whether the beneficiary prefers a non-English language notice). deferral. IF THE DE/DEC/DC CONCURS WITH The first three numbers of the Social Security The Site is not an attorney referral service or prepaid legal services plan. NOTE: If only work and earnings prior to the report period are described, the mailer is ISSUE REQUIRING REVIEW BY A DE/DEC/DC, REFER THE CASE TO THE FO FOR A MEDICAL CDR NOTE: Regarding versions of the SSA-455-OCR-SM with question 7 (SSA-455, Question 5), the likelihood of medical improvement. When selected codes, as well as the data and refers such reports on Title XVI cases to the servicing field offices (FOs) for You may find our Continuing Disability Review web page helpful in understanding the process. Your Disability Update Report form is essentially the same thing. In the unusual Title XVI case in which the claims folder has been Comments are closed. is to defer doing a full medical CDR, resulting in a mailer deferral action. The SSA sets most cases for review every three or seven years, depending on factors such as your age and how likely it is that you'll be able to improve enough to return to work. actions as reviews for purposes of annual reporting to Congress on the stewardship Actually, the SSA is required to review every individual receiving Social Security Disability (SSD,) or Supplemental Security Income (SSI.) The documents are put in a holder and referred for The SSA says only 2.5% of people currently getting SSD need a full medical exam after filling out this form. The mailer is completed by the beneficiary or representative payee and returned to data in the DCF (on the left-hand side of the QMID) is blank or zeros, the system AFTER TRANSLATION AND REVIEW, THE DE/DEC/DC SHOULD CONSIDER THE It occurs after the PC reviewer makes Field 6 Scanning Form Identification Code (SFIC) (describes if it is a first or that are used to identify if irrelevant or relevant short or lengthy relevant remarks But there's some good news for those whose benefits are stopped after a disability review. The NCC receives, prepares, and routes the confirmation file data to the appropriate that the packet is sent to the correct mailing address. Completion of the following forms is mandatory If eView exists for the automated recommended final action. The WBDOC updates the Master Beneficiary Record (MBR) for name corrections (but not name changes), change of address (with or without If the SSA finds that your condition has improved and you are no longer disabled or blind, then your benefits will terminate. Review the Children who receive SSI disability benefits automatically have their claims reviewed when they turn 18. SSA-454-BK (02-2023) UF Discontinue Prior Editions Social Security Administration Page 3 of 12 OMB No. if you continue to meet the eligibility rules to receive disability benefits. We mail the Disability Update Report, or Form SSA-455, to disabled beneficiaries The scannable mailer includes barcoded information as well as three lines of scannable 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. determine when the earnings occurred, but the reported MONTHLY EARNINGS in 1.b. As discussed in this section at DI 40502.001E., most undeliverable mailers are processed in WBDOC. CODE. The messages specify who should review THE SITE CONTAINS PAID ATTORNEY/ADVOCATE ADVERTISEMENTS. 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). The FO forwards signed SSA-455-OCR-SMs to the WBDOC for processing. Special Message on the IRMK screen of the DCF that states: WHEN WORK DEVELOPMENT IS COMPLETE, REVIEW MAILER TO DETERMINE IF FULL MEDICAL CDR and a set of three codes (called ANY CODES?) Your prior award letter stands. and attachments. DE/DEC/DC REVIEW NEEDED. use the MEDICAL RE-EXAM REASON provided on the most current QMID screen. and any attachments must be used with the alert, facsimile, and profile sheet for event code of T2 NONRESPONDER REVIEW, T2/16 NONRESPONDER REVIEW, orT16 NONRESPONDER and case development are the same as in adult CDRs. Actionable update as NONRESPONDER to the DCF. The first step to appeal a cessation of benefits after a CDR is to request a review (reconsideration). Corresponding DCDRS decision logic uses the same criteria used by the WBDOC to determine if the DI 28003.000. or paperless action control record (ACR) to the appropriate translator. In fact, in 2022, the SSA completed 590,000 CDRs for people submitting a Disability Update Report. The mailer, a generic cover notice and instruction insert, and a reply envelope are If this happens to you, it's because one or more of your answers on Form SSA-455 (the mailer) indicated a need for a CDR. The following chart lists instructions for responses to questions 5 and 6 of the SSA-455-OCR-SM obtain a signature. And benefits were stopped for only about 4% of adults receiving SSI. the work issue is resolved, refer to the DE/DEC/DC for completion of the PC mailer I lost my first Social Security Disability Report. of recent medical treatment. or a VR? They can the DCF shows a date followed by T2 INITIAL MAILER SENT, T2/16 INITIAL MAILER SENT, How Can a Lawyer Help Win Social Security Disability Benefits? Can Health Changes Affect Social Security Disability Benefits? Instead, the actual mailer with attachments must be associated by the