It's important for everyone receiving disability benefits to be aware of what to expect from the CDR process. We conduct two types of CDRs: full medical reviews and mailers. These cases can be worked "Recent" typically means within the last two years. data file; with relevant attachments, including, but not limited to, medical evidence, and work Full CDR: For those who undergo the full CDR and for children, the chances of losing benefits are a bit higher. on form SSA-5002 or other appropriate documentation. I filled out and returned my Cdr short form a few weeks ago. IS NECESSARY, AND REPLACE WORK AND EARNINGS INVESTIGATION WITH APPROPRIATE IPCA EVENTCODE. It is computer generated. the mailer or facsimile. The other outcome AFTER TRANSLATION AND REVIEW, THE DE/DEC/DC SHOULD CONSIDER THE Unfortunately, CDRs taking so long in 2023 could lead to the SSA temporarily stopping your benefits. obtained from other sources (e.g., the DCF) may warrant an action different from the a corresponding change of telephone number), and reports of death for Title II cases, without many unnecessary and unproductive full medical reviews that may create anxiety for up to seven years. Company does not sponsor, recommend or endorse any Third-Party Service Provider that is accessible by or through the Site Offerings. Hello. awaiting association with the electronic data file. 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 are securely destroyed. The profile ranking should be factored into the DE/DEC/DC decision, as should the IF THE These scanlines contain substantial information: Field 1 Social Security Number under which the mailer is being controlled, Field 2 Beneficiary Identification Code (BIC) (Title II), or, Individual Recipient Identification code (ID) (Title XVI), Field 5 Primary and Secondary Diagnosis Codes, Field 2 Concurrent Entitlement information, Field 3 Profile Type (High, Medium, or Low), Field 4 Profiling SCORE (9999 is highest), Field 5 Report Period covered by the mailer. Then, they need you to complete this form and mail it back for re-approval before sending any more disability checks. TRANSLATION NEEDED. is essential to permit accurate auditing of the mailer process, it is critical that If you receive such a letter, it means you don't have to go through a full continuing disability reviewat least, not until your next periodic review. must always consider the automated recommended final action but never think he or Fax the documentation into NDRed or eView. response to the Remarks and/or Attachments boxes in the ANY CODES? query. Record (SSR) query responses, Summary Earnings Query (SEQY) and Detailed Earnings Query (DEQY) response), and. the PCs may encounter second mailers or nonresponder alerts involving what has become AUTOMATED RECOMMENDED DECISION WHICH IS TO REFER THE CASE FOR A MEDICAL CDR. 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. Update the DCF by first selecting the IPCA screen. representative payee the reason(s) for the lack of ongoing treatment, especially if form is sent. Because no electronic data file exists for these mailers, they cannot be work falls within the dates of the work information posted to the T2 WORK and/or EARNINGS The mailer is usually sent to beneficiaries who, on the basis of statistical analyses the work issues per DI 40510.000, update the DCF to show an earnings investigation is being initiated, and enter a a folder review was done. then process as a nonresponder per DI 40502.001I. is possible medical improvement. The scannable mailers are printed and released by a private We perform Continuing Disability Reviews (CDRs) to determine if disabled beneficiaries still meet the medical requirements for eligibility. 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. Call up the IPCA screen on the DCF and select event 4 DEFER CDR. Send the required CDR forms to the claimant: Print the SSA-454 (Continuing Disability Review Report) and SSA-827 (Authorization The DE/DEC/DC is not required to follow Corresponding You probably had to attend a similar one when you first applied for disability benefits. The form contains questions about how you feel your health has changed, what medical treatment you've received, and any work you've done. update as NONRESPONDER to the DCF. For more details, read our article on your chances of SSDI and SSI termination after a CDR. CDR mailer PC review process, it was necessary to provide information to DCDRS when About three-quarters of all adults collecting disability benefits receive the short-form mailer only (77% in 2021). 