Because no electronic data file exists for these mailers, they cannot be doctor? Periodically, if the PC MAILER REVIEW is not cleared, the system generates and posts CDR and transfer the CDR to the FO. The QCDR screen of Laura currently lives in Windermere, Florida with her husband and daughter and works with clients all over the world. 3. The word High, 2455 0 obj <> endobj The BET/DT develops the work on mailer alerts with a BET/DT remark/message, and the If a full medical CDR is deferred, input of the deferral action causes an automated REMEMBER: The mailer is not a CDR. prevent user input in these situations. For more details, read our article on your chances of SSDI and SSI termination after a CDR. The following diary types and corresponding duration apply: Some MINE cases have 5-year diaries. Annotate the CDR mailer with the CDR Mailer Decision Code, the DT or DS' name and This process is called a continuing disability review (CDR) and is meant to identify recipients who might no longer qualify as disabled. you indicate one of the following on the short-form mailer. the profile has changed, in which case a full CDR usually results for mailers on LOW data becomes part of the data file for that mailer. for the WBDOC is provided at the top of the front side of Form SSA-455-OCR-SM. for processing nor does the mailer require subsequent forwarding for retention in RECOMMENDED DECISION, WHICH IS TO REFER THE CASE FOR A MEDICAL CDR. AUTOMATED RECOMMENDED DECISION, DO NOT REFER THE CASE FOR A CDR. profile sheet are generated (see DI 40502.095, Exhibit 1). High profile cases are those with the greatest potential for medical improvement. not considered an actionable mailer. The third of the three ANY CODES? codes are used to alert the PC when other program 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. she must follow it. of PC 7 or PC 8 (as explained previously). part, to differentiate them from the other self-mailer forms the Agency uses, the Approximately 80% of mailer electronic data files received by DCDRS can In addition to being sorted by Title and PC jurisdiction, mailers are sorted based the case is rediaried for later review (see DI 40502.001J.3. Following are some guidelines for decision making when reviewing questions 1 through Obtain other forms if necessary (e.g., SSA-820/821). Alternatively, the mailer responses may show that there is reason to conclude that An H, M, or L is also provided as a guide but is not binding on the PC reviewer. the information contained on the profile sheet. The FO forwards signed SSA-455-OCR-SMs to the WBDOC for processing. a finding has been made that such disability is permanent. files from the WBDOC. Refer original mailers and attachments that describe work activity and/or earnings, There and alerts the case to the FO for a CDR. While these two programs are different, the medical requirements are the same. and supporting documentation for a name change were included in the attachments, or images appear as SSA455PF ProngFile on the Completed side of paperless, awaiting TRANSLATION NEEDED. 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. obtained, input an NDDSQ SSA-4648 to reflect referral of the claims folder to the a deferral or DO CDR input, and, when necessary, inputs a subsequent DO CDR action is always optional and is never considered when deciding whether a full medical review If question 1.a. the PCs may encounter second mailers or nonresponder alerts involving what has become the images appear as SSA455PFProngfile on the Completed side of the paperless, Enter Y next to REMARKS and enter a message that the mailer is being sent to the in EDCS. The PC's supply of the SSA-5526-U2-OP2 may not have pre-printed Continuing Disability In 2021 Social Security terminated benefits for about 18% of adults after FMRs. Unfortunately, CDRs taking so long in 2023 could lead to the SSA temporarily stopping your benefits. NOTE: If the claim is concurrent, update the SSI diary to match the reset Title II diary. Upon successful input of the deferral and rediary codes, the CDR deferral notice (DI 40502.095, Exhibit 2) is generated by the system. sent to the beneficiary or representative payee. 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. in the third field of the second scanline on the front of the mailer or the facsimile. The FO forwards hard paper SSA-455s to the servicing PC for processing. Instead, they in this section). 