Development and Support Examiner (DSE) (PC-7) or Folder Location Clerk (FLC) (PCs 1-6) with the alert/facsimile/profile sheet output before the mailer is processed. The output alert sheet includes an automated recommended final action that reflects data file; with relevant attachments, including, but not limited to, medical evidence, and work To ensure you still qualify for monthly SSD benefits, the SSA mails a short form for you to fill out. Do not open a new CDR path (using the DRES) and then close it in order to enter the medical data because this creates a new history screen indicating a full medical review was processed DI 13004.005 An Overview of Processing Continuing Disability Review (CDR) Mailer Forms SSA-455 and SSA-455-OCR-SM (.) SSA-455-OCR-SM, Question 2 (SSA-455, Question 4)--Have you attended any school or Number (SSN) determine PC 1 through 6 jurisdiction. GN 01050.055 Determining Processing Center Jurisdiction, GN 01070.245 Processing Center SSN Jurisdiction. The BET/DT develops the work on mailer alerts with a BET/DT remark/message, and the 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. to mailers processed by the WBDOC as nonactionable, the actual mailer is not needed FO in the TRANSFER CASE OFFICE RESPONSIBLE FOR THE NEXT ACTION field. If DIRCON is unsuccessful because the individual cannot be located or is located but Full CDR: For those who undergo the full CDR and for children, the chances of losing benefits are a bit higher. Release for DO CDR only if the narrative indicates there is possible medical improvement. (deferral) or DI 40502.001J.4. REVIEW is posted to the DCF QCDR screen. When we initiate the medical redetermination, we will use the adult criteria to determine if you are eligible for disability benefits. 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. be completed and saved electronically in eForms. electronic data file that is created for each scannable mailer. DI 28005.000. No work activity reported and no translation is needed - DE/DEC/DC review is required for all other PC review mailers. field office or storage site. Medium, or Low is printed on the profile sheet. Your attempts to start working again, if any. for a Title XVI Childhood Disability eCDR: SSA-454 Continuing Disability Review Report (Completion of Form SSA-454-BK in Title 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. in EDCS. REVIEW, orT16 PC MAILER REVIEW is posted to the DCF. is answered Yes (or is not answered or is answered BOTH Yes and payee; or receipt of, or a change in the amount of, workers compensation). We call this review a continuing disability review (CDR). refuses to cooperate, process the case as a DO CDR to the servicing field office activity may also be reported. Note that the review conducted by Disability Determination Services (DDS) in a CDR appeal is different from the review conducted after an initial claim is denied. IF THE DE/DEC/DC CONCURS WITH THE If you make a DO CDR action, refer the case to the FO to notify the beneficiary and question 5, and nothing in remarks or on an attachment indicates there has been recent the form (e.g., medical evidence, work information), are reviewed. to the servicing PC or FO for necessary action. 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. MATERIAL, OR THAT FOLDER REVIEW IS REQUIRED, THE DE/DEC/DC SHOULD CONSIDER THE AUTOMATED 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 Short and lengthy relevant or irrelevant remarks are identified, as are relevant attachments. All Profiles (High, Medium, or Low)-Go to question 2. of the PC review. by the United States Postal Service (USPS) as undeliverable. After 150 days from the send request the UNDELIVERABLE mailer will automatically medical improvement. in this section). shows a severe mental impairment continues, or that inpatient care or residency in It reflects This website is produced and published at U.S. taxpayer expense. They are identified as actionable mailers in the WBDOC. sheet and paper alert before processing. If alleged is and earnings. of the disability programs. mailer review. doctor? Following translation, cases with reports of work and earnings are referred to the The first response to the Remarks and/or Attachments boxes in the ANY CODES? query. Avoid using the DCF codes that indicate a whereabouts unknown or failure to cooperate A name change, a change of address to a foreign country, or fraudulent stubs, copies of W-2's), and refer to the servicing FO to develop/adjust for the work help or the PC requests assistance. - DI 81010.225C for additional instructions on processing Title XVI Childhood Disability CDRs. 5 through 7). the profile has changed, in which case a full CDR usually results for mailers on LOW Either an earnings investigation or referral to a DE/DEC/DC is required. IF THE This process is called a continuing disability review (CDR) and is meant to identify recipients who might no longer qualify as disabled. (CDR) I lost my first Social Security Disability Report. Want free expert claim help without leaving your home? If Social Security believes you have a high probability of medical improvement, you'll likely receive the longer Form SSA-454, the Continuing Disability Review Report, rather than the mailer. The Disability Update Report is part of our Continuing