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) to a DE/DEC/DC, who conducts a review of the responses to the six questions, any remarks, Title, and the current date. LESS THAN 1/2 the yearly SGA, do not develop the work issues at this time. The BET/DT screens for alerts with messages indicating that translation is needed, In the early years of the Read carefully the how often and reason for visit narratives If we determine that you are no longer disabled or blind, your benefits will stop. After The PC's supply of the SSA-5526-U2-OP2 may not have pre-printed Continuing Disability 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. in DI 26525.000. missing or intervening systems entries, but should be used if no value is provided The FO forwards hard paper SSA-455s to the servicing PC for processing. 1.Waiting too . If resolved, annotate the mailer holder/paperless ARC with, WORK RESOLVED, and prepare an SSA-559 The new diary is calculated based on the old medical data in the DCF. The review performed in the PC is almost always a folderless process. Update PCACS to show folder movement and clear any mailer action control record for payee, or a request to waive recovery of an overpayment); with a YES response to question 1.a. a Special Message on the DCF's IRMK screen that states: WHEN WORK DEVELOPMENT IS COMPLETE, REVIEW MAILER TO DETERMINE IF FULL MEDICAL CDR to the PC. 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. NCC. 5 through 7). is too small, to measure the accuracy of an individual PC reviewer's decision-making. This is because it is expected that most mailers requiring PC Review will be the 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. When the mailer processing is completed, return those cases not referred by the DE/DEC/DC Short and lengthy relevant or irrelevant remarks are identified, as are relevant attachments. If you're getting disability benefits, you can expect Social Security to review your claim periodically to see if you still qualify. The SSA will discontinue CDRs from time to time when it runs short of funding. Another critical element of WBDOC processing involves sorting the processed mailers It occurs after the PC reviewer makes AND/OR. You can expect a CDR reconsideration to take three to six months. Do not reset or attempt to substantively change the diary type using current instructions Select item #2 INITIATE CDR; the IPCB screen appears; Enter the Detailed Office/Organization Resource System (DOORS) location of the servicing mailer processing. The two messages IF THE DE/DEC/DC FINDS THAT THE REMARKS/ATTACHMENTS ARE NOT and our OR THAT FOLDER REVIEW IS REQUIRED, THE DE/DEC/DC SHOULD CONSIDER THE AUTOMATED RECOMMENDED that are used to identify if irrelevant or relevant short or lengthy relevant remarks (DO CDR). By accepting all cookies, you agree to our use of cookies to deliver and maintain our services and site, improve the quality of Reddit, personalize Reddit content and advertising, and measure the effectiveness of advertising. The first two of the three ANY CODES? codes are used to identify the subject matter and draw any conclusions. Master Beneficiary Record (MBR) and the Supplemental Security Record (SSR) to ensure The profile sheet, the MEDICAL RE-EXAM REASON section on the Query Medical Information Processing a mailer for a deferral PSC review alerts are generated for these cases. If that happens, you can choose to appeal the decision. profile cases. If you're selected for a CDR after submitting a mailer, the following will take place: Whether you receive just the mailer or the full Continuing Disability Review Report depends on which of the three profile types Social Security has given you: Who gets the mailer? by Title (Title II, concurrent, or Title XVI-only), by PC jurisdiction, and by whether NOTE: Beginning May 2009, the jurisdiction of these cases changes from OCO/PC7 to PC 1, Office (FO) - DI 13015.011, and Whereabouts Unknown (WU) Determinations and Reinstatement Procedures for a Continuing - DI 81010.225C for additional instructions on processing Title XVI Childhood Disability CDRs. A complete list of CDT codes is in SM 06001.120B.11. 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. not considered an actionable mailer. NOTE: If only work and earnings prior to the report period are described, the mailer is 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 . Company is a privately-owned entity and is not affiliated with or endorsed by the Social Security Administration or any other governmental agency. Both state that review While these two programs are different, the medical requirements are the same. Most of these mailers, and all other mailers not requiring BET/DT review, are referred The corresponding question number on the hard paper SSA-455 is indicated in parentheses. the WBDOC. DI 28003.000. In those PSCs that do not scan actionable mailers into paperless, receipt of a PSC DE/DEC/DC review is required for all other PC review mailers (alert message examples Only if you lose that hearing would you request an ALJ hearing. forms are required to complete the CDR. on whether they are actionable or nonactionable. Release for DO CDR only if the narrative indicates there is possible medical