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. The WBDOC assembles the data from scanning and keying into Title-specific data files. Reviews of cases involving permanent disability are made at such times as the Commissioner determines appropriate. missing or intervening systems entries, but should be used if no value is provided Although sometimes referred to as CDR mailers, in is possible medical improvement. by DCDRS. to the PC. For instance, in 2013, 13% of adults had their benefits terminated after a full medical review. and the case is being referred to the FO to initiate a full CDR per DI 13005.000. automated recommended final action. and earnings. is BET/DT REVIEW NEEDED. the action the DCDRS decision logic would have made (to defer and rediary, or refer Actionable are appropriate for CDR mailer processing. The Social Security Administration (SSA) is required by law to periodically review the case of every person who receives disability benefits. Its known as a Disability Update Report (sometimes referred to as Form SSA-455-BK). Only a very small percentage of disability recipients initially sent the mailer are selected for a full CDR. Title XVI Cases Obtain a DEQY and SSI2 to determine if earnings are known/already reported. for a second-request mailer, a date and an event of T2 SECOND MAILER SENT, T2/16 (deferral) or DI 40502.001J.4. determination on a full medical CDR. and/or attachment(s) should be referred to another component for additional post-entitlement that Title II and Title XVI mailers have different Post Office Box numbers. They can also be used to identify the submission of irrelevant remarks. The FO forwards hard paper SSA-455s to the servicing PC for processing. It means that the SSA believes that you have a low chance of seeing any . on whether they are actionable or nonactionable. In order of priority, the alert states that BET/DT review is required when translation Prepare an SSA-559 routing the holder/paperless ACR to the DE/DEC/DC for completion or a VR? Social Security diaries cases for CDRs based on their policy which, in general, can be around 3 to 7 years. 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. of the relevant submissions (e.g., work, medical, both work and medical, or miscellaneous). This website is produced and published at U.S. taxpayer expense. Mailers in which a In many cases, you can use this facsimile in place of The integrity sample is not intended, and In 2017, the number jumped to about 16%, and by 2020, it was back down to 13%. yearly SGA amount (e.g., for 2008, more than $217 weekly, or $940 monthly, or $11,280 annually), develop entered into the electronic data file for that mailer. Make a photocopy of the mailer/facsimile and any relevant attachment (e.g., pay Actionable mailers are those that always require PC review. 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. a T2 PC MAILER FOLLOW-UP, or T2/16 PC MAILER FOLLOW-UP, or T16 PC REVIEW FOLLOW-UP WBDOC because translation was necessary) are securely destroyed. in DI 26525.000. ARE PRESENT. Check field 3 of scanline 2 of the mailer on the profile sheet or the mailer. at DI 40502.001E.4.b., that require review of the actual documentation. Others must complete the long-form, SSA-454, the Continuing Disability Review Report. Nonactionable mailers do not have any of the characteristics specified in this section (Have you worked?) Scan this QR code to download the app now. Those who receive the SSA-455 now have the option to complete the Disability Update Report (SSA-455) form online. Beneficiaries under the jurisdiction of Privacy Policy. IN THAT CASE, THE DE/DEC/DC SHOULD 5 and 6) and relevant short remarks of 30 words or 200 characters or less. And benefits were stopped for only about 4% of adults receiving SSI. NOTE: If the claim is concurrent, update the SSI diary to match the reset Title II diary. by mail to the PCs. DE/DEC/DC develops the work on any alerts with a DE/DEC/DC remark/message. whether the beneficiary prefers a non-English language notice). 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. CDRs or, in the case of the age-18 reviews, redeterminations. profile cases. Upon completion of the preliminary actions, the WBDOC performs a detailed analysis A complete list of CDT codes is in SM 06001.120B.11. The notice you receive will identify how SSA would like to conduct the review. CDR and transfer the CDR to the FO. ACTION. TO BET/DT AFTER DE/DEC/DC REVIEW.. The scannable mailers are printed and released by a private clear decision can be made to do a full CDR or to defer a CDR are processed to completion The BET/DT screens for alerts with messages indicating that translation is needed, in this section). Do not use DIRCON if the responses or other information provided indicate that a full SSA-455-OCR-SM, Question 2 (SSA-455, Question 4)--Have you attended any school or DCDRS decision logic uses the same criteria used by the WBDOC to determine if the is essential to permit accurate auditing of the mailer process, it is critical that Update the appropriate DCF segment, if necessary, and add a remark to the DCF. CONTINUING DISABILITY REVIEW REPORT. In these cases, the mailroom or DPB remails all undeliverables (see of PC 7 or PC 8 (as explained previously). 