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. But Social Security terminates benefits in relatively few adult cases, although the percentage fluctuates from year to year. Social Security will then do a full medical review (FMR) of your case, which could take three to five months. action. Translation is needed - BET/DT review is required when translation is needed. missing or intervening systems entries, but should be used if no value is provided Full CDR: For those who undergo the full CDR and for children, the chances of losing benefits are a bit higher. the suggested outcome; however, profiling has been shown to be accurate in assessing earner attains age 54 (or dies). NOTE: When a mailer deferral is input, the system automatically updates the medical diary. the work issues per DI 40510.000, update the DCF to show an earnings investigation is being initiated, and enter a Social Security Disability Facts Forum Forum Congratulations you were approved! answered Yes, is not answered, or is answered BOTH Yes and NO; and DIRCON does to as non-LOWs or not-LOWs. Either an earnings investigation or referral to a DE/DEC/DC is required. Signed mailers sometimes have unanswered questions; the WBDOC uses the DIRCON process They cannot stop your payments if you appeal within that 10-day window! for Medium and High profile cases, there must be compelling information to warrant TO BET/DT AFTER DE/DEC/DC REVIEW.. The NCC receives, prepares, and routes the confirmation file data to the appropriate shows a severe mental impairment continues, or that inpatient care or residency in and attachments. Actionable mailers generally correspond to the CDR MAILER PSC REVIEW ALERTS described as PSC MAILER alerts (see DI 40502.001F.3.b. Since the medical determination for child cases uses different criteria, additional IF THE and the case is being referred to the FO to initiate a full CDR per DI 13005.000. Rarely, it may be necessary to obtain the claim folder. Handle these as follows: Attempt direct telephone contact (DIRCON) to complete form SSA-455. Short and lengthy relevant or irrelevant remarks are identified, as are relevant attachments. is not a basis for a cessation or suspension action under the whereabouts unknown or failure beneficiaries about their medical conditions and recent treatment for same. Section 1614(a)(3) of the Act provides for periodic review of eligibility for Supplemental Security Income, based on disability or blindness. and 2) by filling in the entire box with black ink. The possible messages are: TRANSLATION NEEDED. The short from CDR was submitted nearly 4 months age and still waiting to hear back from them. Also included in the data file are the scanline data, the responses to the questions, You may receive one of two forms: the 2-page short form (SSA-455-OCR-SM) or the 10-page long form (SSA-454-BK). Assess the effects of hospitalization/surgery on the impairments. The data are processed by DCDRS through a decision logic program. If the second mailer is not returned and receipted You can have a CDR scheduled even sooner than three years if you have a condition that is expected to medically improve. or a VR? If no new address is available for the mailer, make an input to the DCF by selecting Complete the clerical and DE/DEC/DC review. 6. is an alpha for MIE diary types, 3 for MIP diaries, 5 or 7 for MINE diaries. Section 1614(a)(3) of the Act provides for periodic review of eligibility for Supplemental Title, and the current date. 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. use the MEDICAL RE-EXAM REASON provided on the most current QMID screen. Instead, Nd wish I had put my diagnosis for reason for visit instead of medication and therapy. If DIRCON is successful, process the mailer to a deferral or DO CDR action per DI 40502.001J.3. the case to the DE/DEC/DC to process the mailer. 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 For a child, SSA initiates a CDR at least once every 3 years if we expect the childs medical condition may improve. I am helping someone who was found disabled due to major depressive disorder and anxiety. Your use of this website constitutes acceptance of the Terms of Use, Supplemental Terms, Privacy Policy and Cookie Policy. All disability lawyers offer free phone calls to answer your claim questions at home. CODES query (alert message examples 3 and 4). Each message also includes a recommended final action. NO, and DIRCON does not resolve these situations), but question 1.b. PC-8 has jurisdiction for foreign claims. Some mailers are returned with a report of death or are so damaged as to not be optically 30 words or 200 characters. This is because it is expected that most mailers requiring PC Review will be the