SSD review, short version
 

Hey all!
In the mail today, I received a disability report I have to fill out for Social Security. It's the little 2-page version. I'm on a 3-5 year review schedule and it's been 6 years since I was approved for disability so it's actually overdue.

I didn't think it was a big deal until I started reading a few of the threads here -- now I'm nervous! I didn't fill out my SSD application because I have problems with cognition and physical difficulties that make writing and sitting difficult. So a rep. at SSA wrote up my application for me. I just answered questions, took in all of my meds, and some of my med. records. My application was approved.

I have 12 diagnoses and more since then! I don't know if i was approved on one, a few, or all of them! So how do I fill out the review report? My most recent doctor visits, tests, and hospitalizations have been in the past month. I was just released from Baylor Heart Hospital a couple of weeks ago after having a major procedure. And I had a gastro-enterology appointment Thursday and med. changes for Crohn's Disease. These are new issues, though.

I have to see a lot of doctors and take a lot of meds. I have no shortage of medical documentation. But from reading the info here, I guess they are only interested in the medical problems related to the disabling conditions? I've had so much wrong, I don't know which ones they want documented!

The form asks for the last three medical visits and surgeries and says I should respond to the questions based on changes since Feb. 2010. I don't know why that year is signifcant but I figure SSA looks over our Medicare records from time to time to see how things are going and if we're receiving treatment.

Anyhoo, should I provide the latest visits and surgeries chronologically or should I emphasize the orthopedic surgeries I've had related to my connective tissue problems, instead? The heart problems might be related to the autoimmune stuff, though.

Well, if no one has any insight, I guess I should just take my own advice and call SSA with my questions, lol.

I would give them all your doctor's notes from the last three visits and any documentation on surgeries.
I'm like you-are they really concerned with a PCP,when it's the specialists that know if you are able too work.
If you have a new condition-I don't know if you want to rock the boat or not but since you have many impairments,it shouldn't be a problem.
What if you had an MRI from a few yrs ago stating that a condition has worsen-should that be given to SSA but it only says doctor visits plus surgeries?
It would be a good idea and call them and ask them what impairments have you disabled. My approval letter stated my impairments plus mentioned something else that wasn't disabling but might be down the road.
I thought only 5-7 yr reviews got the short form?

But they don't ask for documentation and med. notes. Just dates and reason for visits/surgeries. I'm afraid that if I'd send in a bunch more stuff than they ask for, I'd be looking defensive or suspicious and could create a red flag where one didn't exist. I dunno -- maybe I'm over-analyzing, lol.

My hands are crippled up so I will need help writing. It's a scan sheet so you have to stay in the boxes and on the lines.

[QUOTE=Teatime;853413]But they don't ask for documentation and med. notes. Just dates and reason for visits/surgeries. I'm afraid that if I'd send in a bunch more stuff than they ask for, I'd be looking defensive or suspicious and could create a red flag where one didn't exist. I dunno -- maybe I'm over-analyzing, lol.

My hands are crippled up so I will need help writing. It's a scan sheet so you have to stay in the boxes and on the lines.[/QUOTE

Call and ask if too much information isn't needed.

on these short forms do not put any more information than is asked for. do not write in the comments section. do not attach anything. donot send in anything extra. any of the above will result in it having to be looked over by a person and could result in the long form being sent out. a full review. i have some links you could look at. ill look for them.

if you look at number 8 in this link you will see that scanline 1 field 5 contains the medical diagnosis or diagnosises that they have listed for the reason you were approved.

https://s044a90.ssa.gov/apps10/poms....1!opendocument

these are the diagnosis codes

https://secure.ssa.gov/apps10/poms.nsf/lnx/0426510015

and this is something from nystate about the cdr. it applies to anyone doing a cdr.

http://nymakesworkpay.org/docs/Guide_CDR.pdf

WOW, mega-informative, thanks! According to these codes, I'm a low priority and they approved me for inflammatory arthritis. I'm still going to report my recent heart problems but I'll also be sure to report my orthopedic surgeries. I've had three in the past 2 years.

The other question that threw me is the one about whether your doctor says you can work. We've never talked about it because there's no way I could with all of my health problems. She referred me for home health so it's obvious that she doesn't think I can work.

So do I talk to her about it so i can check the box indicating she says I can't work or do I just check off that we haven't discussed it? From those SSA form links, it doesn't look like there's any penalty if you're a Low priority case and you indicate you haven't discussed it.

dont worry about it just put it hasnt been discussed.

continuation of ssdi benefits
 

hi teatime,just make sure you provide all of your doctors visits and any medications you are takeing.with your current health issues your ssdi benefits will most likely continue after the review provided your not working.iv'e been collecting ssdi benefits for the better part of 16 years now and have had 3 reviews during that time.the one factor that social security looks at when reviewing a disibility case is if your working or not.

