TN 35 (09-12)

DI 13010.027 Continuing Disability Review Enforcement Operation (CDREO)

A. Background

The CDREO alerts records of title II and concurrent beneficiaries with potentially uninvestigated substantial earnings after disability onset. The CDREO alert shows the earning amount and trial work period (TWP) information from the disability control file (DCF), including the TWP start month and any TWP months completed during that enforcement year.

The CDREO includes wages covered by the Federal Insurance Contributions Act (FICA), non-FICA covered earnings, and self-employment income under the Self-Employment Contributions Act (SECA), beginning with the 1984 enforcement. Although the output documents show pension postings, they are not included in the posted summary earnings amount.

B. CDREO process

The following chart outlines the CDREO process:

Stage

Description

1

The CDREO produces numerically categorized output documents that contain various alert legends.

2

The CDREO assigns the output documents to the processing center (PC) that maintains jurisdiction of the continuing disability review (CDR) case.

3

To facilitate the control of this workload, CDREO alerts posted to the DCF as “T2 Work CDRs”. Access the enforcement information through the Query Work Information Data (QWID) screen.

The QWID screen shows the investigation start date, the earnings amount, the first work month, and the last work month for the enforcement. If there is a T2 work CDR pending, the system closes the pending work CDR, and establishes a new T2 work CDR that combines the information from the previous pending event.

4

If the CDREO combined work CDRs, the office that established the original work CDR maintains jurisdiction.

C. CDREO alert criteria and threshold amounts

The CDREO compares the enforcement earnings against set thresholds, and earnings posted to the DCF as verified. The threshold amounts are different based on the Medical Diary Reason (medical improvement expected (MIE), medical improvement possible (MIP), or medical improvement not expected (MINE) recorded in the DCF. The following conditions alert a case:

For MIE diaries

For MIP, MINE or no diaries

Enforcement earnings must be equal to or greater than 1 month of substantial gainful activity (SGA) for that enforcement year

AND

There must be a difference of 1 month of SGA between the enforcement earnings and verified earnings on the DCF.

Enforcement earnings must be equal to or greater than 6 months of SGA for that enforcement year

AND

There must be a difference of one month of SGA between the enforcement earnings and verified earnings on the DCF.

D. Types of enforcement alerts

The following chart provides the legends of possible alerts, brief descriptions and the Program Operations Manual System (POMS) references for the appropriate action(s):

Legend

Description

POMS

References

POSSIBLE STATUTORY BLIND

Posted earnings for a statutorily blind beneficiary.

DI 13010.135

DI 41001.001

FUTURE MIE DIARY MM/YY

An upcoming medical issue is on the record. You can access diary information from the QMID screen.

DI 13010.012

DI 13010.660

PAST DUE MIE DIARY MM/YY

A mature medical diary is on the record. Examine the QMID screen for diary information.

DI 40505.100

DI 13010.012

PRIOR WORK ALERT COMBINED

The CDREO combined the prior T2 Work CDR data with this new alert.

DI 13010.010

DI 13010.035

DI 13010.090

DI 13010.215

NO SPECIAL CONDITIONS APPLY

Posted earnings, but there are no special conditions associated with this case.

DI 13010.010

E. Enforcement alert events that will not result in a work review

The following chart provides guidelines for processing CDREO alerts that do not prompt a work CDR, and only apply to situations when development of a work CDR was not initiatied.

IMPORTANT: If you initiated development of a work CDR in eWork and received a reply from the beneficiary, complete the work review and mail the eWork generated L-1013 (Notice of Continuance). To view the notice language, see DI 13095.155.

The Situation Is:

Take This Action:

  • Previous determination shows earnings were not pay for work performed (i.e., the earnings were sick pay, vacation pay, disability benefits, etc.); and

  • the CDREO posted amount is from the same employer and consistent with the prior development

  • Write no action necessary (NAN) on the DCF Remarks Screen;

  • Fully document your rationale on the DCF REMARKS screen; and

  • Close the DCF as a “STOP CDR.”

  • Previous determination indicates earnings are “clearly not SGA”, (For SGA information, see DI 10501.025);

    • earnings are from the same employer,

    • the earnings amount meets the criteria for “clearly not SGA” earnings, and

    • there are no prior work cessations on the record.

