SSA-455-OCR-SM Questions
 

Dearest Members, I have read through all of your messages. I know that this may have already been covered by one of you(SO forgive me off hand if I am coming across as rhetorical)...Though I had to ask, a couple of questions and convey my story if it's for the 50th time you hear it I apologize ahead of time.

I have been disabled a long time. I was reviewed once and saw a State Doctor. Now I get a letter from SSA from Wilkes Barre and I live in whole other state. Not even sure what that is about? I had lived in PA about 8 years ago, do they process all these applications from Wilkes Barre?

I never received a letter like this before. I have no clue what I am dealing with. I really really am one messed up person. This is stressful. I haven't been seeing my Medical Doctor but I have been seeing my Psychiatrist. Even though I have been surviving on my existing Medicines during the time period it requests an answer for Question 5.

I just went tonight I am in such bad shape as I thought this would help my case. I have been afraid to see that particular Doctor do to what I think was malpractice. My situation is far worse, though I am not sure I should even state that on the form?

I am so so so so so so so stressed. I'm literally having a panic attack tonight receiving this form. I do not know what to do with myself. Any hope or help in regards to this would be wonderful...

P.S. I do not recall ever receiving as letter stating what is the precise reason I even receive disability. Just that I have. It has been for overall medical reasons both body/mind... I assume but there has never been an exact or precise letter or reason I can recall off hand why. So on questions 5 what should I do?


I really don't want to go through a review process, it's been 2 years since I've walked more than 200 meters, these last few years I live in my bedroom and on my PC. I have no strength in me for this. My heart is with you and everyone else that know's what this is like. Thank you for any help, hope or good wishes offered.

Your profile confirms this is your first posting as well as you are a "new" & joined today.

Not unusual. More common than you think! I live in another state too. Never received any SSDI correspondence from the state I reside in.

Find another medical doctor and/or file a malpractice suit if you have documented proof & an atty believes you have a case.

Since I don't know what question 5 is, I can't answer. The only thing I can advise you is to tell the truth!!!
Get in touch w/your treating physician(s) & ask them what your disabilities are.

Then I strongly recommend that you start going to your medical physician(s) ASAP even if it's just once a year. Not going at all is a red flag to SSDI & SSI.

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Helpful resource:

Processing Center Instructions for the Continuing Disability Review Mailer Forms SSA-455 and SSA-455-OCR-SM
Scroll down to the following section: B. Process



GOOD LUCK! :hug:

Thank you for the introduction and fast response, warm welcome I am very glad for it.

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All former SSI reviews and conversation I have come from my state going back to the early 2000s. This is the first time having to converse out of state. My state capitol in fact. I never knew aside Washington that there would be out of state correspondence.


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The Doctor gave me a prescription that I researched will not be something I can take him to court over. It's been over 24 months since I've seen him and I would love to sue him and the drug company. He gave me a medication that has made me sicker and refused to explain it's side effects prior to prescribing it. One of his staff threw away my culture. A lawyer to sue him with is something I considered but I was told it's extremely difficult and tedious. Maybe one day...(There seems to be a lot of people who share my situation there)

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Question 5 was have I gone to any clinics or Doctors for treatment from Feb 2014 till now. Has only 3 open spots for answers. I have been afraid to return to a medical Doctor I guess I have no choice I had planned to. After what happened I stayed with just my psychiatrist and ignored my medical Doctor.

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You're right I think I messed up not seeing some medical Doctor. I have been in near an emergency situation 4 or 5 times in the past 6 months alone but I am been fearing the same situation as above repeated. Doctors are supposed help you not make your situation worse. I went to an actual clinic tonight and needed to.

Thanks again for responding... This sort of stuff is awfully difficult.. I opened up my briefcase back 16 years I have hundreds of forms. How people manage to get help amazes me.

It's possible SSI claims mailing procedures are different than SSDI claims. Two separate departments.
I am receiving SSDI & all of my correspondence from them are from Washington DC, the headquarters.

In answering question #5, be truthful.

If you were comfortable w/the clinic physician(s) that treated you, perhaps you should consider making the clinic your treating facility for your medical (physical) needs.
It is your right & the law to obtain your original medical records from your old doctor to give to your new doctor(s).
Or you can request your new doctor(s) to obtain your medical records. You will need to sign a medical authorization so that your new doctor(s) can obtain your medical records from your old doctor.
Another option would be asking your psychiatrist for treating physician recommendations. Specifically one that accepts SSI patients and/or whatever type of health insurance program you are on.