Hi Gilbert,
The form I got doesn't ask for all sorts of info on doc visits and medications. It just wants the three most recent medical contacts and the reason for them plus the three most recent surgeries or hospitalizations and the reason for those, too. That's it, besides asking whether I've worked or gone for any additional training and some basic questions.

It says if they have any questions about my responses, they'll call me.

I thought the main and final decison on a CDR ( review) is your current doctors opinions on ones condition to be considered still disabled or not? And When SSA sends you to their docs, dont they have a say if we keep or lose our SSDI?

Why would they offer the ticket to work program if one will lose benefits?

I think a lot of it depends on how likely it is that they think you'll improve. Apparently they rate your review as a low, medium, or high priority. Check out the links that the other member provided. They're pretty amazing!

They are not doing a full review of me, at this point. I only have to fill out a questionnaire and from that they will decide if they want to do a full review. LOL, I'm hoping they won't because things like that make me nervous but I surely don't have anything to hide. I have so dang many health problems that keep multiplying instead of getting better.

If you plan to see your doc in the next 60 days, I'd ask if she thinks you can work and answer no, if you're positive of his/her response.

The short form is not a big deal, BUT you should follow the advice of the NY link listed and fill it out very carefully. The long form is similar to going through the original application process.

SSDI eligibility is a medical/legal definition that involves a complex set of rules and evaluations. Doctors opinions are just one step in the process. With the short form, if your condition hasn't changed, you're continuing to receive some medical attention, you're not working or going to school or receiving work training, then there is no reason to go through the (potentially) lengthy and complicated process of reevaluation.

Ticket To Work encourages those that can work to attempt it and provides some protections. Not everyone that chooses to work PT uses the TTW program (I don't believe Gilbert did.) Using the TWP doesn't make a person permanently immune to the review process either. This is a matter to discuss in a different thread, at a different time, though.

the ticket to work program
 

the ticket to work program is kind of like a double-edge sword.Meaning that this program encourages people to try to return to work while on the other hand any work you do can and will be used against you by social security and the judges.if they can see that you can do the slightest bit of work they will terminate benefits.such was the case with me.

Does an added impairment mean an automatic long review?

no but it is not something you would want to put on a short form to muddy the waters in anyway.

you are better off if you dont check that you have talked to your doctor about returning to work if you havent. first of all its the truth and second of all if the subject hasnt been raised by you or the doctor then obviously both of you believe that you are not ready to return to work at the present time. sources i have read have indicated to check the have not discussed box if this applies to you and not to worry about that choice.

So if you are disabled with 2 impairments,another impairment could jeopardize the other two?

What about on my approval letter,something is mentioned that isn't an impairment and now its a possible problem?

I thought as long as you have one severe impairment,it doesn't matter about the other impairments.

There has never been a discussion about returning to work. The cardiologist won't do a heart stress test because of my other impairment so I don't know if its a slam dunk for disability with the heart problem,since a test can't be performed.

I'm just asking basic questions that others may want answered.

I may never be reviewed because of my age.

Teatime was asking about the short form review.

On the long form review you would put down everything you were first found disabled for plus anything else that may have developed in the meantime or may have gotten worse or that you mentioned originally in your first application but which wasnt included in the orignal award. For the long form review you would send your records, tests, medications taken etc.

for the short form review, just answer the questions asked. dont add anything, dont write in remarks section, dont write past last box even if not able to complete sentance, only include last 3 visits for what you were found disabled for.

I was approved because of inflammatory arthritis and inflammatory arthritis is typically auto-immune. It surely is in my case and it causes all sorts of problems, some systemic. I've had documented cardiac arrhythmia and auto-immune GI problems from the very beginning.

But that is what makes my report a bit more tricky. I see several specialists regularly and am receiving treatment and having tests done a lot. In the past three weeks I've had a cardiac cryoablation done, a GI visit with new meds prescribed, a doc appointment over my hip and back pain, MRIs of my hips and SI joint, and at-home physical therapy for my hips and back.

This is a snapshot of the way it goes -- welcome to my world, SSA! lol.

Does that include PCP visits?

Whats the difference between inflammatory arthritis and severe degenerative arthritis?

Babyboomer i think it would be better to put a specialist in the specialty that you were approved for, but if you are also being treated or tested by a pcp sure you should put that

I don't know. I'm only familiar with the type I've got. Inflammatory includes rheumatoid arthritis and spondylitis or Ankylosing Spondylitis in the spine.

Well, I sent it in so fingers crossed and prayers ascending that it's accepted and all is well.

I did call Social Security, though, to ask what constituted a "hospitalization or surgery." I had to have my esophagus dilated and biopsies last fall and I didn't know if it was considered a surgery. It was. And SSA considers being in the hospital 24 hours or longer as a hospitalization.

