JACK, or anyone, What Does This Form Mean?
Pedro Sanchez
it seems it's the one to DECIDE if the full one is needed?
OMB NO. 0960 - 0511
SSA-445-OCR-SM (10-2003)
What are my chances of a Full medical review?
What are some of the things they look at to decided yes/no for the
full medical review?
thanks all.
Dr Feelgood WA
"Pedro Sanchez" <Dr.Pedr...@yahoo.com> wrote in message
news:epf9t25ds6lilkk5a...@bbb.org...
If that's the 7 question form you simply fill it out, sign it and send
it in. They will determine if a review is needed or defer a review based
on how you answer the questions.
I got one of those recently and about three weeks after sending it back
got a notice no review was needed at this time.
Jack
https://s044a90.ssa.gov/apps10/poms.nsf/lnx/0440502001#J2
You were categorized as MIE (improved expected), MIP (improvement
possible), or MINE (improvement not expected) when your claim was
allowed. Based on statistical profiling, the 455 further refines the
MIE, MIP, MINE process by considering other data to categorize you as
LOW (probability of medical improvement), MEDIUM, or HIGH. The bulk
of 455s are sent to LOWs, For statistical control purposes, some are
sent to MEDIUMS and a few to HIGHs. Overall, 3.5% of those who
receive 455 questionnaires will get CDRs.
Go to the URL above and scroll down to near the bottom. You will see
how they evaluate answers. If you need further answers, come back to
the group here.
Pedro Sanchez
Thanks for the URL. I did read the parts you mentioned. I cannot
decide if they place me in the Low medium high category. I can tell
you my CDR's seems to be every 7 years. My SSDI is based on
Bipolar/Depression/Panic etc, no Physical problem.
It said to explain more if you needed, I did. It also said I could
include a sheet with more details if I needed to, I did that.
Also, when asked if I was same, better, worse, I said Worse and I
couldn't say it more strongly.
I've also had [3] hospital stays for my condition since the last
review in the year 2000.
Based on this, what can you conclude?
thanks
Rick
Personally, I think you over explained it. In my case I just answered
the obvious - my condition has worsened in the last two years (it has)
and gave very current dates for the most recent treatments I had
received for the disorders - one for the therapy and one for the
prescribing MD. And no work attempt. (Which is all true.) I got a form
letter about 30 days later stating no CDR was necessary at this time.
What you put down won't hurt. But considering this is an OCR form it's
most likely the "yes" or "no" items you check off are going to be the
biggest triggers as to what happens, not the added detail you include.
The added detail may only slow down the reply since someone now has to
read that. I think what they are looking for on the OCR form when it
gets scanned by a computer is: Are you still in treatment? (yes/no "X"
in box) And how recent was the treatment? (blocky OCR numbers filling in
the date boxes)
Rick
Pedro Sanchez
>Personally, I think you over explained it.
perhaps.thanks for your experience in the ocr letter.
Jack
<Dr.Pedr...@yahoo.com> wrote:
Seven years suggests MINE:
https://s044a90.ssa.gov/apps10/poms.nsf/lnx/0426525040!opendocument
https://s044a90.ssa.gov/apps10/poms.nsf/lnx/0426525045!opendocument
The statistical refining scheme AFAIK is not in the POMS and I'm not
privy to it. They probably factor-in age, impairment category code,
time on the rolls, etc. . At any rate, the bulk of MINEs are LOWs.
Probably safe to assume that you're a LOW.
Assuming that you got the 6-question scannable form, and are LOW:
1) No work
2) No school or tng.
3) Cannot work
4) Worse
5) Yes (Narrative explaining frequent or at least regular visits. If
narrative is meaty, it could avoid direct phone contact with you.)
6) Yes (Three hospitalizations since 2000)
I'd defer. The "scoring" is kind of a no-brainer.
Pedro Sanchez
Thank You Jack
sybilll
> "Pedro Sanchez" <Dr.PedroSanc...@yahoo.com> wrote in message
My disability at this moment, bars me from comprehending the *likely
to recover*, to paraphrase. I got a retroactive settlement, after 7
years, from UN*M as a result of a class action lawsuit. But, they say
my disability is *self reported*, and I should have recovered in 1
year. I have had Chronic Fatigue Immune Deficiency Syndrome for 10
years, and have recovered 25%.
As usual, I am exhausted, and just need to know how to build my case
to fight the *1 year limit*. I only have about 30 days. Geez, why
did I not find you all earlier.
And, I have been through ALL the SSA applications, denials, lawyers,
hearings, etc., so I will be glad to help.
Sue
>The statistical refining scheme AFAIK is not in the POMS and I'm not
>privy to it. They probably factor-in age, impairment category code,
>time on the rolls, etc. . At any rate, the bulk of MINEs are LOWs.
>Probably safe to assume that you're a LOW.
>Assuming that you got the 6-question scannable form, and are LOW:
>1) No work
>2) No school or tng.
>3) Cannot work
>4) Worse
>5) Yes (Narrative explaining frequent or at least regular visits. If
>narrative is meaty, it could avoid direct phone contact with you.)
>6) Yes (Three hospitalizations since 2000)
>I'd defer. The "scoring" is kind of a no-brainer.
Hi Jack, What do you think the "scoring" is for someone who gets reviewed
every 3 years and is labelled "M" or Medium, and answers all but question
6 the same as you listed above? Thanks.
Jack
A disability examiner will make a judgment after considering the
additional factors of your age; time on the rolls; whether the most
recentprevious action was based on the Listings, med-voc, or no
med.improvement; and any narrative information you submit. A phone
call to you is possible. The default action is to do a CDR unless in
the DE's judgment the totality of the data "indicates no likelihood of
medical improvement."
Sue
Hi Jack, I'm (not much) under 50, been on the rolls since 1992, last full review
was 2001, wrote worse for how my health is, for question 5 listed 3
doctor visits in the last 4 months and for reason for visit gave answers that
match the coding for the 2 disabilities I was approved for, and did not
submit any remarks. Do you have any sense of where the DE would come out
on this information? Thanks so much for your help.
Jack
Not trying to evade the issue but if I were in the DE's shoes, I'd
want to scrutinize the 2001 medical evidence pertaining to your two
impairments and the basis for the 2001 continuance: Listings vs. No MI
vs. med-voc. If you had a subsequent mailer, perhaps 2004, I'd want
to compare your answers then to 2007's answers.
The reason for this further micro-analysis is driven primarily by your
rating which you say is MEDIUM rather than LOW, and your relative
youth.
The other person in this thread had more of a no-brainer profile but
yours requires the exercise of some judgment.