  • Write NAN on the DCF Remarks Screen;

  • Fully document your rationale on the DCF REMARKS screen; and

  • Close the DCF as a “STOP CDR.”

  • Posted earnings are in the year a person attains full retirement age (except disabled child claims), or in the year of death.

  • Write NAN on the DCF remarks screen.

  • Close the DCF Work CDR as a Stop CDR.

PCs only: If postings exceed annual retirement test limit, send case to a benefit authorizer (BA) for adjustment action.

  • Statutory blind person is not eligible for cash benefits because he or she is in a freeze status.

Write STAT BLIND Freeze-NAN on the DCF remarks screen. Close the DCF Work CDR as a STOP CDR.

Medical CDR in progress

If medical CDR is in progress in the FO, the FO has jurisdiction of the CDREO. If postings cannot be NAN'd under another situation listed in this chart, the PC must:

  • transfer the DCF to the FO with the jurisdiction of the medical CDR; and

  • fully document why you are transferring jurisdiction on the REMARKS screen of the DCF.

Person is in terminated status - postings in or before the year entitlement terminated.

Write Nan on the DCF remarks screen. Close the DCF Work CDR as a STOP CDR.

Exception: The posting requires a reopening and revision under the rules of administrative finality. For more information on administrative finality, see DI 13010.145.

Prior SSA-833-U3
determination shows that:

  • work was not SGA;

  • subsidy or impairment related work expenses (IRWE) were not material to the previous determination;

  • wages/SEI for the same employer are consistent with the amount(s) previously developed; and

  • there is no previous cessation on the record.

  • Write “NAN” on the DCF remarks screen;

  • Fully document your rationale; and

  • Close any DCF Work Event as a STOP CDR.

Prior 833-U3 determination shows shows that sheltered work was not SGA, and the current postings are below SGA.

  • Write “NAN-No CDR issue on the DCF remarks screen;

  • Document that the prior SSA-833-U3 determination shows sheltered work not SGA, subsequent sheltered workshop earnings work not SGA;” and

  • Close the DCF event as a STOP CDR.

Disability freeze exists because use of military or railroad credits preclude disability payments. Person now meets insured status using Social Security earnings.

  • Send a request for action to the FO requesting an application for benefits, if applicable. For request for action procedure, see MSOM PCACS 009.005).

  • Handle as a conversion case per DI 40525.010.

F. CDREO and DCF alerts and jurisdiction

To prevent duplication of development efforts, and to facilitate control, it is important to keep the work review together in both the eWork and DCF systems. If a work CDR is currently open in the DCF, you will see a CDREO alert displayed within eWork. Follow these guidelines to process a CDREO alert:

  • Check the location of the alert, and if it is in your location, continue processing the CDR. If the alert is pending in another location, contact the other component to determine the proper jurisdiction based on the stage of development already completed.

  • Either transfer jurisdiction to your own location, or transfer the newly established work review within eWork (and any earnings information) to the other component.

NOTE: If you transfer a work review to another component, eWork automatically transfers the work event in the DCF.

G. CDREO alert pending in the PC and a work report is pending in the FO

If a work report is pending in eWork, but no one initiated a work review, the FO maintains jurisdiction of the work report and subsequent work review. Follow the steps below:

  • Initiate the work review in eWork as outlined in DI 13010.025.

  • Enter a remark on the eWork development worksheet explaining that you are transferring the CDREO alert and the work review to the FO location based on the pending work report.

  • Go to pending work reviews and locate the review you want to transfer. Click the “TR” button and transfer the work review to the FO with jurisdiction of the pending work report.

  • Place a dated remark on the IRMK screen explaining that you are transferring the CDREO alert based on the pending work report.

  • Clear the paperless controls as NAN, and add a comment that you transferred the enforcement to the FO.

H. Processing CDREO alerts for eWork exclusion cases

For eWork exclusions, process the CDREO alert outside of eWork using the procedures for manual processing explained in DI 13010.026.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0413010027
DI 13010.027 - Continuing Disability Review Enforcement Operation (CDREO) - 01/28/2013
Batch run: 01/28/2013
Rev:01/28/2013