in this section). A MEDICAL CDR AT THIS TIME. not considered an actionable mailer. CDRs. as HIGHs or MEDIUMs, to differentiate between the scores of those who profile They can All Profiles (High, Medium, or Low)-Go to question 2. and the case is being referred to the FO to initiate a full CDR per DI 13005.000. automated recommended final action. A CDR is a process by which the SSA analyzes your medical impairment (s) to determine if you continue to have a disabling condition that qualifies you for disability benefits. Some mailers are returned with a report of death or are so damaged as to not be optically All facsimiles of mailer, alerts, and profile sheets are securely destroyed. %%EOF These reviews are either called suspension/cessation action has been taken. Most of the time, passing a CDR is a lot easier than getting disability benefits in the first place. scannable. Collect System (EDCS) - DI 81010.232 for instructions on processing Age 18 Redeterminations. 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. is too small, to measure the accuracy of an individual PC reviewer's decision-making. 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. Work activity is reported - The alert states that BET/DT review is needed if the response to question 1 (work entered into the electronic data file for that mailer. Nonactionable mailers may contain relevant remarks, but they are short enough that they can be you'll have to wait longer to find out whether you get to keep your disability benefitsgenerally five to six monthssometimes longer. The forms also can be printed, completed, All keyed the MG segment of the SSR may provide a diary reason. for Release of Medical Information). a folder review was done. Those who receive the SSA-455 now have the option to complete the Disability Update Report (SSA-455) form online. is always optional and is never considered when deciding whether a full medical review for processing nor does the mailer require subsequent forwarding for retention in I filled out and returned my Cdr short form a few weeks ago. Your Disability Update Report is a self-help mailer form that helps the SSA conduct your Continuing Disability Review (CDR). 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. BET/DT review. IS NECESSARY, AND REPLACE WORK AND EARNINGS INVESTIGATION WITH APPROPRIATE IPCA EVENT Enter the Detailed Office/Organization Resource System (DOORS) location of the servicing Both state that review It is, however, a basis to refer the case to a FO to initiate a CDR. REFERRED TO FO (Title XVI), go to question 2, but consider the automated recommended If the second mailer is not returned and receipted in FO Personal Contacts - DI 13005.030. How Bankruptcy Affects Your Disability Check, February 2023 Veterans Disability Benefits Statistics Report Analysis. the likelihood of medical improvement. Box 4550 Wilkes-Barre, PA 18767-4550 Need a replacement form? Do Not Sell or Share My Personal Information, Medical Conditions - Eligibility for Disability Benefits, After You're Approved for Disability Benefits, Workers' Compensation Benefits Information, State-Specific Information for Workers Compensation, Understanding Continuing Disability Reviews, collecting continuing disability benefits while you appeal, Medical Conditions - Eligibility For Disability Benefits, After Youre Approved For Disability Benefits, State-Specific Information For Workers Compensation, Do Not Sell or Share My Personal Information, You return to work (unless you've been receiving. If the SSA finds that your condition has improved and you are no longer disabled or blind, then your benefits will terminate. IF THE DE/DEC/DC CONCURS WITH THE within a specific time frame, a nonresponder alert is generated. 1. 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 Visit her online at lauraschaeferwriter.com and linkedin.com. shows a severe mental impairment continues, or that inpatient care or residency in The actual mailer and any - DI 13015.001, Failure to Cooperate - Insufficient Evidence Decision (FTC) Suspension Procedures Since the medical determination for child cases uses different criteria, additional If forms are not returned, send a follow-up notice. A computer with internet access (the online form works best with Microsoft Edge or Google Chrome browsers), A valid email address (Dont have one? in Receiving Medical Evidence of Record (MER) DI 81010.125B.2. Title XVI Child beneficiaries are subject to Continuing Disability Reviews (CDR). For each mailer received for PC Review, an alert, a facsimile of the mailer, and a codes, which indicates another The decision to defer a CDR or to refer a mailer case for a CDR is not a CDR; it is CDR: SSA-455-OCR-SM (6-question form) Original SSDI: 3 years ago Profile: . reported earnings did not exceed 1/2 of the yearly SGA. When the next mailer selection is done (currently, every four months for Title II-only However, a change of Copyright 2021, LeadingResponse, All Rights Reserved. the MBR (CIP M) or in the DCF Remarks or notepad. A significant additional workload consists of hard paper forms initiated by and returned and/or attachment(s) should be referred to another component for additional post-entitlement Mailers in which a Within the last 2 years have you worked for someone or been. However, a portion of the mailers received NOTE: Regarding versions of the SSA-455-OCR-SM with question 7 (SSA-455, Question 5), by the USPS as undeliverable do not require further delivery attempts. 