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+  Social Security Disability Facts Forum
|-+  Helpful SSDI and SSI Topics
| |-+  General Disability Discussion
| | |-+  cdr long form 454 question
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Topic: cdr long form 454 question  (Read 298 times)
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~ Copper ~
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« on: May 17, 2017, 03:19:26 PM »

Does anyone have a download for the form? I've made copies and now can't tell what's original haha. Specifically, page 13 with section 11 remarks. Is this a two sided page, and is the medical record authorization release form on the back side of page 13 or it's own separate page?
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~ Copper ~
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People helped 1
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« Reply #1 on: May 17, 2017, 03:31:10 PM »

Also, the instructions say bring prescription containers to my appointment at ssa office to turn in my cdr packet. Does it have to be my current bottles or can it be last months? Or what about just scanning the labels and taking those? That's what I did last time.
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newdawn
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« Reply #2 on: May 17, 2017, 08:15:24 PM »

This is the only pdf download I found:
https://www.reginfo.gov/public/do/DownloadDocument?objectID=68033400

It shouldn't matter if you bring last month's prescriptions vs. this month's if your prescriptions haven't changed. I also don't think it matters if you bring a scanned copy of the labels or the original bottles, but I'm not sure.
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Name: Dawn
Location: IL
Age at Application: 31
Disability: Depression, anxiety
Date Applied: 11/2013
First Approval/Denial Date: 03/2014
Reconsideration Approval/Denial Date: 11/2014
Hearing Date: 11/13/2015 (Friday the 13th!)
ALJ Approval/Denial Date: 01/15/2016 Fully Favorable (rec'd 01/21)
Date Award Letter Received: 02/17/2016 (rec'd 02/20)
Date Back Pay Received: 02/13/2016 (paper check)
Additional Info: 02/09/16 mySSA account updated with approval info. 02/22 rec'd medicare card in mail. Hired lawyer after reconsideration denial. Requested an in-person hearing.
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