SIDEBAR: You should also have copies of your medical records for YOUR records. Read them w/a fine tooth comb. Especially the doctor NOTES. Make sure there are no errors/mistakes.



GOOD LUCK! :hug:

Mz Migraine, thank you, something I will check into. I have plans to document the new issues created by the last Doctor.(My Mother suggested a Doctor) From now I will have to watch these Doctors, they have furthered my disability longer, rather than shortened it. I was beginning to start to feel better almost! For the first time since the 90s. I will definitely get a hold of my records. My best Doctors handed them to me. I didn't realize how much a person has to keep in control of their stuff(what would I do if my mind went completely? What does anyone do who has lost their mind!)


My phone number has changed and I'm near done with my form, not sure I should update it on this form or wait and call SSA myself and change it later. I've read that creates more issues. As well as adding any additional conditions I've picked up. If I get a long form later I can add everything. This has got to be the most stupid form I've ever received.

I guess another thing to stress about, at least this reminds me of something I forgot. NO matter how sick you are, it doesn't matter, be prepared for what comes next. The Government may or may not take care of you. I think a lot of us forget that.(I have been taking this stuff for granted way too much)

Changing your phone number on a document is not the same as changing your phone number on the data base that issues your checks. You should always tell the people who send you money your contact information. SSA sends you money. SSA needs your contact info. There is no 'red flag' for changing your phone number, mailing address, direct deposit. Happens every day.

Janke, yes, you're right. Since I virtually never receive phone calls from SSA I usually only change addresses and phone number when I move. In fact I haven't had a phone call from them directly in my life I think. For anything... Though who would know back years ago precisely. It is definitely something I will not forget twice. They usually always write me everything.

Ssa-455-ocr-sm
 

I'm working on it too. I have some new info, but I fainted the other day and hit my head & now have a worse headache and nausea... Thought j could put my head back and loo on here for info. I will try to respond to u ASAP. But basically, if it's ur first notice, if they don't get it back in 30 days, they just send u a second one and don't flag u. So it's not as urgent as all the anxiety it creates. Item 5 is the tricky one for me and I'm not even sure how much it matters if u check that ur worse, ur dr says u can't work, u haven't worked or gotten training, ur dx(s) basically remain related to the original application, and u are under medical care. I was consistently told not to hand write or attach anything. It's machine scored & they get so many that it costs more to do a full review..so don't provide TMI to trigger one & only list ur last 3 appts (but I still don't know if u list dx or symptoms or what & not sure how much it matters but just don't put some completely unrelated thing). But my friend (more like a friend of a friend) is a soc sec attorney & im going to ask him. So, mine will be arrive after the 30 days and soc sec said not to worry. So I should have gone to the ER right after hitting my head. Ok, I said more than I planned. Helping someone else makes me feel better. If u find out anything or have found out anything, pls update. It's amazing how much stress a 2 pp form can cause when ur dealing with managing ur health. Sorry for typos. It's hard to type and see.

Disability update reply
 

Pls see my response on thread called disability. I hope it reduces your stress. Yes, Q 5 is stressful no matter what. I also have a thread under new members. There is a place on the form u can decode what soc sec has as ur diagnosis and if u are high, med, low profile. The lower ur profile score and if u see a letter L, (vs M, or H) in the second row of numbers under ur phone nbr, u are not expected to get better & have the lowest probability of being flagged for a full review. I'll try to post a link about interpreting all that but I am not feeling well enough right now to find it.

these should help you fill it out

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

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

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

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

Please answer
 

I have asked several times & can't get a straight answer here or anywhere. U can find if ur L, M, H in the numbers separated by / below ur phone Nbr at top right, second line, 3rd field. That is followed by ur profile score. 0000-9999. The closer u r to 0, the less likely they think u can ever work. My letter is L & score is 0071 (I think that's pretty low). The last eight nbrs on the row above your score are ur primary and secondary diagnoses that qualified u for ssdi (4 digits each). It is easy to search online and find out what they mean. ITEM 5 still is a problem for me. I have a multisystem serious, rare condition for which there are mounds of medical evidence but no social security diagnostic code (as opposed to icd medical codes) & my thus, my SSDI diagnoses codes basically amount to that in 2 4 digit codes. I can't write the codes in item 5. I can't pick out my worst symptoms (all of my subdiagnoses subsumed under the main multisystem illness DO have SS codes and each would in & of itself qualify me, especially given their severity). My original app had one of many overarching terms used for my condition. I got it on the first try. And I did and do have a recognized secondary diagnosis that was not recorded on the SSA-255-Ocr-sm. so, MY QUESTION REMAINS, Do I list non SS dX in the boxes (cuz everything falls under that & my dr visits are long & complicated), a few SS official sub diagnoses (that would give an incomplete picture), "complications," "medication/disease management," SYMPTOMS (per Instructions that even list BAD BACK as an example, or what? Has anyone successfully completed this or found the specific answer how to answer and whether the machine scoring looks for certain key words (and are they related to ur original application b/c the form doesn't include all the info from my app & remember it's not a full review. The idea is to avoid red flags. PLS PLS RESPOND. I need a specific answer whether u successfully completed this yourself, or found the answer elsewhere & where? Pls pls pls. I feel no one is responding, maybe cuz I'm new here. I tried to provide helpful info that I've learned thus far. Can someone please help me ASAP? Thank you very much.