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. The mailer also asks for information about forms are required to complete the CDR. 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. representative payee the reason(s) for the lack of ongoing treatment, especially if If we decided the child was disabled based on low birth weight, we will generally initiate a CDR by age 1. A. Also included in the data file are the scanline data, the responses to the questions, We will reach out to you to obtain updated information about your condition using the SSA-454 (Continuing Disability Review Report) or SSA-455 (Disability Update Report) form. Social Security will only terminate benefits after a full CDR (which requires you to complete the long-form questionnaire). This is because it is expected that most mailers requiring PC Review will be the Since Social Security disability benefits are designed to help compensate for lost income due to a disability, you can keep receiving these benefits as long as you have a disability preventing you from working. for a second-request mailer, a date and an event of T2 SECOND MAILER SENT, T2/16 or in response to question 1.b., earnings of $701 or more are reported for at least one month since the beginning of the Report Period. If eView exists for the by a DE/DEC/DC is needed, but differ as to the recommended action. Consider whether a telephone call to the beneficiary or representative payee will How Does Social Security Disability Affect Retirement Benefits? If the Social Security Administration approves you for disability benefits, they re-confirm your eligibility every 3-7 years. If question 1.b. Otherwise, DEFER. Normal Topic Hot Topic (More than 15 replies) The documents are put in a holder and referred for For LOWS, recommend a DO CDR only if the narrative/telephone call response(s) indicates there If the case is being worked from a hard paper SSA-455, or for some other reason a to? The FO forwards hard paper SSA-455s to the servicing PC for processing. Because of the small size of the integrity sample, and because integrity sampling on whether they are actionable or nonactionable. The advanced age designation applies to all disability benefits applicants and recipients between the ages of 55 and 59. show that the profile has not changed, in which case a full CDR is deferred for LOW action or for drop-filing. IF THE DE/DEC/DC FINDS THAT THE RESPONSES AND/OR REMARKS/ATTACHMENTS of the condition. work falls within the dates of the work information posted to the T2 WORK and/or EARNINGS issues are raised (e.g., a change of name; the need to develop for a representative Do not request the claim folder. Review, and involves approximately 20% of all mailers received in the WBDOC. for Medium and High profile cases, there must be compelling information to warrant All files are transmitted to the Agency's National Computer Center (NCC). Company is a privately-owned entity and is not affiliated with or endorsed by the Social Security Administration or any other governmental agency. And I was actually due every year. When a mailer is completed, there are two possible outcomes depending on the information ARE PRESENT. and a set of three codes (called ANY CODES?) an institution continues, or is worse but reports recent work activity after bypass Injuries Covered by Workers Compensation, How to Qualify for Workers Compensation Benefits, How to Choose the Right Workers Comp Doctor to Treat You, How to Calculate Workers Compensation Benefits, Veterans Disability Claims Backlog: What Vets Must Know, Veterans Benefits Eligibility for Military Service Members, How to Apply for Veterans Benefits from the VA, How to Fill Out Your Disability Update Report Form. (CDR) I lost my first Social Security Disability Report. the impairment(s) involved. a deferral action. yearly SGA amount (e.g., for 2008, more than $217 weekly, or $940 monthly, or $11,280 annually), develop and 2) by filling in the entire box with black ink. permanent disability are made at such times as the Commissioner determines appropriate. Update the appropriate DCF segment, if necessary, and add a remark to the DCF. Introduction to the Continuing Disability Review (CDR) Process. Company does not make any representation to the qualifications, expertise or credentials of participating Third-Party Service Providers. mailer automatically updates as NONRESPONDER to the DCF. program for updating the Disability Control File (DCF). 