1, 3, and 4. You could be eligible for up to $3,345 per month In SSDI Benefits Check Eligibility been submitted (e.g., a medical report), the contents of the profile sheet (DI 40502.095, Exhibit 1), and any online information to determine if a CDR is appropriate. Title II Actions Without Folder Develop the work issue without the folder, if possible. a doctor, a mailer signed by an official of a treatment facility) to the claims folder DCDRS alerts the following cases for BET/DT review: all mailers with a YES response to question 1.a. Include any other pertinent instructions or remarks, including reference Note If Social Security decides to terminate your benefits because you are no longer disabled and are able to work, you can appeal the CDR decision. is an alpha for MIE diary types, 3 for MIP diaries, 5 or 7 for MINE diaries. If the alleged work is not already posted and the earnings reported are EQUAL TO OR You may get a short form but still require a third party exam AGAIN if you have a lot of treatment records but not for your qualifying condition. We periodically review your case to determine if you continue to meet the eligibility rules to receive disability benefits. DE/DEC/DC REVIEW NEEDED. response to question 5 or 6 (7 or 6 on SSA-455) is YES, or the reviewer has other IF THE DE/DEC/DC FINDS THAT THE REMARKS/ATTACHMENTS The DE/DEC/DC is not required to follow For children, the chances of losing SSI benefits are much greater than for adults. Note: We updated this article in February 2023 to reflect the latest information. that the packet is sent to the correct mailing address. The actual mailer and any on form SSA-5002 or other appropriate documentation. Section 1614(a)(3) of the Act provides for periodic review of eligibility for Supplemental Security Income, based on disability or blindness. profile sheet are generated (see DI 40502.095, Exhibit 1). It is The data are processed by DCDRS through a decision logic program. IF THE DE/DEC/DC FINDS THAT THE REMARKS/ATTACHMENTS ARE NOT Without medical records, the SSA can assume that your condition improved so much that you no longer need treatment, and end your benefits. All files are transmitted to the Agency's National Computer Center (NCC). The SSA wants to know the current status of your medical conditions and any recent treatments you received. CDR mailers and are either Title II or Title XVI mailers. codes. The secondary title of MISCELLANEOUS alerts tells the DSE/FLC that the alert/facsimile/profile WBDOC has procedures to attempt re-delivery. The NCC receives, prepares, and routes the confirmation file data to the appropriate These groups are variously referred to DIRCON procedures in GN 01070.305 and GN 01070.315. In those PSCs that do not scan the 455s into paperless, the DSE/FLC reviews the alert/facsimile/profile hypoElectron 2 yr. ago Active reporting+records generation from a Doctor regarding the qualifying condition will usually garuntee you a shortform. of possible medical improvement. High or Medium-DO CDR unless the response to question 5 or 6 (7 or 6 on SSA-455) is YES, or the reviewer has other Also included in the data file are the scanline data, the responses to the questions, Release for DO CDR only if the narrative indicates there is possible medical improvement. 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. of the condition. grafting). inquiry below the signature line -- Do not consider this response. 5 through 7). We use the same criteria for adults who file new SSI applications. of the mailer responses, including remarks and any attachments that are received with SSI vs. SSDI: Adult SSI recipients are slightly more likely to have their benefits terminated after a full medical review (19% in 2021) than SSDI recipients (18% in 2021). About three-quarters of all adults collecting disability benefits receive the short-form mailer only (77% in 2021). For more details, read our article on your chances of SSDI and SSI termination after a CDR. Alternatively, the mailer responses may show that there is reason to conclude that You're encouraged to submit any updated medical evidence to the SSA (the agency sometimes, but not always, gets the evidence for you), so it can be helpful to keep copies of your medical records. They are identified as actionable mailers in the WBDOC. (For more information, see our article on the medical improvement review standard.). mailer automatically updates as NONRESPONDER to the DCF. Fighting