i dont know what else i can do to answer you. i just put down the two diagnosis i was approved for and the date for the last 3 visits and thats it. ive done that twice and both times was successful.

The diagnoses differ
 

The main multisystem diagnosis on my original application does not have a ssa code. I had help filling it out & got it on my first try. The ssa-255 has diagnosis codes of 2480 (I have sufficient medical evidence but there is no ssa name). I'm not sure why this happened cuz I'm LOW & there are symptoms and subdiagnoses and a secondary diagnosis that have ssa codes. I kept telling the ppl my LTD hired to do my original app to list only all terms consistent with ssa but they first listed terms that don't have ssa codes. After getting it on the first try, I thought the ppl helping me knew what they were doing. But now it's a problem for me, because what I actually was approved for is a vague code(which they know, and I don't know why they don't word the item as "list your last 3 appointments dates for the disability for which u were awarded ssdi"). So I don't know what to put in the boxes that they don't already know or that they were told but they only listed that there is no ssa name for it. So t be consistent with what exactly is listed as my reason for award, I'd have to say something like nonamed documented disability!!!!! That's the problem. Trust me, I'm way sick and they know it, cuz my profile score is well under 0100 & almost every system in my body is affected. I just got more bad news from one of my docs & actually should have gone to the ER the past two days for a potentially serious complication but I have to get this done. I could write "help staying alive" or "dodging bullets." There's officially no name but evidence I won't get well! I have searched everywhere for what to fill in as reasons for my visits. I hope this helps clarify. Thank you very much

i understand you dont have a ssa diagnosis code that fits. do you have a medical diagnosis....a name for what you have? if so put that down and if they have a secondary diagnosis with a ssa diagnosis code put that.

Helenb, getting that letter gave me a lot anxiety. I have put it out of my mind. I will refrain from giving any advice. I have no outcome as of yet. I really hope yours is favorable! I would fill that form out as instructed and toss in the mail with as much info as you can get together. (I doubt anyone is God on how to do it perfectly)

I received an answer, more or less quoting,

"We have decided not to review your case at this time and we do not need to contact your Doctor but may do both or either in the future."

I followed the instructions of the helpful people on this forum and told the truth. Unfortunately my health has taken a turn for the worse but I am out in the world still walking, breathing and free. Though I can forget this for awhile hopefully... I hope that everyone else gets through well too. My answer took near 4 months.

May your God/Gods be with you

I have gotten the 455 before, I dont remember getting an answer of any kind back?

I just would know if my checks stopped.....Am I missing something here?...

Now I'm confused is the Form 455-OCR supposed to ME complete my diagnosis codes where the codes are already on my form 455-A?
I keep pulling this stupid form out of the mailbox - and waiting for answers - my diagnosis codes on pre-printed on the form.
I'm heading back to the mailbox now - if it's not picked up...

They always mail a letter confirming they don't need to perform the Long Form. If SS didn't receive the Short Form back from you, they would mail you a 2nd one. If you failed to respond to that, then they'd notify you that your benefits would be ending in 3 months for failure to comply.

Thank you....I was confused!

Actually, if you don't reply to the second mailer, someone from Social Security is supposed to make a couple of attempts to contact you at the phone number on file.

So, you always want to make sure that Social Security has your correct address AND telephone number on file. If you move or change your phone number, get on their website or call their 1-800 number and update that immediately.

Also, if you move, make sure you have filed a change of address form with the post office so that any mail they might have sent to your old address is forwarded.

If they can't contact you at all, they *will* stop your benefits, so this should be one of your top priorities. More people probably get cut off for not complying with the process and/or not being reachable than for medical improvement.