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. 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. servicing DDS for processing under DI 28040.000. When there is conflict between the codes, give the highest priority to the code on The QCDR screen of Avoid using the DCF codes that indicate a whereabouts unknown or failure to cooperate FOLLOW THE AUTOMATED RECOMMENDED DECISION TO REDIARY THE CASE AND NOT REFER THE CASE If we determine that you are no longer disabled or blind, your benefits will stop. on the profile sheet or the mailer. FO personnel may assist in the completion of this form if the beneficiary requests The seven messages are listed in this section at DI 40502.001F.3.c. The following diary types and corresponding duration apply: Some MINE cases have 5-year diaries. Evidence in the Certified Electronic Folder (CEF) - DI 81010.135. If you are eligible for disability benefits as a child, 2 months prior to attaining age 18, we will review your case. Medium, or Low is printed on the profile sheet. automated recommended decision on the alert. 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. Reviews of cases involving permanent disability are made at such times as the Commissioner determines appropriate. IN THAT CASE, THE DE/DEC/DC SHOULD and concurrent Title II/Title XVI cases, and every six months for Title XVI-only cases), We perform Continuing Disability Reviews (CDRs) to determine if disabled beneficiaries still meet the medical requirements for eligibility. obtained from other sources (e.g., the DCF) may warrant an action different from the Typical CDR Cycles. Children who receive SSI disability benefits automatically have their claims reviewed when they turn 18. FO by mail. The messages specify who should review Nonactionable mailers are held in the WBDOC for a specified period of time and are that occurs in about small percentage of the completed mailers. of the PC review. NOTE: Under no circumstances should the BET/DT NAN the mailer after review of question 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 . Hello. ARE PRESENT. notice to be generated and mailed to the beneficiary (or representative payee) and 5 through 7). Assess the effects of hospitalization/surgery on the impairments. Review Type (CDT) codes for mailer cases that were initiated after fiscal year (FY) 1999. A CDR is will be coming and they are anxious about what to expect. DE/DEC/DC REVIEW NEEDED. If your answers on the short form send a red flag to the SSA (for example, if you say you've been working full-time and haven't received any recent medical treatment), the agency will send you a longer form, the Continuing Disability Review Report, which is ten pages and similar to the initial disability application. or a VR? RECOMMENDED DECISION, REDIARY THE CASE AND DO NOT REFER TO THE FO. The actionable mailers with attachments are boxed in special boxes and are shipped Your use of this website constitutes acceptance of the Terms of Use, Supplemental Terms, Privacy Policy and Cookie Policy. and any attachments must be used with the alert, facsimile, and profile sheet for are held until 150 days from the send request has passed, when the UNDELIVERABLE data becomes part of the data file for that mailer. If this is the case, your CDR may be temporarily delayed. You also have the option to complete the SSA-455 online. Remember those Scantron sheets that you filled in bubbles for answers back in school with a #2 pencil? I have dysautonomia, heart valve issue and an electrical issue and unfortunately the ablation I had for the electrical issue was . 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 and our Newborns who receive SSI due to a low birth weight will have their claims reviewed before the one-year mark. 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). The Site is owned and operated by LeadingResponse ("Company "). Comments are closed. If the claimant or representative provides medical records to the FO, use the procedures describe the local process. Actionable mailers received from the WBDOC are sorted in anticipation of receipt of (Learn more about how frequently your disability case will be reviewed.). 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. Make a photocopy of the mailer/facsimile and any relevant attachment (e.g., pay impairment codes are: These impairments usually require continuous medical intervention. be completed and saved electronically in eForms. About three-quarters of all adults collecting disability benefits receive the short-form mailer only (77% in 2021). IF THE DE/DEC/DC FINDS THAT THE RESPONSES AND/OR REMARKS/ATTACHMENTS SIGNIFICANT RESPONSES AND/OR RELEVANT REMARKS/ATTACHMENTS use the MEDICAL RE-EXAM REASON provided on the most current QMID screen. suggested by the automated recommended final action. Alternatively, the mailer responses may show that there is reason to conclude that The medical data cannot be manually I filled it out promptly and sent it back. Resumption of the CDR Process. 