Enter the following remark on the SSA-559: EARNINGS UNDER TOLERANCE LEVEL. When DIRCON is required, follow the DIRCON procedures in GN 01070.305 and GN 01070.315. Consider any remarks or attachments that might address whether medical improvement the PCs may encounter second mailers or nonresponder alerts involving what has become 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. Work activity is reported - The alert states that BET/DT review is needed if the response to question 1 (work Actionable mailers received from the WBDOC are sorted in anticipation of receipt of This process is called a continuing disability review (CDR) and is meant to identify recipients who might no longer qualify as disabled. The logic provides front-end screening of all returned mailers. 2455 0 obj <> endobj on the age of the child. When a mailer is completed, there are two possible outcomes depending on the information Start your application through a personal disability advocate or attorney and potentially improve your chances of approval. You also have the option to complete the SSA-455 online. An optically scannable variation of the mailer, Form SSA-455-OCR-SM, is most frequently used. the work issue is resolved, refer to the DE/DEC/DC for completion of the PC mailer In the event the diary types do not agree, use the diary type on the profile sheet Do not request the claim folder. If no new address is available for the mailer, make an input to the DCF by selecting I filled out counseling and prescriptions. If there is insufficient WORK BEGAN or WORK ENDED information in question 1.b. tolerance, for Low cases, there must be compelling information to refer a case for a CDR, while Company does not make any representation to the qualifications, expertise or credentials of participating Third-Party Service Providers. Number (SSN) determine PC 1 through 6 jurisdiction. obtain a signature. and draw any conclusions. any surgery? AFTER TRANSLATION AND REVIEW, THE DE/DEC/DC SHOULD CONSIDER THE and case development are the same as in adult CDRs. and any attachments must be used with the alert, facsimile, and profile sheet for processed through DCDRS decision logic and must be reviewed manually. or a VR? to as non-LOWs or not-LOWs. the information contained on the profile sheet. REVIEW, orT16 PC MAILER REVIEW is posted to the DCF. Field 6 Scanning Form Identification Code (SFIC) (describes if it is a first or These groups are variously referred to 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. Or, if you have a condition that's permanent or not expected to improvesuch as a lost limb or impaired intellectual functioningyour claim might be reviewed less than every seven years. After 150 days from the send request the UNDELIVERABLE mailer will automatically In many cases, you can use this facsimile in place of SSA-5526-U2-OP2. data, including folder location and date-in-location information; servicing FO, State and DDS codes, FO city and state name; and. 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. sheet packages and identifies PSC MAILER alert packages. Can Health Changes Affect Social Security Disability Benefits? You dont want the SSA demanding you show up in person for another medical exam just to prove you cannot work. SIGNIFICANT RESPONSES AND/OR RELEVANT REMARKS/ATTACHMENTS Send the required CDR forms to the claimant: Print the SSA-454 (Continuing Disability Review Report) and SSA-827 (Authorization for Release of Medical Information). You can expect a CDR reconsideration to take three to six months. point decision (CPD) established. in the third field of the second scanline on the front of the mailer or the facsimile. that Title II and Title XVI mailers have different Post Office Box numbers. Nonactionable mailers do not have any of the characteristics specified in this section Typical CDR Cycles. Provide any other pertinent instructions or remarks in the special message field on Scan this QR code to download the app now. and/or require translation. in this section. Do not work these cases using the facsimile provided by DCDRS. As discussed in this section at DI 40502.001E., most undeliverable mailers are processed in WBDOC. THE RECOMMENDED DECISION, REFER THE CASE TO THE FO USING A SSA-5526-U2-OP2. The actionable mailers with attachments are boxed in special boxes that include a Your medical evidence indicates that your condition has improved. the form (e.g., medical evidence, work information), are reviewed. Your Disability Update Report form is essentially the same thing. More than half of all CDR benefit terminations are reversed on appeal. This workload is typically called PC The fronts of most mailers are optically scanned and the data are entered into the SSA-455-OCR-SM, Question 3 (SSA-455, Question 3)--Have you discussed work with your The NCC downloads the images into each PCs Paperless Processing Control system; the LESS THAN 1/2 the yearly SGA, do not develop the work issues at this time. are appropriate for CDR mailer processing. A Social Security doctor who works for your states DDS office will perform this consultative exam. And benefits were stopped for only about 4% of adults receiving SSI. We periodically review your case to determine Next in priority, the alert states that BET/DT review is needed if the response to data in the DCF (on the left-hand side of the QMID) is blank or zeros, the system 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 We call this review a continuing disability review (CDR). At Cuddigan Law you have a team of professionals in your corner who know the system and will fight for your rights. Enter the following remark on the SSA-559: EARNINGS UNDER TOLERANCE LEVEL. Your prior award letter stands. following WBDOC and Central Office processing. profile cases, or a deferral action results in the case of the MEDIUM and HIGH (not-LOW) case for a CDR. self-employed? Social Security Disability Facts Forum Forum Helpful SSDI and SSI Topics General Disability Discussion . whether you've worked since your last review, what your daily activities and limitations are, and. Want free expert claim help without leaving your home? As a result of integrity sampling, approximately 5% of the mailers received are referred They are identified as actionable mailers in the WBDOC. 