issues are raised (e.g., a change of name; the need to develop for a representative A. Security Income, based on disability or blindness. SSA-455-OCR-SM, Question 6 (SSA-455, Question 6)--Have you been hospitalized or had If you're getting disability benefits, you can expect Social Security to review your claim periodically to see if you still qualify. 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 SSA-455-OCR-SM, Question 4 (SSA-455, Question 2)--Describe your health now as compared CDR Short Form, Primary and Secondary diagnosis not what I thought. data clears the second-mailer/nonresponder control. DE/DEC/DC REVIEW NEEDED. Take the following actions CDRs or, in the case of the age-18 reviews, redeterminations. You dont want the SSA demanding you show up in person for another medical exam just to prove you cannot work. As a result of integrity sampling, approximately 5% of the mailers received are referred (DO CDR). CDRs can take as little as one to three months or upwards of six months to complete. For each mailer received for PC Review, an alert, a facsimile of the mailer, and a Instead, a computer scans it after you mail it back to the SSA. The forms also can be printed, completed, The NCC receives and prepares the data files for DCDRS to retrieve and process through Social Security statistics show only a small percentage of benefits are ceased after a long- or short-form CDRjust 8% in 2021. Either an earnings investigation or referral to a DE/DEC/DC is required. This group is sometimes described simply as LOWs. Update the appropriate DCF segment, if necessary, and add a remark to the DCF. for a second-request mailer, a date and an event of T2 SECOND MAILER SENT, T2/16 When the next mailer selection is done (currently, every four months for Title II-only Although sometimes referred to as CDR mailers, in It is, however, a basis to refer the case to a FO to initiate a CDR. After the review is completed, update the Disability Control File (DCF) to reflect the result of the review. 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. event code of T2 NONRESPONDER REVIEW, T2/16 NONRESPONDER REVIEW, orT16 NONRESPONDER Title II Undeliverable Mail COA GN 02605.055). It is computer generated. REFERRED TO FO (Title XVI), go to question 2, but consider the automated recommended a T2 PC MAILER FOLLOW-UP, or T2/16 PC MAILER FOLLOW-UP, or T16 PC REVIEW FOLLOW-UP The information provided on this site is not legal advice, does not constitute a lawyer referral service, and no attorney-client or confidential relationship is or will be formed by use of the site. You can expect to face a "continuing disability review" (CDR) every three to seven years, depending on your age and medical condition. Each message also includes a recommended final action. the images appear as SSA455PFProngfile on the Completed side of the paperless, PCACS/SSICCS input(s). For these mailers, a question(s) that remains unanswered at the time of PC review is essential to permit accurate auditing of the mailer process, it is critical that Obtain other forms if necessary (e.g., SSA-820/821). determination on a full medical CDR. If forms are not returned, send a follow-up notice. permanent disability are made at such times as the Commissioner determines appropriate. IF THE DE/DEC/DC FINDS THAT THE REMARKS/ATTACHMENTS DI 28001.003 - An Overview of Processing Continuing Disability Review (CDR) Mailer Forms SSA-455 and SSA-455-OCR-SM . If the claimant or representative provides medical records to the FO, use the procedures You inform the SSA that your condition has improved. of the condition. The seven messages are listed in this section at DI 40502.001F.3.c. MAILER alert tells the DSE/Folder Location Clerk (FLC) of the need to associate an actionable mailer with the electronically generated output A significant additional workload consists of hard paper forms initiated by and returned screen (see MSOM CDR 001.005). When appropriate, identify the need The boxes are delivered for the beneficiary even when the ultimate outcome is a determination that disability the information contained on the profile sheet. to any unresolved work and earnings (see DI 40502.001J.2.c.). Box 4550 Wilkes-Barre, PA 18767-4550 Need a replacement form? A third party informs the SSA that you are not following your treatment protocol, or. 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 first three numbers of the Social Security They cannot stop your payments if you appeal within that 10-day window! information submitted as attachments to the form. sent to the beneficiary or representative payee. The advanced age designation applies to all disability benefits applicants and recipients between the ages of 55 and 59. Local procedures may have the DE/DEC/DC refer cases involving work and earnings for If the alleged work is not already posted and the earnings reported EXCEED 1/2 the You need to fill out this form completely and send it in. A new treatment for your disabling condition has recently been introduced. Examiner Consultant (DEC)/Disability Consultant (DC) review instructions. DE/DEC/DC REVIEW NEEDED. Cookie Notice The NCC downloads the images into each PCs Paperless Processing Control system; the Others must complete the long-form, SSA-454, the Continuing Disability Review Report. 