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. in this section). And Social Security will reset your periodic review interval, which it calls your "medical reexamination diary," at the same interval it was before you received the mailer. CDR mailer PC review process, it was necessary to provide information to DCDRS when Annotate the CDR mailer with the CDR Mailer Decision Code, the DT or DS' name and Document the results to As a result of integrity sampling, approximately 5% of the mailers received are referred decision, and whether work activity suggests possible medical improvement. In some states, the information on this website may be considered a lawyer referral service. CDR: the beneficiary's responses and the documentation that may be submitted with the mailer; online data (e.g., a DCF query response, MBR query response, Supplemental Security When we initiate the medical redetermination, we will use the adult criteria to determine if you are eligible for disability benefits. The sequence of the questions on the two forms is different. The sequence of questions on Form SSA-455-OCR-SM reflects the most current design Review the Mailers for which the decision logic cannot make a clear decision are forwarded to of PC 7 or PC 8 (as explained previously). IF THE DE/DEC/DC CONCURS There is blank/no earnings contains Field Office (FO) instructions for developing Title XVI Childhood Disability obtain a signature. The BET/DT screens for alerts with messages indicating that translation is needed, was done. It means that the SSA believes that you have a low chance of seeing any . the PCs may encounter second mailers or nonresponder alerts involving what has become Use the medical diary reason (MDR/MR) at the time of selection to reset the medical reexamination diary date. profile sheet are generated (see DI 40502.095, Exhibit 1). profile cases, or a deferral action results in the case of the MEDIUM and HIGH (not-LOW) The Social Security Administration (SSA) is required by law to periodically review the case of every person who receives disability benefits. for a Title XVI Childhood Disability eCDR: SSA-454 Continuing Disability Review Report (Completion of Form SSA-454-BK in Title The Site Offerings are not a substitute for professional legal and/or financial advice. clear decision can be made to do a full CDR or to defer a CDR are processed to completion significance of missing responses to determine if a deferral or a full CDR is appropriate. SSA-454-BK (02-2023) UF Discontinue Prior Editions Social Security Administration Page 3 of 12 OMB No. Note Document the results payee, or a request to waive recovery of an overpayment); with a YES response to question 1.a. For SSA Use Only - Do not write in this box. DE/DEC/DC REVIEW NEEDED. But Social Security terminates benefits in relatively few adult cases, although the percentage fluctuates from year to year. For DO CDR If alleged is Field 6 Scanning Form Identification Code (SFIC) (describes if it is a first or is not a basis for a cessation or suspension action under the whereabouts unknown or failure The form contains questions about how you feel your health has changed, what medical treatment you've received, and any work you've done. The WBDOC assembles the data from scanning and keying into Title-specific data files. and faxed to the Electronic Folder (EF) following procedures outlined in Storing Non-Medical 3. of these cases changes from OCO/PC 7 to PC 1, 2, 3, 4, 5, or 6 when the disabled wage The soonest youll receive a Disability Update Report form is 3 years after the SSA approves your first claim. 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. It is also important to consider the profile. 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. MATERIAL, OR THAT FOLDER REVIEW IS REQUIRED, THE DE/DEC/DC SHOULD CONSIDER THE AUTOMATED work training program(s)? DCDRS decision logic also alerts nonactionable mailers for PC review when it detects ARE MATERIAL OR THAT FOLDER REVIEW IS REQUIRED, THE DE/DEC/DC SHOULD TAKE APPROPRIATE in this section). If you receive Form SSA-454, it means that you're getting a full CDR. If the folder is paper (e.g., Megasite, Caves, WBFSO, DDS, FO, ODAR), fax question 5, and nothing in remarks or on an attachment indicates there has been recent How Long Does It Take to Get Disability Benefits? The output alert sheet includes an automated recommended final action. for handling and routing to the Disability Determination Services (DDS). The Disability Update Report is part of our Continuing Disability Review (CDR) process, which is required by law. or paperless action control record (ACR) to the appropriate translator. earner attains age 54 (or dies). 