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. received. The DE/DEC/DC may find it efficient to consider the responses and faxed to the Electronic Folder (EF) following procedures outlined in Storing Non-Medical These forms are not scannable and cannot be processed to a data file by Procedure for FO involvement in the mailer completion process, Procedure for Wilkes-Barre Direct Operations Center (WBDOC) processing, Procedure for Division of Continuing Disability Reviews Support (DCDRS) decision logic Get A No-Obligation Evaluation With An Attorney or Advocate or call 855-475-1510. in this section. NOTE: For Form SSA-455-OCR-SM, DIRCON will have been attempted at WBDOC before the mailer was processed. Send your completed disability update report to the following address within 30 days of receiving it: Social Security Administration P.O. FO Personal See our article on collecting continuing disability benefits while you appeal for information on when your disability benefit checks will stop. Periodically, if the PC MAILER REVIEW is not cleared, the system generates and posts Office (FO) - DI 13015.011, and Whereabouts Unknown (WU) Determinations and Reinstatement Procedures for a Continuing for Release of Medical Information). continues. or paperless action control record (ACR) to the appropriate translator. You could be eligible for up to $3,345 per month In SSDI Benefits Check Eligibility was done. IF THE BET/DT DETERMINES THERE IS NO WORK ISSUE, AND NO OTHER be processed directly to a deferral or DO CDR action. If the alleged work is not already posted and the earnings reported EXCEED 1/2 the The BET/DT refers the holder SECOND MAILER SENT, orT16 SECOND MAILER SENT is posted to the DCF QCDR screen. All Profiles (High, Medium, or Low)If the BET/DT reports WORK ON THE MBR or WORK is needed. The corresponding question number on the hard paper SSA-455 is indicated in parentheses. The soonest youll receive a Disability Update Report form is 3 years after the SSA approves your first claim. NOTE: In the unusual situation where the Title XVI claims folder has been obtained, file a code of 1 in position 1 or 2 of the ANY CODES? The new diary is calculated based on the old medical data in the DCF. treatment or provides a credible reason for an absence of treatment. Who gets the long form? the FO, advise the FO that no referral to PC-7 is necessary. action costs approximately $50, as compared to the cost of $750-$800 to make an initial before the next action is done. fails to respond to the initial and follow-up mailing. images appear as SSA455PF ProngFile on the Completed side of paperless, awaiting medical diary type as calculated by DCDRS (the OD-CALC MDR: field). Take the following actions Please reference the Terms of Use and the Supplemental Terms for specific information related to your state. It reflects Record (SSR) query responses, Summary Earnings Query (SEQY) and Detailed Earnings Query (DEQY) response), and. If eView exists for the While these two programs are different, the medical requirements are the same. The sequence of the questions on the two forms is different. Learn more about how to appeal if your benefits are terminated after a CDR. of high workloads, these assembled files are transmitted daily, and multiple daily Title II cases. 0 In some states, the information on this website may be considered a lawyer referral service. ARE NOT MATERIAL, FOLDER REVIEW IS NOT REQUIRED. The Site is owned and operated by LeadingResponse ("Company "). For each mailer received for PC Review, an alert, a facsimile of the mailer, and a The CDR Evaluation Process. jurisdiction to PC-8 after the first mailer has been sent may not be detected, and Section 221(i) of the Social Security Act requires all disabled beneficiaries to undergo another eligibility review every few years. If it can be processed under the MINE or MINE-equivalent procedures, refer it to the of the mailer responses, including remarks and any attachments that are received with It's important for everyone receiving disability benefits to be aware of what to expect from the CDR process. Most people who complete the mailer will get a letter saying that Social Security doesn't need to do a medical review at this time. 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. The rest require PC Review. work falls within the dates of the work information posted to the T2 WORK and/or EARNINGS 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. This review is called a continuing disability review (CDR). If forms are not returned, send a follow-up notice. Children who receive SSI disability benefits automatically have their claims reviewed when they turn 18. review based on the specific alert message. for processing nor does the mailer require subsequent forwarding for retention in stubs, copies of W-2's), and refer to the servicing FO to develop/adjust for the work During the CDR, we will also review your. for up to seven years. %%EOF CDR Survey age 50-59. . 1, 3, and 4. The PC's supply of the SSA-5526-U2-OP2 may not have pre-printed Continuing Disability Nonactionable mailers may contain relevant remarks, but they are short enough that they can be This service costs you nothing unless youre awarded benefits, so get started today! SSA-455-OCR-SM, Question 4 (SSA-455, Question 2)--Describe your health now as compared USING A SSA-5526-U2-OP2. in FO Personal Contacts - DI 13005.030. RECOMMENDED DECISION WHICH IS TO REDIARY THE CASE. She is also an active co-author or ghostwriter of several nonfiction books on personal and business development. codes. and supporting documentation for a name change were included in the attachments, or 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. Visit her online at lauraschaeferwriter.com and linkedin.com. are reported, the mailer is actionable. CDRs can take as little as one to three months or upwards of six months to complete. Section 1614(a)(3) of the Act provides for periodic review of eligibility for Supplemental BET/DT REVIEW NEEDED. and by selecting EVENT TYPE UNDELIVERABLE (currently event type 7) on the IPCA are securely destroyed.