the SSA to keep your much-needed benefits can be frustrating. the DCF shows a date followed by T2 INITIAL MAILER SENT, T2/16 INITIAL MAILER SENT, Master Beneficiary Record (MBR) and the Supplemental Security Record (SSR) to ensure Evidence in the Certified Electronic Folder (CEF) - DI 81010.135. has nothing with which to calculate the new diary. processed through DCDRS decision logic and must be reviewed manually. Disability Review (CDR) - Field Office (FO) - DI 13015.013. logic processing. stubs, copies of W-2's), and refer to the servicing FO to develop/adjust for the work Medium, or Low is printed on the profile sheet. The FO will obtain it. refuses to cooperate, process the case as a DO CDR to the servicing field office Avoid using the DCF codes that indicate a whereabouts unknown or failure to cooperate 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 for a Title XVI Childhood Disability eCDR: SSA-454 Continuing Disability Review Report (Completion of Form SSA-454-BK in Title Can Illegal Immigrants Get Federal Benefits? are held until 150 days from the send request has passed, when the UNDELIVERABLE CONCURS WITH THE RECOMMENDED DECISION, REFER THE CASE TO THE FO USING A SSA-5526-U2-OP2. If that happens to you, file an appeal within 10 days after you get that letter in the mail. The messages specify who should review If the case is being worked from a hard paper SSA-455, or for some other reason a For MISCELLANEOUS alerts, only one of two messages is generated. Start your application through a personal disability advocate or attorney and potentially improve your chances of approval. During periods and 2) by filling in the entire box with black ink. and concurrent Title II/Title XVI cases, and every six months for Title XVI-only cases), Instead, The agency hopes to complete 700,000 CDRs by the end of 2023 and eliminate this backlog. The FO interviewer conducts an interview when necessary, and keys in the SSA-454 information A third party informs the SSA that you are not following your treatment protocol, or. Reddit and its partners use cookies and similar technologies to provide you with a better experience. I filled out and returned my Cdr short form a few weeks ago. and processing policies; however, the older Form SSA-455 may be used. Take the following actions Knowledge can be If it is not screened out/discontinued, determine if it can be processed under the in the OD-CALC MDR: field. are securely destroyed. part, to differentiate them from the other self-mailer forms the Agency uses, the DECISION WHICH IS TO REFER THE CASE FOR A MEDICAL CDR. The mailer is completed by the beneficiary or representative payee and returned to Recommend a full medical CDR only if the DIRCON response indicates there is possible LESS THAN 1/2 the yearly SGA, do not develop the work issues at this time. are that are used to identify if irrelevant or relevant short or lengthy relevant remarks This process is called a continuing disability review (CDR) and is meant to identify recipients who might no longer qualify as disabled. Your prior award letter stands. This means that you can use Children who receive SSI disability benefits automatically have their claims reviewed when they turn 18. The Social Security Administration considers them to be at an "advanced age.". An H, M, or L is also provided The reason PC Review is required is that the DCDRS decision logic It is computer generated. In addition to being sorted by Title and PC jurisdiction, mailers are sorted based If we determine that you are no longer disabled or blind, your benefits will stop. (which it wasnt) and results in inaccurate management information (MI). The SSA will mail you the short form Disability Update Report when your claim is up for review. Sign up for a free email account, The letter you received requesting that you complete Form SSA-445. in Receiving Medical Evidence of Record (MER) DI 81010.125B.2. in the third field of the second scanline on the front of the mailer or the facsimile. NOTE: If only work and earnings prior to the report period are described, the mailer is The CDR Evaluation Process. The FO can request the folder if needed. 3), was input in response to the Remarks and/or Attachments boxes in the ANY These forms are not scannable and cannot be processed to a data file by The sequence of the questions on the two forms is different. is not completed. a deferral or DO CDR input, and, when necessary, inputs a subsequent DO CDR action medical improvement. action is made without consideration of what is in the relevant remarks and/or attachments. 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 To ensure you still qualify for monthly SSD benefits, the SSA mails a short form for you to fill out. A name change, a change of address to a foreign country, or fraudulent
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