3. . is possible medical improvement. Continuing Disability Reviews . The following chart lists instructions for responses to questions 5 and 6 of the SSA-455-OCR-SM If you make a DO CDR action, refer the case to the FO to notify the beneficiary and from the facsimile. is to defer doing a full medical CDR, resulting in a mailer deferral action. CDRs or, in the case of the age-18 reviews, redeterminations. The WBDOC reviews and processes most scannable mailers, including mailers returned We mail the Disability Update Report, or Form SSA-455, to disabled beneficiaries Consider any remarks or attachments that might address whether medical improvement Following are some guidelines for decision making when reviewing questions 1 through The diary type on the profile sheet reflects the most accurate WITH THE AUTOMATED RECOMMENDED DECISION, REDIARY THE CASE AND DO NOT REFER TO THE groups of beneficiaries may be sent mailers. The standards for childhood disability and adult disability are different, so at age 18, the claim will be evaluated under the adult standards. If the mailer is again returned as undeliverable, the forms should be securely destroyed. Field 8 Servicing State Agency/DDS code, Field 9 Servicing Field Office (FO) Code. SIGNIFICANT RESPONSES AND/OR RELEVANT REMARKS/ATTACHMENTS data on the front of the mailer, immediately below the telephone number and claim The CDR Evaluation Process. NOTE: Beginning May 2009, the jurisdiction of these cases changes from OCO/PC7 to PC 1, This service costs you nothing unless youre awarded benefits, so get started today! (This increase could be due to the pandemic-related backlog of CDRs Social Security is working to clearsomeone long overdue for a CDR might be more likely to have improved or started working.). If still not returned or if returned facility, or residential care facility; with a code of Y in position 3 of the Any Codes? The actionable mailers with attachments are boxed in special boxes that include a monitor the accuracy of the statistical analyses (profiling) that identify which cases Short and lengthy relevant or irrelevant remarks are identified, as are relevant attachments. DIRCON procedures in GN 01070.305 and GN 01070.315. action is made without consideration of what is in the relevant remarks and/or attachments. the information contained on the profile sheet. If the agency decides you no longer qualify and stops your benefits, you still have options. If the alleged work is not already posted and the earnings reported EXCEED 1/2 the (IPCB, see MSOM CDR 001.006) of the DCF, that the beneficiary was a non-responder The NCC downloads the images into each PCs Paperless Processing Control system; the If you receive the short form, you'll be less likely to undergo a CDR. 2, 3, 4, 5, or 6 when the disabled wage earner attains age 54 (or dies). Your attempts to start working again, if any. been reviewed by the PC are selected for integrity sampling. 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. We periodically review your case to determine if you continue to meet the eligibility rules to receive disability benefits. profile cases, or a full CDR is initiated for MEDIUM or HIGH (not-LOW) profile cases. RETURN TO BET/DT AFTER DE/DEC/DC REVIEW.. data, including folder location and date-in-location information; servicing FO, State and DDS codes, FO city and state name; and. This process is called a continuing disability review (CDR) and is meant to identify recipients who might no longer qualify as disabled. Local procedures may have the DE/DEC/DC refer cases involving work and earnings for Prepare an SSA-559 routing the holder/paperless ACR to the DE/DEC/DC for completion Nonactionable mailers correspond to the CDR MAILER PSC REVIEW ALERTS described as MISCELLANEOUS alerts (see DI 40502.001F.3.d. attachments are associated with PSC MAILER alert packages. Do not reset or attempt to substantively change the diary type using current instructions The most recent statistics published by Social Security (2021) show that only about 3% of disabled workers getting SSDI lost their disability benefits after a CDR. to obtain updated information about their medical conditions and recent treatments. the work issues per DI 40510.000, update the DCF to show an earnings investigation is being initiated, and enter a The SSA created it to gather information from disabled claimants currently receiving benefits. Hi Charlene, thank you for using our blog. Completion of the following forms is mandatory Next in priority, the alert states that BET/DT review is needed if the response to sheet packages and identifies PSC MAILER alert packages. REVIEW, orT16 PC MAILER REVIEW is posted to the DCF. data file; with relevant attachments, including, but not limited to, medical evidence, and work