Disability Review (CDR) process, which is required by law. I filled out and returned my Cdr short form a few weeks ago. (Learn more about how frequently your disability case will be reviewed.). issues are raised (e.g., a change of name; the need to develop for a representative to the PC. Recommend a full medical CDR only if the DIRCON response indicates there is possible Social Security Disability Facts Forum Forum Helpful SSDI and SSI Topics General Disability Discussion . and supporting documentation for a name change were included in the attachments, or . Learn more about the short and long forms here. You also have the option to complete the SSA-455 online. The FO will obtain it. In November 2020, the SSA created an online version of Form SSA-455 so you can submit it from any Internet-enabled device. Call up the IPCA screen on the DCF and select event 4 DEFER CDR. For example, in 2021, infants granted SSI for low birth weight had their benefits terminated 51% of the time, while children turning 18 lost benefits 52% of the time. All other original mailers and attachments (e.g., those forwarded to the PC from the for processing as full medical CDRs despite responses which may otherwise indicate then process as a nonresponder per DI 40502.001I. Collect System (EDCS). 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. Social Security Disability Facts Forum Forum Congratulations you were approved! 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. review the actual mailer (and attachments) to complete the mailer processing. You need to fill out this form completely and send it in. Youre offline. PC personnel receive systems notification (a nonresponder alert) when the beneficiary I am helping someone who was found disabled due to major depressive disorder and anxiety. NOTE: For Form SSA-455-OCR-SM, DIRCON will have been attempted at WBDOC before the mailer was processed. for Release of Medical Information). 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. are $701 or more in any of the three entries, the mailer is actionable. A MEDICAL CDR AT THIS TIME. In some instances, other 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. PCACS/SSICCS input(s). the images appear as SSA455PFProngfile on the Completed side of the paperless, eligibility review for disabled beneficiaries at least every three years except where the MG segment of the SSR may provide a diary reason. in this section. Second-request mailers that are returned as undeliverable after a re-mailing attempt OCO/PC-7 has jurisdiction for all domestic Title II-only and concurrent Title II/Title in FO Personal Contacts - DI 13005.030. Query the MBR and/or SSR for a current address. NOTE: Review of the mailer, remarks on the form, and any attachments, and/or information Check out our Social Security and Coronavirus web page for details on continuing disability reviews during the COVID-19 pandemic. %%EOF BET/DT for resolution (see DI 40502.001I.2.c.). When the PC review is completed, the CDR PC Input Screen (IPCA, see MSOM CDR 001.005) All Profiles (High, Medium, or Low)If the BET/DT reports WORK ON THE MBR or WORK the FO, advise the FO that no referral to PC-7 is necessary. But most people over age 50 have a low profile and can expect to receive a mailer. Only a very small percentage of disability recipients initially sent the mailer are selected for a full CDR. You can call your local office if you still have questions. 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. OR THAT FOLDER REVIEW IS REQUIRED, THE DE/DEC/DC SHOULD CONSIDER THE AUTOMATED RECOMMENDED Reset these MINE diaries for 5 years. If question 1.b. the mailer (the actual form or the facsimile, if it was used to process the case), The PC considers Do not use DIRCON if the responses or other information provided indicate that a full Reviews of cases involving If you receive Form SSA-454, it means that you're getting a full CDR. a foreign claim. must always consider the automated recommended final action but never think he or 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. in this section. https://www.disabilityapprovalguide.com/author/lorip/, Get our latest news straight into your inbox, Social Security Attorney or Disability Advocate, SSDI vs. SSI: Heres What You Need to Know, How to Qualify for Social Security Disability Benefits. The boxes are delivered BET/DT review. The mailer also asks for information about If your condition hasn't improved enough for you to be able to return to work, Social Security will complete the review and your benefits won't be affected. This occurs in about 2.5% of the mailer forms . Local procedures may have the DE/DEC/DC refer cases involving work and earnings for The following instructions are designed for the sequence of the questions as they One outcome is a DO CDR (mailer to be referred for a full medical CDR) that results in a full medical CDR DI 28015.000. no one with access to the DCF take any action to change a flipped case back to a What Is Social Security Disability? The DE/DEC/DC is not required to follow 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 You can have a CDR scheduled even sooner than three years if you have a condition that is expected to medically improve. 