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06/03/2011 09:17 AM

CDR Mailer Questionnaire

waybackjack

Questions relating to the CDR Mailer Questionnaires in these forums continue. (CDR = Continuing Disability Review.)

When your claim is allowed, you are classified as medical improvement expected (MIE), medical improvement possible (MIP), or medical improvement not expected (MINE). The system calls up your case as follows:

MIE = 6-18 months

MIP = 3 years

MINE = 5-7 years

When the system pulls up your case, one of four things happens:

1) A full-blown CDR is scheduled. This is typically the case with MIEs.

2) Your case is further "profiled" to determine whether you are low, medium, or high probability to have medically improved. The "lows" usually get the CDR mailer questionnaire rather than an imminent CDR, but your answers will be the ultimate determinant as to whether you get the CDR. 5% of the questionnaires are randomly picked and get the full CDR regardless of the answers. This is done for sample integrity purposes. Of the remaining 95%, only 2.5% get the CDR, the others are deferred for 6-18 months, 3 years, or 5-7 years as the case may be.

3) If your DDS is backlogged with initial claims, all of the above may be put on the back burner until the backlog clears.

4) Some cases - but very, very few - simply fall through the cracks. Some people have been on the rolls for 20 or more years and have received neither a CDR nor the mailer questionnaire.

__________

Regarding #2 above, you can see how SSA evaluates your answers to the six questions by clicking the URL below, and scrolling down to the charts near the bottom of the page.

https://secure.ssa.gov/apps10/poms.nsf/lnx/0440502001

Jack

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06/03/2011 10:01 AM
LostInCyberspace12
LostInCyberspace12  
Posts: 9960
Group Leader

Thanks Jack. This is really good info. Question? Once approved and if they say in the approval letter you are scheduled for review in 3 years, does that mean you are a MIP?

06/03/2011 10:42 AM
waybackjack

MIPs are three years. It's surprising though that they told you. Many times they omit reexam info on the award letter. They just tell most folks that they'll be reexamined periodically. Keep in mind though that if you return to work within 24 months from your month of entitlement, the work activity per se, even though it doesn't exceed the SGA limits, could trigger a CDR. Whether it does trigger the CDR depends on the nature of your impairment, e.g., if your impairment meets or equals the automatic allowance criteria (Listing of Impairments) the work will not trigger a CDR. - - Jack

06/03/2011 02:26 PM
jmick
jmickPosts: 13899
VIP Member

Jack,

Thanks for the great info... I have a question that I think you just answered above. Are beneficiaries normally told what category they fall into as far as MIE/MIP/MINE? I ask because I was never informed what my case was considered. All I know is that I was approved, but not how soon they "expected" a recovery. So many people I talk to are told over the phone by SSA agents when to expect a review. I expect some of these SSA agents are speaking out of turn, revealing information they're not meant to reveal, especially considering someone I know was told 2 years, which doesn't fall into any of the categories -- but this person may have been going by how long it really takes them because of the backlog. Wish I had a loose-mouthed adjudicator who gave me info like that.

And I completely get what you are saying about the circumstances regarding a return to work, even though you are under the SGA amount. Common sense tells me that if you are truly disabled, you can't work. BUT, there are exceptions. I have a distant relative who has been on disability for years, and has worked on and off for years, with no problem. She has MS, in addition to many other major ailments. With MS, it's easily explainable why she can work some, but not full-time. She can work three days straight and be fine, but wake up the next morning paralyzed and unable to move for two weeks. So I think they definitely take your specific disability into consideration... but, personally, I would not work one hour unless I was prepared to get taken off of disability, because I hear all too often that people work a few hours, and their benefits are taken away. And sometimes it takes months for SSA to "catch up," so you may end up owing them money they say you should not have received. I don't want my benefits taken away because I was able to force myself next door and fix the neighbors computer for 100 bucks.


