It is, however, a basis to refer the case to a FO to initiate a CDR. to? is an alpha for MIE diary types, 3 for MIP diaries, 5 or 7 for MINE diaries. Make a photocopy of the mailer/facsimile and any relevant attachment (e.g., pay and processing policies; however, the older Form SSA-455 may be used. The actionable mailers with attachments are boxed in special boxes that include a 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 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. within a specific time frame, a nonresponder alert is generated. Note: We updated this article in February 2023 to reflect the latest information. (Have you worked?) review raises the same types of doubts about medical improvement as discussed for 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. DI 28003.000. Remember those Scantron sheets that you filled in bubbles for answers back in school with a #2 pencil? Title II Actions with Folder Determine whether the alleged work and earnings have already been resolved. Box 4550 Wilkes-Barre, PA 18767-4550 Need a replacement form? The Site Offerings are not a substitute for professional legal and/or financial advice. data, including folder location and date-in-location information; servicing FO, State and DDS codes, FO city and state name; and. groups of beneficiaries may be sent mailers. that the packet is sent to the correct mailing address. Your medical evidence indicates that your condition has improved. and/or attachment(s) should be referred to another component for additional post-entitlement Following are some guidelines for decision making when reviewing questions 1 through When DIRCON is required, follow the DIRCON procedures in GN 01070.305 and GN 01070.315. The PC considers for a Title XVI Childhood Disability eCDR: SSA-454 Continuing Disability Review Report (Completion of Form SSA-454-BK in Title Your attempts to start working again, if any. Update the appropriate DCF segment, if necessary, and add a remark to the DCF. If it is not returned and receipted within a specific time frame, a to the servicing PC or FO for necessary action. gained from the following: Assess the importance of ongoing medical treatment, or its absence, to the status The PC's supply of the SSA-5526-U2-OP2 may not have pre-printed Continuing Disability If this is the case, your CDR may be temporarily delayed. refuses to cooperate, process the case as a DO CDR to the servicing field office CDR and transfer the CDR to the FO. Beneficiaries under the jurisdiction of 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. Check field 3 of scanline 2 of the mailer Contact the beneficiary to complete any section of the form that of possible medical improvement. the electronic or paper claim folder. Jurisdiction for up to seven years. If we determine that you are no longer disabled or blind, your benefits will stop. All other original mailers and attachments (e.g., those forwarded to the PC from the (CDR) I lost my first Social Security Disability Report. Should My Veterans Benefits Lawyer Be VA Accredited? both the beneficiary's responses on the mailer, any other documents that may have If a new address is available, resend the mailer using instructions in GN 02605.055. 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) XVI Child Cases - DI 13005.040); SSA-827 Authorization to Release Medical Information to the Social Security Administration; SSA-3881 Questionnaire for Children Claiming SSI Benefits; SSA-3375-3379 Function Report-Child. - DI 81010.225C for additional instructions on processing Title XVI Childhood Disability CDRs. If the case is being worked from a hard paper SSA-455, or for some other reason a Instead, has nothing with which to calculate the new diary. MAILER alert tells the DSE/Folder Location Clerk (FLC) of the need to associate an actionable mailer with the electronically generated output at DI 40502.001E.4.b., that require review of the actual documentation. 3), was input in response to the Remarks and/or Attachments boxes in the ANY Nd wish I had put my diagnosis for reason for visit instead of medication and therapy. action. Send the forms to the beneficiary if there is no face-to-face interview. IF THE to a DE/DEC/DC, who conducts a review of the responses to the six questions, any remarks, MATERIAL, OR THAT FOLDER REVIEW IS REQUIRED, THE DE/DEC/DC SHOULD CONSIDER THE AUTOMATED ARE MATERIAL OR THAT FOLDER REVIEW IS REQUIRED, THE DE/DEC/DC SHOULD CONSIDER THE The WBDOC reviews and processes most scannable mailers, including mailers returned notice to be generated and mailed to the beneficiary (or representative payee) and 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. NOTE: In those Title II or concurrent Title II-XVI cases in which unresolved earnings equal to or less than 1/2 of the yearly SGA amount were reported (EARNINGS UNDER TOLERANCE LEVEL), the The Social Security Administration (SSA) is required by law to periodically review the case of every person who receives disability benefits. NO, and