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| | |-+  Anybody here lose their SSDI benefits after a CDR? Review
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Topic: Anybody here lose their SSDI benefits after a CDR? Review  (Read 5700 times)
templobe
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« on: November 15, 2011, 04:19:51 PM »

Hi everybody!

My husband was approved for SSDI for Epilepsy & Arthritis. But because he is young-42, SSA said they will review him in 1 year. Some told me that reviews are tough to pass others said its pretty basic and benefits will continue.

So my question here is- Has anyone here lost their benefits during a CDR-Review? If so why did you lose them?

What is the most likely cause of losing benefits?

To be its annoying to hear that every year my husband & I have to go through all this stress again just to keep his SSDI. I sure hope the review isnt as stressful as was the original application.

Thanks!!!-hope everybody is well
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SSDAdmin
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« Reply #1 on: November 15, 2011, 06:29:53 PM »

Great question and one hopefully someone can answer.  My thought is the most common reason for losing benefits would be unreported work. 

I think the first thought would be lack of medical evidence however lack of evidence doesn't necessarily equal improvement and they can't take away your benefits without proof of improvement.

Marci
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I speak from experience not expertise.
Name: Marci
Location: Florida
Age at Application: 35
Disability: Arthritis, Degenerative Disc, Migraines, Foot Injury
Date Applied: September 2005
First Approval/Denial Date: Denied February 2006
Reconsideration Approval/Denial Date: Denied October 2006
Date Hearing Notice Received: October 2008 two weeks before hearing
Hearing Date: October 2008
ALJ Approval/Denial Date: Letter Received December 2008
Date Award Letter Received: January 2009
Date Back Pay Received: February 2009
Additional Info: Approved at hearing, no Attorney
Dragon Fly
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« Reply #2 on: November 15, 2011, 07:36:59 PM »

Hi templobe,
Interested to hear other member's experience on this as well.
It is supposed to be harder to lose your benefits than get them...SSA has to prove he has improved.
Please stick around and keep us posted on your experience.
It will definitely help others!
>;<
Dragon Fly
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"And those who were seen dancing were thought to be insane by those who could not hear the music." --  Friedrich Nietzsche
Name: >;<
Location: CA
Age at Application: 37
Disability: Complex PTSD, Major Depressive Disorder, Anxiety Disorder
Date Applied: October 8, 2010
First Approval/Denial Date: Approved verbally March 15th, 2011. Approval letter dated April 5, 2011
Additional Info: 2 weeks in QR, Received backpay April 4th, 2011
templobe
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« Reply #3 on: November 16, 2011, 12:39:18 AM »

Thanks! I hope someone here chimes in with more info. What I do not understand though is why they would review my husband every year? Ok he's young,in his early 40's. But he already had brain surgery, they removed a tumor plus some brain tissue. Since that surgery not only does he now get seizures 3-5 times a week but he is also slower and now has a learning issue. And his secondary disability is arthritis. How can one improve from all that?

He does not work, he goes to all his Doctors every 2-3 mnths and takes his meds like prescibed. A year review seems unnecessary to me. Speaking of doctors, tomorrow we see his Neurosurgeon for his latest MRI results.

Keep this post alive. Hope everybody the best!

Thanks again
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Dragon Fly
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« Reply #4 on: November 16, 2011, 02:03:30 AM »

Temp,
It sounds like he/you are doing all the right things. I know it seems like a PITA to have the review so soon. It's possible they "expect" medical improvement because he had surgery....but your records and continued treatment will show he has not.

I am wondering, if they will consider the "new" evidence and change the review period next time to a longer period??

That's a question for the  clever so maybe we'll here in the morning.
xo
>;<
Dragon Fly
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"And those who were seen dancing were thought to be insane by those who could not hear the music." --  Friedrich Nietzsche
Name: >;<
Location: CA
Age at Application: 37
Disability: Complex PTSD, Major Depressive Disorder, Anxiety Disorder
Date Applied: October 8, 2010
First Approval/Denial Date: Approved verbally March 15th, 2011. Approval letter dated April 5, 2011
Additional Info: 2 weeks in QR, Received backpay April 4th, 2011
MissingNY
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« Reply #5 on: November 16, 2011, 02:57:25 AM »

I Lost my benefits as a result of a cdr(medical cessation). According to the paperwork, it said that I had shown medical improvement, but as all of my latest mri's and x-ray's, doctors of varying specialties concur that my condition has gotten worse with new ailments over time. The last time I was reviewed was in 2001 and kept my ssdi. I don't know what happened now, as the paperwork doesn't go into detail. Supposedly, social has to prove my condition has improved, but so far with my ammo, I feel strongly that my ssdi will be reinstated. But, we will see.
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Name: Don
Location: N.E. Florida
Age at Application: 32
Disability: Bilateral Sciatica/SI Joint Disorder/Degenerative Disc Disease/Cervical Stenosis/Spondylosis/Panic Disorder w/o Angoraphobia
Date Applied: 2/1993
First Approval/Denial Date: Approval 8/94-ALJ Hearing-Not Present/CDR Approval-4/01
Hearing Date: CDR-Medical Cessation Reconsideration Hearing(Face to Face at Local Office on 12/21)
ALJ Approval/Denial Date: 8/94-Approved(On Initial Claim-Not Present)
Additional Info: Benefits Reinstated As Of 12/21/2011(unofficially verbally from hearing officer during hearing)/Offically via letter on 1/25/2012
templobe
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« Reply #6 on: November 16, 2011, 03:07:59 AM »