06/03/2011 03:25 PM
waybackjack

The DDS has been very lax in recent yrs. in telling people when the system will call up their cases. They usually use the catchall "You will be reviewed periodically" or words to that effect. If you phone and deal with a laid-back claims rep, it would take him/her a few seconds to give you that info. It's readily available on the SSA-831 disability determination. But if you're dealing with some hard case who dots all the "i's" and crosses all the "t's," (s)he'll make you file a formal request under the Privacy Act. Technically this is medical information and they require you to name a doctor on your request to whom they'll send medical info if they think direct release to you would be harmful. That's so stupid, ain't it? Anyway, if they decide it would not be harmful, they send it to you directly. They start counting the time period, e.g., 3 years, beginning with the date of the decision which is the same month of the notice, or the previous month. Incidentally, you can figure out whether you're MIE, MIP, or MINE by reviewing the POMS instructions that they use. I can furnish them if anyone's interested.

There are a number of work incentives that have become increasingly liberalized over the years. E.g., if you've been on the rolls for two yrs., work, exhaust your trial work period, and continue to work below the SGA level, the work activity per se will not trigger a CDR. You will still be subject to your regularly-scheduled review. And if you're enrolled in the Ticket To Work program, all CDRs are suspended. You're still at risk for an SGA cessation of course. - - Jack


06/04/2011 04:14 AM
LostInCyberspace12
LostInCyberspace12  
Posts: 9960
Group Leader

waybackjack wrote>>>>>MIPs are three years. It's surprising though that they told you. Many times they omit reexam info on the award letter. They just tell most folks that they'll be reexamined periodically. Keep in mind though that if you return to work within 24 months from your month of entitlement, the work activity per se, even though it doesn't exceed the SGA limits, could trigger a CDR. Whether it does trigger the CDR depends on the nature of your impairment, e.g., if your impairment meets or equals the automatic allowance criteria (Listing of Impairments) the work will not trigger a CDR. - - Jack Thanks Jack, but I have not been approved yet. I was just using that as an example. I have talked to others who have stated that SSA told them they would be reviewed in 5-7 years so I just assumed they told you in the approval letter. Jack, how important are the CE exams they send ppl to in your opinion? Do these carry much weight? I am using Allsup to represent me btw and I am now waiting at the ALJ level. Total wait time = 16 months now.

Post edited by: LostInCyberspace12, at: 06/04/2011 04:15 AM

Post edited by: LostInCyberspace12, at: 06/04/2011 04:16 AM


06/04/2011 07:45 AM
waybackjack

Procedure requires them to tell you, but the DDS more-often-than-not is lax in this regard, and SSA does not take them to task.

SSA was killed in the courts for relying too much on 1/2 hr. CEs while shortchanging the input from your treating sources who may have followed you for months or years. So in the 1980s, SSA rewrote their regulations to emphasize to adjudicators the importance of the treating physician's role. If your atty. believes that too much emphasis has been given to the CE, (s)he is undoubtedly aware of the relevant regulations and court precedents relating to this issue, and will bring them to the ALJ's attention.

Waiting times for ALJ hearings are disgraceful. They have tried a number of remedies without any significant improvement.


07/30/2011 05:56 PM
sleepwalking
sleepwalking  
Posts: 654
Member

I am just starting to research this issue. My award letter that I received in 2009 said I would be reviewed in 7 yrs.

Will I see the same ALJ or a different one? I no longer live in the same county where I was approved.

I no longer have the same doctor that supported me through the process.

Will I have to get an attorney again?


07/30/2011 06:43 PM
Vannort54

You will not see a judge you will just fill out a shotrt form and you do not have to be in the same state.since it is 7 yrs the SSa dose not think you will get any better.

07/30/2011 07:32 PM
sleepwalking
sleepwalking  
Posts: 654
Member

You guys are such a great resource. Thanks so much for the information.

WaybackJack, can you furnish the POMS instructions here?

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