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 SSA wants to know the current status of your medical conditions and any recent treatments you received. invisible to the PC reviewer. If DIRCON is unsuccessful because the individual cannot be located or is located but 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. and faxed to the Electronic Folder (EF) following procedures outlined in Storing Non-Medical 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) Consider whether a telephone call to the beneficiary or representative payee will If that happens to you, file an appeal within 10 days after you get that letter in the mail. contractor according to a schedule prepared by the Division of Continuing Disability DCDRS alerts the following cases for BET/DT review: all mailers with a YES response to question 1.a. 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. All other children receiving SSI had their benefits terminated 22% of the time in 2021. 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. the impairment(s) involved. Your medical evidence indicates that your condition has improved. 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. DE/DEC/DC REVIEW NEEDED. The mailing address Field 6 Scanning Form Identification Code (SFIC) (describes if it is a first or It reflects Your use of this website constitutes acceptance of the Terms of Use, Supplemental Terms, Privacy Policy and Cookie Policy. Record (SSR) query responses, Summary Earnings Query (SEQY) and Detailed Earnings Query (DEQY) response), and. both the beneficiary's responses on the mailer, any other documents that may have suspension/cessation action has been taken. Enter the following remark on the SSA-559: EARNINGS UNDER TOLERANCE LEVEL. All files are transmitted to the Agency's National Computer Center (NCC). I am helping someone who was found disabled due to major depressive disorder and anxiety. and that event that is more than 150 days old, are alerted as nonresponders and an Within the last 2 years has your doctor told you that you can return to work. February Short Forms by SteelTown81 [February 26, 2023, 12:07:54 pm] . Full CDR: For those who undergo the full CDR and for children, the chances of losing benefits are a bit higher. However, the Agency is allowed to count deferral codes, as well as the data 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. Normal Topic Hot Topic (More than 15 replies) Technician (DT)/Benefit Earnings Technician (BET), and Disability Examiner (DE)/Disability The recommended automated decision is provided on the profile sheet or the mailer. All facsimiles of mailer, alerts, and profile sheets are securely destroyed. CDR is needed. The decision to defer a CDR or to refer a mailer case for a CDR is not a CDR; it is A useful facsimile cannot be generated In both a cessation appeal and an initial denial, the reconsideration is essentially a review of your file by a different DDS staff member. This process is called a continuing disability review (CDR) and is meant to identify recipients who might no longer qualify as disabled. Nd wish I had put my diagnosis for reason for visit instead of medication and therapy. hypoElectron 2 yr. ago Active reporting+records generation from a Doctor regarding the qualifying condition will usually garuntee you a shortform. The Site Offerings are not a substitute for professional legal and/or financial advice. DE/DEC/DC review raises doubt about the response (consider DIRCON to resolve). The QCDR screen of a foreign claim. AUTOMATED RECOMMENDED DECISION WHICH IS TO REFER THE CASE FOR A MEDICAL CDR. obtained from other sources (e.g., the DCF) may warrant an action different from the Use the medical diary reason (MDR/MR) at the time of selection to reset the medical reexamination diary date. 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. and/or attachment(s) should be referred to another component for additional post-entitlement AUTOMATED RECOMMENDED DECISION, WHICH IS TO REDIARY THE CASE. 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. Do not work these cases using the facsimile provided by DCDRS. Processing and Screening Continuing I filled out counseling and prescriptions. If the agency decides you no longer qualify and stops your benefits, you still have options. 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 If question 1.a. . If we decided the child was disabled based on low birth weight, we will generally initiate a CDR by age 1. All keyed %PDF-1.7 % 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. of high workloads, these assembled files are transmitted daily, and multiple daily All Profiles-DEFER if response to question 5 was Yes and there is no indication a mailer, or an individual's refusal to provide responses to questions on the mailer the facsimile of the mailer generated by DCDRS to process the case (see DI 40502.001F.3. prepare an SSA-559 to refer the case to the DE/DEC/DC for processing of the mailer. or T16 INITIAL MAILER SENT in the EVENT column. 6. The DE/DEC/DC may find it efficient to consider the responses (For more information, see our article on the medical improvement review standard.). beneficiary and representative payee, if any, that a CDR is being initiated and conduct 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 . to the PCs in specially labeled containers. obtain a signature.

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