Very sorry to hear! Please share more info. Were you working? Taking your meds as prescribed? Going to your doctors regularly? If you dont mind me asking-what condition do you have?



I Lost my benefits as a result of a cdr(medical cessation). According to the paperwork, it said that I had shown medical improvement, but as all of my latest mri's and x-ray's, doctors of varying specialties concur that my condition has gotten worse with new ailments over time. The last time I was reviewed was in 2001 and kept my ssdi. I don't know what happened now, as the paperwork doesn't go into detail. Supposedly, social has to prove my condition has improved, but so far with my ammo, I feel strongly that my ssdi will be reinstated. But, we will see.
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Kittyholic
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« Reply #7 on: November 16, 2011, 05:31:15 AM »

Welcome templobe:

The one year review indicates that Medical Improvement is Expected (MIE), and is generated by a computer profiling model. The DDS does recommend a diary frequency, but it is the computer model that SSA uses. The profile contains some 20 variables, so it would be impossible to know what variable triggered the one year review.

However, I suspect your husband's surgery may have been the influencing factor. The MIE diary is considered a continuation of the original determination, and a one-year follow-up may be indicated to determine if the surgery resulted in improvement.

The good news is that it may not always be one year. The diary is reestablished at each CDR. So, after the one-year review he may be changed to Medical Improvement Possible (MIP), which is +/- 3 years, or Medical Improvement Not Expected (MINE), which is 5-7 years.

You can read more here:

https://secure.ssa.gov/apps10/poms.nsf/lnx/0413005010
https://secure.ssa.gov/apps10/poms.nsf/lnx/0413005011

Pati
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The best way to pay for a lovely moment is to enjoy it. (Richard Bach)
Name: Pati
Location: East Tennessee
Age at Application: 53
Disability: Small Fiber & Autonomic Neuropathy; Sjogren's Syndrome; DJD
Date Applied: 02/19/2009
First Approval/Denial Date: Approved 10/26/2009
Date Award Letter Received: 11/17/2009
Date Back Pay Received: 10/25/2009
Additional Info: Assigned to DQB on 10/5/09. Approved.
Sharbear50
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« Reply #8 on: November 16, 2011, 07:39:02 AM »

Indeed that is a good question and one I have been wondering about myself. Mine is a 3 year approval.

Patti, thanks so much for posting this reply.

Sharon
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Sharon
I wish I had land - grow food
Age at Application: 51
Disability: Rhuematoid Arthritis, Degenerative Disc, Small Vessel Disease, past Encephalitis, Hip Replacement, Migraines, Carpal Tunnel, Graves and Hashimotos, Mitral Valve Prolapse, etc.
Date Applied: Oct. 2009
First Approval/Denial Date: Denied Oct 2010/Denied again/Missed ALJ Deadlline
Reconsideration Approval/Denial Date: Reapplied May 2011/Approved Sept 9, 2011
MissingNY
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« Reply #9 on: November 16, 2011, 08:48:42 AM »

@templobe: I have not "ever" worked since my bus accident with NYC on 5/25/92. My orthopedic surgeon at that time had suggested a lumbar laminectomy for one of my ailments, but he said that I can expect up to a maximum of a 25% success rate. But after he had said what the surgery risks were for that partcular proceedure, I said no to the operation because the success rate did not outweigh the risk rate. As far as the meds, I was on lodine for a very long time(years) and I was taking much more than the prescibed dose and was starting to have issues from that, so I weaned myself off of the scripts and just kept up with otc's since then up until a few months ago where i'm taking mild pain killers(that don't work, plus my neurologist has left the practice), along with xanax and trazodone. i'm loopy and tired all day and keep dozing off no matter what i'm doing(that's why I had quit with the meds in the past, they just screw with your brain so much). My condition that I got approved for was herniated disc's(neck&back) with radiculopathy.
Logged
Name: Don
Location: N.E. Florida
Age at Application: 32
Disability: Bilateral Sciatica/SI Joint Disorder/Degenerative Disc Disease/Cervical Stenosis/Spondylosis/Panic Disorder w/o Angoraphobia
Date Applied: 2/1993
First Approval/Denial Date: Approval 8/94-ALJ Hearing-Not Present/CDR Approval-4/01
Hearing Date: CDR-Medical Cessation Reconsideration Hearing(Face to Face at Local Office on 12/21)
ALJ Approval/Denial Date: 8/94-Approved(On Initial Claim-Not Present)
Additional Info: Benefits Reinstated As Of 12/21/2011(unofficially verbally from hearing officer during hearing)/Offically via letter on 1/25/2012

