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SSDI Letter Jan 21, 2013 - Question
Feb 21, 2013

Mr. Chambers,

I have read with great interest your response to a correspondence posted here dated Jan 21, 2013 regarding an SSDI letter and what the author should expect. I am writing about your response - "Assuming HIV/AIDS is your primary diagnosis for Social Security, they really shouldn't be doing a Continuing Disability Review on you."

Having received a fully favorable decision in the mid 2000's for an AIDS DX with AIDS Related Dementia enhancement, I have been required by the SSA to complete a CDR (short form) twice in the past 3 years. Unable to decipher POMS DI 34001.036F as it reads like a foreign language, I question the reality of how often "On occasion, a case is incorrectly selected and alerted for a CDR" is actually incorrect and more so intentional. In your response to the author of the original correspondence, they really shouldn't be conducting a CDR, the fact is they are. Short forms are easy to complete, but are also quite disturbing knowing that at any given moment a mountain of administration and re-decision could await. It appears the most important component to being one of the lucky ones receiving a CDR is the Comparison Point Decision (CPD) Date something which sounds like a backend process known only to the ALJ and something I am unable to find anywhere in my written decision. It also appears from your interpretation of SSA procedure, some of the ones chosen who really shouldnt be chosen in the first place are done so in the spirit of evaluation purposes- is this being done to improve the process?

My questions:

Is the CPD medical evidence you mentioned new/current evidence or the original evidence used in making the SSDI decision? i.e. An individual who reaches an undetectable status no longer would be considered disabled under the rules?

Should an individual wish to question the reason for the CDR, what is the proper procedure for doing so?

Can you kindly in simpler language describe why they should not be conducting a Continuing Disability Review when HIV/AIDS is the primary diagnosis?

Thank you for your time and considerations Mr. Chambers.

Response from Mr. Chambers

The main part of that provision is quoted below: "Screen out cases involving HIV infection (not age 18 redetermination case), that are selected for CDR only if the initial decision was made in 1991 or later. If the initial decision was made before 1991, the CDR should be completed." If the initial decision was made before 1991, the CDR should be completed." This is saying that HIV claims should be "screened out" i.e. taken out of the CDR process as long as they were approved in 1991 or later.

I have no doubt that CDRs are requested more than they should be, and I have heard of the SSA toll-free number telling people that "since you already have the form, fill it out." But, according to their rules, that is not right.

This came up in a recent discussion with other benefit counselors and our experience has generally been once we make SSA known of that provision, they stop the process and you don't have to return the form. I admit sometimes that works best by taking the form and a copy of the POMS provision (DI28003.005C) to the local district office.

I hope that helps clarify and answer your questions. Jacques



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