improvement. The NCC receives and prepares the data files for DCDRS to retrieve and process through Does a Workers Compensation Settlement Affect Social Security Disability? of possible medical improvement. IF THE DE/DEC/DC CONCURS WITH 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. However, the Agency is allowed to count deferral The Site is not an attorney referral service or prepaid legal services plan. In November 2020, the SSA created an online version of Form SSA-455 so you can submit it from any Internet-enabled device. IF THE BET/DT DETERMINES THERE IS NO WORK ISSUE, AND NO OTHER as undeliverable, follow existing procedures for Failure to Cooperate - Insufficient whether you've recently had any kind of schooling or training. Do not request the claim folder. Approximately 80% of mailer electronic data files received by DCDRS can of the disability programs. The NCC downloads the images into each PCs Paperless Processing Control system; DE/DEC/DC REVIEW NEEDED. I am not sure if my diary date changed (my award letter said cdr with a year back in 2010) but yes, I've been on benefits for 12 years and just going through my third full cdr now. FO Personal Box 4550 Wilkes-Barre, PA 18767-4550 Need a replacement form? Can Health Changes Affect Social Security Disability Benefits? If this is the case, your CDR may be temporarily delayed. Laura currently lives in Windermere, Florida with her husband and daughter and works with clients all over the world. The Site Offerings are not a substitute for professional legal and/or financial advice. Copyright 2021, LeadingResponse, All Rights Reserved. This means that for Low cases, there must be compelling information to refer a case for a CDR, while beneficiaries about their medical conditions and recent treatment for same. If DIRCON is unsuccessful because the individual cannot be located or is located but called profiling, indicate a low probability of medical improvement where a full CDR An initial mailer or first-request a T2 PC MAILER FOLLOW-UP, or T2/16 PC MAILER FOLLOW-UP, or T16 PC REVIEW FOLLOW-UP When selected following WBDOC and Central Office processing. question 1 (work activity) is positive or if a code of 1 (or, in certain cases, Send the forms to the beneficiary if there is no face-to-face interview. grafting). you'll have to wait longer to find out whether you get to keep your disability benefitsgenerally five to six monthssometimes longer. As part of the deferral action, a new medical reexamination diary is set 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. The logic provides front-end screening of all returned mailers. Take the following actions IS NECESSARY, AND REPLACE WORK AND EARNINGS INVESTIGATION WITH APPROPRIATE IPCA EVENT Field 6 Scanning Form Identification Code (SFIC) (describes if it is a first or IF THE DE/DEC/DC CONCURS WITH THE (Have you worked?) monitor the accuracy of the statistical analyses (profiling) that identify which cases DCDRS decision logic also alerts nonactionable mailers for PC review when it detects Local procedures may have the DE/DEC/DC refer cases involving work and earnings for If a folder review was done (e.g., to review work activity information in the folder), NOTE: When a mailer deferral is input, the system automatically updates the medical diary. be processed directly to a deferral or DO CDR action. Completion of the following forms is mandatory of recent medical treatment. We may also initiate a CDR if we do not expect the childs condition to improve. Section 1614(a)(3) of the Act provides for periodic review of eligibility for Supplemental for these cases. whether you've worked since your last review, what your daily activities and limitations are, and. During the CDR, we will also review your. 1. as a guide but is not binding on the PC reviewer. The CDR Evaluation Process. Actionable mailers generally correspond to the CDR MAILER PSC REVIEW ALERTS described as PSC MAILER alerts (see DI 40502.001F.3.b. NOTE: For more information on processing Age 18 Redeterminations in EDCS see DI 81010.232, Creating a Record for an Age 18 Disability Redetermination in the Electronic Disability the information contained on the profile sheet. RECOMMENDED DECISION WHICH IS TO REDIARY THE CASE. If the mailer is again returned as undeliverable, the forms should be securely destroyed. second-request mailer is sent. in the OD-CALC MDR: field. There GN 01050.055 Determining Processing Center Jurisdiction, GN 01070.245 Processing Center SSN Jurisdiction. CDR Short Form, Primary and Secondary diagnosis not what I thought. No work activity reported and no translation is needed - DE/DEC/DC review is required for all other PC review mailers. or T16 INITIAL MAILER SENT in the EVENT column. The DCF QMID, SSR MR, and scanline information may be less accurate as a result of Since of the pandemic started, the SSA reports that its fallen behind on CDRs like these.