Finally got a letter from SSA
 

I returned the review form they sent me two months ago and was wondering what was going on. I got a letter today and it said they don't see the need to do a review or contact my doctor. It said I should contact them if I return to work or my doctor says my health is better.

What's weird is it doesn't say anything about my future review schedule. It just says that they'll contact me later if they need to review my case. I thought they usually reset your diary/schedule and let you know when they'd be looking to review again.

LOL, don't get me wrong, I'm very glad I won't have to go through a big ole process and review. I'm in no condition to deal with all of that! But I do like to be informed about procedures and such. Maybe they don't expect me to improve and aren't putting me on a schedule?

short form vs the long form
 

the people who recieve the short form in the mail are the ones who's disabling condition isn't likely to improve and almost always have the benefits continued once they return the form provided they are not working.

Yes, but I've read that the letter confirming the continuation of benefits usually contains a diary/review schedule so you know how often you'll be reviewed in the future. My letter said nothing about that.

ssdi short form
 

i recieved the same letter teatime confirming my continuation of benefits after returning the short form back to SS.my letter also said nothing about any future review schedules which i guess for me and you is a good thing since they think our conditions are not likely to improve so i guess there is no reason for a future set schedule of reviews.the only real reason that they would schedule a review in the future would be if you returned to work or your health has improved.GIL

i just got my short form review today. first time. we'll see how it goes.

Results of Review, Teatime?
 

Hi Teatime, I wondered if you minded my asking you how your review went? I am concerned because my disability causes me not to think as clearly at times. I should have researced the internet before filling out the short form SSA-455-OCR-SM. Anyway, I read on another advocasy site that if you don't list your qulifying disability illness in at least one of the three "boxed" areas where it asks for your last three reasons for medical treatment/visits, that the computer will kick it back and you will automatically be tagged for a long form review. My last 3 medical appts/treatments have been for a new condition. I did however, handwrite; in the section where you can add additional information, that I still suffered from original disability as well as new illnesses which enhance my disability. I really don't want to have to go through a full medical review again. It is so stressful. Oh, did they ever call you with any questions. Any advice is appreciated. Thanks. :)

UH OH, should have looked at your post before sending form in
 

Hi Echoe,
I am 59 years old. Been on disability since I was 48. Had one long SSDI Review at age 49. Got the SSA-455-OCR-SM form the other day. I have since my original disability (which has not improved) also developed an additional disability and am considering surgery for. My last 3 medical visits were for the new disability. So I used the 3 questions that you answer in the Blocks for the new condition, because the form instuctions are not clear that way. Now I want to know if computer does kick out to a person, will I automatically have to go through long reevaluation review or will someone call me to clarify? I did explain in the comment area that my original disability had not changed but that my last 3 doctor visits were for my subsequent condition. I wondered also, since I am not a "spring chicken" anymore either, if that would work in my favor for not having to go through a long review. Thanks for any info that anyone can give.

This is the best guide i have seen for a disability review particularly short form. Three weeks after the last post they sent me a letter saying that they did not need to do a full review at this time. i put the last three doctors visits for the conditions for which i received ssdi, not just my last three doctors visits. Hopefully it will work out for you. Let us know how you do and goodluck.

http://nymakesworkpay.org/docs/Guide_CDR.pdf


this is from directions for the processing center to process short forms.


SSA-455-OCR-SM, Question 5 (SSA-455, Question 7)--Have you gone to a doctor or clinic...?

If the answer to 5 is:
Your action on all profiles is:

YES
Check the profile sheet for information about the prior decision. Knowledge can be gained from the following:

Date of birth

Date of onset

Date of initial decision

Date of latest decision

Reg basis code

Vocational rule met

Diaries set

Blindness

Assess the importance of ongoing medical treatment, or its absence, to the status of the condition. Read carefully the “how often” and “reason for visit” narratives and draw any conclusions.

Consider any remarks or attachments that might address whether medical improvement is or is not indicated.

Consider whether a telephone call to the beneficiary or representative payee will provide further details.

For LOWS, recommend a DO CDR only if the narrative/telephone call response(s) indicates there is possible medical improvement.

For HIGHS/MEDIUMS, take a DO CDR action unless the narrative/telephone call response(s) indicates no likelihood of medical improvement.

NO
All Profiles-If not explained on the form, obtain by DIRCON to the beneficiary or representative payee the reason(s) for the lack of ongoing treatment, especially if impairment codes are:

4140 (angina)

4430(arterial)

5710 (liver)

5840 (renal)

2500 (diabetes)

These impairments usually require continuous medical intervention.

Recommend a full medical CDR only if the DIRCON response indicates there is possible medical improvement.

NO RESPONSE
All Profiles-Go to question 6.



this is the link that the directions are from. scroll most of the way to the bottom and you will see the section.

https://s044a90.ssa.gov/apps10/poms....1!opendocument