« Last Edit: November 16, 2011, 08:51:17 AM by MissingNY »
acemagoo
Guest
« Reply #10 on: November 16, 2011, 10:07:37 AM »

@templobe: I have not "ever" worked since my bus accident with NYC on 5/25/92. My orthopedic surgeon at that time had suggested a lumbar laminectomy for one of my ailments, but he said that I can expect up to a maximum of a 25% success rate. But after he had said what the surgery risks were for that partcular proceedure, I said no to the operation because the success rate did not outweigh the risk rate. As far as the meds, I was on lodine for a very long time(years) and I was taking much more than the prescibed dose and was starting to have issues from that, so I weaned myself off of the scripts and just kept up with otc's since then up until a few months ago where i'm taking mild pain killers(that don't work, plus my neurologist has left the practice), along with xanax and trazodone. i'm loopy and tired all day and keep dozing off no matter what i'm doing(that's why I had quit with the meds in the past, they just screw with your brain so much). My condition that I got approved for was herniated disc's(neck&back) with radiculopathy.

Wow, that is scary. I know someone with fibromyalgia who went to a SS CE who said they did not have it. SS then sent paperwork for her treating doctor to fill out and their benefits were continued.

Were you sent to a CE?

Did SS send any paperwork to your current treating doctor?

Do you know if your treating doctor supports you not being able to return to work?
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templobe
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« Reply #11 on: November 16, 2011, 10:34:07 AM »

Thanks for the info! Do you think my husband will get the long form at review time then? Being he is a yearly review? How does SSA decide on the short review form vs long? And is one form harder to pass then the other?

Thanks again!






Welcome templobe:

The one year review indicates that Medical Improvement is Expected (MIE), and is generated by a computer profiling model. The DDS does recommend a diary frequency, but it is the computer model that SSA uses. The profile contains some 20 variables, so it would be impossible to know what variable triggered the one year review.

However, I suspect your husband's surgery may have been the influencing factor. The MIE diary is considered a continuation of the original determination, and a one-year follow-up may be indicated to determine if the surgery resulted in improvement.

The good news is that it may not always be one year. The diary is reestablished at each CDR. So, after the one-year review he may be changed to Medical Improvement Possible (MIP), which is +/- 3 years, or Medical Improvement Not Expected (MINE), which is 5-7 years.

You can read more here:

https://secure.ssa.gov/apps10/poms.nsf/lnx/0413005010
https://secure.ssa.gov/apps10/poms.nsf/lnx/0413005011

Pati

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Kittyholic
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« Reply #12 on: November 16, 2011, 11:17:32 AM »

Again, the computer profile determines whether or not the short-form mailer us mailed or the long form and full medical review is required. However, typically the MIE diaries do receive the long form and go through the full medical CDR.

You can see a sample of both forms on our SSA Forms page SSA-455 is the short form mailer. Many people who receive this simply return it and have benefits continued, while a small percentage later receive the long form and full medical review.

SSA-454 is the long form. Looking at the sample of it now will prepare you for what you can anticipate.

Pati
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The best way to pay for a lovely moment is to enjoy it. (Richard Bach)
Name: Pati
Location: East Tennessee
Age at Application: 53
Disability: Small Fiber & Autonomic Neuropathy; Sjogren's Syndrome; DJD
Date Applied: 02/19/2009
First Approval/Denial Date: Approved 10/26/2009
Date Award Letter Received: 11/17/2009
Date Back Pay Received: 10/25/2009
Additional Info: Assigned to DQB on 10/5/09. Approved.
templobe
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« Reply #13 on: November 16, 2011, 03:09:17 PM »

Oh great the Longgg form-lol. I really hope my husband does not get the long. And if he does I hope the review is not as tough as his original app. I guess I shouldnt stress too much about it because he does not work, takes his meds and has not improved.

Thanks! Smiley




Again, the computer profile determines whether or not the short-form mailer us mailed or the long form and full medical review is required. However, typically the MIE diaries do receive the long form and go through the full medical CDR.

You can see a sample of both forms on our SSA Forms page SSA-455 is the short form mailer. Many people who receive this simply return it and have benefits continued, while a small percentage later receive the long form and full medical review.

SSA-454 is the long form. Looking at the sample of it now will prepare you for what you can anticipate.

Pati

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atomic83
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« Reply #14 on: November 17, 2011, 04:43:00 PM »

I am currently going through CDR I got the long form first I will keep you updated when I find out what the verdict is.
Logged
Location: New York
Age at Application: 20
Disability: Agoraphobia, Xenophobia, Depression, Anxiety, Migraines,
Date Applied: March 2004
First Approval/Denial Date: July 2004
Additional Info: Currently having CDR
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