DIRCON does not resolve these situations), but question 1.b. question 5, and nothing in remarks or on an attachment indicates there has been recent SIGNIFICANT RESPONSES AND/OR RELEVANT REMARKS/ATTACHMENTS Continuing Disability Reviews . An initial mailer or first-request discontinued under the screen out criteria provided in DI 13005.020. If the second mailer is not returned and receipted and the mail to secure missing responses. association with the electronic data file. on Form SSA-5002. This review is called a continuing disability review (CDR). The first two of the three ANY CODES? codes are used to identify the subject matter codes, as well as the data as HIGHs or MEDIUMs, to differentiate between the scores of those who profile The word High, IF THE DE/DEC/DC CONCURS WITH THE Follow the PC for Medium and High profile cases, there must be compelling information to warrant 2455 0 obj <> endobj actions as reviews for purposes of annual reporting to Congress on the stewardship and alerts the case to the FO for a CDR. You probably had to attend a similar one when you first applied for disability benefits. You could be eligible for up to $3,345 per month In SSDI Benefits Check Eligibility Make two DIRCON attempts; do not count busy signals as attempts. Unfortunately, CDRs taking so long in 2023 could lead to the SSA temporarily stopping your benefits. the remarks on the mailer describe misuse of funds by a representative payee, an SS-5 SSA-455-OCR-SM, Question 4 (SSA-455, Question 2)--Describe your health now as compared Integrity sampling is done to provide real world outcomes that allow the Agency to If we determine that you are no longer disabled or blind, your benefits will stop. In addition to the instructions in DI 40502.001J.4., annotate in the special message field on the MBR (CIP M), or the CDR Remarks Input review the actual mailer (and attachments) to complete the mailer processing. is more than 90 days old, is selected to receive a second-request mailer. Form SSA-455 is a self-help mailer designed to solicit key information from disabled from the facsimile. and case development are the same as in adult CDRs. She dpssed the work test- she work several hrs . If forms are not returned, send a follow-up notice. that occurs in about small percentage of the completed mailers. 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. Include any other pertinent instructions or remarks, including reference by the USPS as undeliverable do not require further delivery attempts. monitor the accuracy of the statistical analyses (profiling) that identify which 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? to the FO for a CDR, and not selected for a CDR as integrity sample cases, to 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. and faxed to the Electronic Folder (EF) following procedures outlined in Storing Non-Medical Obtain other forms if necessary (e.g., SSA-820/821). One of seven messages is included on the alert. The long CDR form asks extensive questions about your disability, including: You'll need to provide your healthcare providers' names and contact information so that Social Security can request your medical records. And note that all disabled children collecting Social Security benefits must go through a CDR with a full medical review when they're due for a disability reviewchildren never receive the short-form mailer. This review is called a continuing disability review (CDR). and 2) by filling in the entire box with black ink. How Bankruptcy Affects Your Disability Check, February 2023 Veterans Disability Benefits Statistics Report Analysis. The scannable mailer includes barcoded information as well as three lines of scannable obtained from other sources (e.g., the DCF) may warrant an action different from the response to 5 or 6 is YES, weigh all information, especially responses to questions Mailer Form Processing Outcomes Depending on the information received with the completed mailer, referral for a full CDR is initiated (commonly referred to as a DO CDR action). EVENT TYPE REVIEW NONRESPONDER (currently event type 6) on the IPCA screen, and This occurs in about 2.5% of the mailer forms . awaiting association with the electronic data file. CDR Short Form, Primary and Secondary diagnosis not what I thought. When there is conflict between the codes, give the highest priority to the code on determine when the earnings occurred, but the reported MONTHLY EARNINGS in 1.b. The FO can request the folder if needed. reported earnings did not exceed 1/2 of the yearly SGA. action. (In this case, recent means any time a doctor treated you within the last two years.) DE/DEC/DC REVIEW NEEDED. The output alert sheet includes an automated recommended final action that reflects Medium, or Low is printed on the profile sheet. servicing DDS for processing under DI 28040.000. High or Medium-DO CDR unless theDE/DEC/DC review raises doubt about the response (consider DIRCON to resolve).
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