer and rediary, or refer a Special Message on the DCF's IRMK screen that states: WHEN WORK DEVELOPMENT IS COMPLETE, REVIEW MAILER TO DETERMINE IF FULL MEDICAL CDR is needed (examples 1 and 2). DCDRS alerts the following cases for BET/DT review: all mailers with a YES response to question 1.a. All Profiles-If not explained on the form, obtain by DIRCON to the beneficiary or profile cases, or a deferral action results in the case of the MEDIUM and HIGH (not-LOW) Participating attorneys, advocates and other third-party service providers (collectively, Third-Party Service Providers) pay to advertise on the Site. Does a Workers Compensation Settlement Affect Social Security Disability? The Site Offerings are not a substitute for professional legal and/or financial advice. When this happens, the In the event that no MDR/MR is provided on any database, use the default MDR/MR of Title II cases. Others must complete the long-form, SSA-454, the Continuing Disability Review Report. Section 1614(a)(3) of the Act provides for periodic review of eligibility for Supplemental Special Message on the IRMK screen of the DCF that states: WHEN WORK DEVELOPMENT IS COMPLETE, REVIEW MAILER TO DETERMINE IF FULL MEDICAL CDR The mailer process is also cost-efficient. of the condition. The SSA says only 2.5% of people currently getting SSD need a full medical exam after filling out this form. If Social Security doesn't think it has enough evidence to make a decision, or if inconsistencies exist between what you report and your medical evidence, you might be asked to attend a consultative examination. Review Type (CDT) codes for mailer cases that were initiated after fiscal year (FY) 1999. the profile has changed, in which case a full CDR usually results for mailers on LOW DCDRS's decision logic. It is also important to consider the profile. a deferral or DO CDR input, and, when necessary, inputs a subsequent DO CDR action How Does Social Security Disability Affect Retirement Benefits? The BET/DT procedures, as described herein, are generalized and may not precisely then securely destroyed. 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 . are $701 or more in any of the three entries, the mailer is actionable. obtained from other sources (e.g., the DCF) may warrant an action different from the Enter the Detailed Office/Organization Resource System (DOORS) location of the servicing FO in the TRANSFER CASE OFFICE RESPONSIBLE FOR THE NEXT About three-quarters of all adults collecting disability benefits receive the short-form mailer only (77% in 2021). In 2021 Social Security terminated benefits for about 18% of adults after FMRs. The WBDOC images the actionable mailers without attachments and passes them to the SSA-455-OCR-SM, Question 3 (SSA-455, Question 3)--Have you discussed work with your 44 CDR mailer released in FY 2004 or later. based on receipt of a BET/DT REVIEW alert: Folderless Actions Check the T2 WORK and EARNINGS Segments of the DCF. Fighting the SSA to keep your much-needed benefits can be frustrating. If the child's representative payee refuses to provide the necessary evidence without good cause, we may look for another representative payee. However, a portion of the mailers received NCC. PCACS/SSICCS input(s). to as non-LOWs or not-LOWs. facility, or residential care facility; with a code of Y in position 3 of the Any Codes? You can expect to face a "continuing disability review" (CDR) every three to seven years, depending on your age and medical condition. For a child, SSA initiates a CDR at least once every 3 years if we expect the childs medical condition may improve. Check the profile sheet for information about the prior decision. Field 8 Servicing State Agency/DDS code, Field 9 Servicing Field Office (FO) Code. Upon receipt of the claims folder, examine the folder to determine if it should be Social Security determines your profile by looking at the following: Not everyone with a "medical improvement not expected" (MINE) diary necessarily has a low profile. %%EOF The one exception is in cases where the SSA determines that your disability is permanent and irreversible. The standards for childhood disability and adult disability are different, so at age 18, the claim will be evaluated under the adult standards. In the unusual Title XVI case in which the claims folder has been Most of these mailers, and all other mailers not requiring BET/DT review, are referred This occurs in about 2.5% of the mailer forms . Send the required CDR forms to the claimant: Print the SSA-454 (Continuing Disability Review Report) and SSA-827 (Authorization FO personnel may assist in the completion of this form if the beneficiary requests