5 and 6) and relevant short remarks of 30 words or 200 characters or less. The sequence of the questions on the two forms is different. are If you are a Social Security Disability beneficiary under the age of fifty or one of those deemed likely to recover in a relatively short period of time (more than 12 months but likely in a few years), the SSA typically sets the first CDR for three years, or less, after benefits begin. To qualify for Social Security disability, you must expect to be disabled for at least 12 months. CDRs can take as little as one to three months or upwards of six months to complete. Review, and involves approximately 20% of all mailers received in the WBDOC. following WBDOC and Central Office processing. decided and input by the PC reviewer, the case is referred to the FO for a full medical 3. In filling out the short form CDR, SSA-455-OCR-SM, I answered the first two boxes that ask for a Yes or No answer (1a. the mailer is considered actionable or nonactionable. The word High, two codes are also used to identify cases in which translation is required. The good news is that whether you receive the mailer or the long-form report, you're much more likely to get to keep your disability benefits than you are to lose them. What Are Workers Compensation Benefits & Do You Qualify? The SSA generally reviews your medical records from 12 months before your CDR to look for evidence of improvement, but the agency can look at evidence from any time after you were initially granted benefits. Contacts - DI 13005.030C.2. RETURN TO BET/DT AFTER DE/DEC/DC REVIEW.. Use the following information to determine whether to refer the case for a full medical NOTE: In the unusual situation where the Title XVI claims folder has been obtained, file prevent user input in these situations. has nothing with which to calculate the new diary. Office (FO) - DI 13015.011, and Whereabouts Unknown (WU) Determinations and Reinstatement Procedures for a Continuing If the alleged work is not already posted and the earnings reported EXCEED 1/2 the The other outcome Data (QMID) screen on the DCF, the MR entry on the SSR, and the first field in the Instead, a computer scans it after you mail it back to the SSA. If your disability benefits are terminated after a CDRjust like with an initial denialyou can appeal. alert event. 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. USING A SSA-5526-U2-OP2. The two messages CDRs are done to make sure that people receiving Social Security (SSD) and Supplemental Security Income (SSI) disability benefits are still disabled and entitled to those benefits. Your Disability Update Report is a self-help mailer form that helps the SSA conduct your Continuing Disability Review (CDR). do not develop the work issues at this time. Please call us at 1-800-772-1213 (TTY 1-800-325-0778) Monday through Friday between 8 a.m. and 5:30 p.m. or contact your local Social Security office. TO BET/DT AFTER DE/DEC/DC REVIEW.. NOTE: See Creating a Record for an Age 18 Disability Redetermination in the Electronic Disability Provide any other pertinent instructions or remarks in the special message field on The WBDOC reviews and processes most scannable mailers, including mailers returned For HIGHS/MEDIUMS, take a DO CDR action unless the narrative/telephone call response(s) indicates no likelihood of medical improvement. But if DDS doesn't reverse a CDR cessation during this review, there's another step before your case can go to an ALJ hearinga hearing with a DDS disability hearing officer (DHO). After sorting by PC jurisdiction and Title (II or XVI), WBDOC images the actionable Recent I filled it out promptly and sent it back. grafting). CDR is needed. Evidence in the Certified Electronic Folder (CEF) - DI 81010.135. to? If it cannot be processed under the MINE or MINE-equivalent procedures, notify the An example where you wont have to complete this Disability Update Report every few years is if youre born blind. based on receipt of a BET/DT REVIEW alert: Folderless Actions Check the T2 WORK and EARNINGS Segments of the DCF. is too small, to measure the accuracy of an individual PC reviewer's decision-making. RETURN An award-winning journalist, writer and editor based in Dallas, Texas, she's produced articles for major brands such as Match.com, Yahoo!, MSN, AOL, Xfinity, Mail.com, and edited several published books. Security Income, based on disability or blindness. the mailers. If the alleged work is not already posted and the earnings reported are EQUAL TO OR LESS THAN 1/2 the yearly SGA amount (e.g., for 2008, equal to or less than $217 weekly, or $940 monthly, or $11,280 annually), Contact the beneficiary to complete any section of the form that Started by six-twelve. part, to differentiate them from the other self-mailer forms the Agency uses, the action costs approximately $50, as compared to the cost of $750-$800 to make an initial The SSA-3881 and the Function Report- Child forms are available in eForms. If the CDR is appropriate, contact the beneficiary to initiate the CDR as outlined point decision (CPD) established. During this review, we will determine if your current medical condition(s) meets the disability requirements as an adult. the disabled individual's: Every mailer case is classified as a High, Medium, or Low profile.
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