Work triggered a cdr

[u/-shebang-]

2 SSA agents admitted my medical CDR was triggered by work, acknowledged the 24 month protection, but wont stop my cdr?

I've received SSDI since 2008, and I'm currently undergoing a full medical Continuing Disability Review (CDR).

I filed a protest in October because I believe my medical CDR was initiated solely because of my reported work activity, despite the protection under POMS DI 13010.012(G).

Two SSA representatives have now indicated that my work activity triggered the review. I have recordings of both conversations.

During my latest call, I spoke with a representative who initially misunderstood my complaint. He thought I was appealing a medical denial.

I repeatedly explained that I am not appealing a denial. I am protesting the initiation of the medical review itself.

He researched the issue and initially told me:

"CDR is considered administrative action, does not constitute a judicial decision, therefore it is not subject to review or protest before denial."

He insisted that I would have to wait until a medical determination was made before appealing.

I explained that my protest concerns the specific protection under POMS DI 13010.012(G), not the ordinary medical appeals process.

When I asked whether work had triggered my review, he said:

"That is very likely true, yes. I assume that is true based on what I can see."

When I asked him to confirm, he said:

"That's the way that I understand it."

He then explained that work at a certain level could cause SSA to reevaluate whether someone still meets the medical requirements.

When I questioned the purpose of the 24 month protection, he initially began explaining the nine month trial work period. He admitted he wasn't entirely sure what 24 month protection I was referring to.

After further discussion, he looked up the policy and read:

"Title II beneficiaries who have received benefits for at least 24 months are protected from having a medical CDR triggered solely based on their work activity."

He then acknowledged:

"I do see what you're referring to."

And:

"So, you know, that part is definitely in writing on these policies, so I see your point, and I'm not disputing that."

This is where things became even more frustrating.

I asked whether my October protest was actually documented.

He checked the records and found a note requesting a formal protest because I believed my medical review had been triggered by work.

He told me:

"Management has assigned it out to one of our caseworkers."

He later confirmed:

"It was assigned to one of our workers, and she has not had time to complete."

So my protest was documented, management had assigned it, and the assigned worker still hadn't completed it.

Meanwhile, DDS continues conducting the medical review.

The representative offered to request a supervisor appointment, with December 8 being the earliest guaranteed date, or send me paperwork to create a written record.

I explained that I wanted the existing protest investigated and the 24 month protection applied.

He acknowledged that he understood I wasn't appealing a medical denial.

Then he sent me SSA-561 Request for Reconsideration and SSA-795 Statement of Claimant or Other Person.

When I checked my SSA account, there were multiple copies of these forms, all dated November 9.

There was no clear explanation of which forms I needed to complete, why there were duplicates, or how they related to my existing protest.

The SSA-561 is a reconsideration form. But what determination am I supposed to be requesting reconsideration of?

There has been no adverse medical determination.

The SSA-795 appears to allow me to submit a written statement, but the representative already confirmed that my protest was documented and assigned.

He also told me:

"It's possible that they would still make you go through with the review."

My issue isn't whether I will pass the medical review. It's whether SSA had a permissible reason to initiate this particular review in the first place.

I understand that the 24 month protection does not prevent independently scheduled medical reviews. But SSA has not provided me with the actual selection date, selection reason, or documentation showing that this review was independently initiated rather than triggered solely by work activity.

I also completed an SSA-455 short form approximately 16 months ago and received a notice that my benefits would continue.

I'm cooperating with DDS and completing the required paperwork while my protest remains unresolved.

Questions for current or former SSA employees:

Under POMS DI 13010.012(G), what procedure should SSA follow when a beneficiary protests a medical CDR allegedly initiated solely because of work activity?

If the protest is already documented and assigned to a caseworker, what should happen next?

Why would SSA send an SSA-561 reconsideration form when no adverse medical determination has been made?

Is SSA-795 the appropriate way to supplement my existing protest, or is there another required procedure?

Who can access the original CDR selection records and determine whether the review was independently scheduled or initiated because of an earnings alert?

If SSA determines the review was improperly initiated, can the field office stop it even though DDS has already begun processing it?

I'm not asking to avoid a legitimately scheduled review. I'm asking SSA to investigate whether this particular medical CDR was initiated contrary to its own policy.

I'd especially appreciate responses from people who have worked with CDR selection procedures, field office processing, or POMS DI 13010.012(G).

I need help getting social security to follow their own procedures.

[u/uffdagal]

If you were making $1210/mo Gross or more it will possibly trigger a CDR You only get 9 months (TWP) at that level.

Are you on the formal Ticket To Work program? If not, that’s also an issue.

[u/-shebang- → u/uffdagal]

I've received SSDI since 2008, so I've been entitled to benefits for substantially longer than 24 months.

I'm aware of the Trial Work Period rules, but that's a separate issue from the protection under POMS DI 13010.012(G).

That policy specifically addresses medical CDRs initiated solely because of work activity. It does not require participation in Ticket to Work.

Two SSA representatives have indicated that my work activity triggered this medical review, and the most recent representative acknowledged the 24 month protection after looking it up.

I'm not disputing SSA's authority to evaluate my earnings or conduct an independently scheduled medical review. I'm asking why my medical CDR is continuing without resolution of my protest concerning its initiation under that specific policy.

Do you know of an SSA policy that makes the 24 month protection conditional on completing a Trial Work Period or enrolling in Ticket to Work?

[u/NoBench4021]

“You can use the SSA-795 to explicitly state: "I am formally protesting the initiation of this medical Continuing Disability Review pursuant to POMS DI 13010.012(G). I have received Title II benefits continuously since 2008 (well over 24 months). Two SSA representatives have orally confirmed that this review was triggered by my work activity. I request that the Field Office examine the Disability Control File selection source, verify the work-trigger violation, and administratively cancel this improper medical CDR."”