When a CDR is necessary for a U.S. resident forward the folder to the appropriate DO via SSA-5526-U3. Request the DO to obtain an SSA-454-BK and conduct a face-to-face interview. The DO will also obtain the required SSA-827's at the same time and forward the folder to the DDS for medical development and a determination. Upon completion of its action, the DDS will return continuances to INTPSC and cessations to the DO for the appeals period.

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  NOTE: Beneficiaries residing in foreign countries will generally not receive a face-to-face interview. However, when a foreign beneficiary is interviewed in a U.S. district office, a face-to-face interview will be conducted. A foreign beneficiary may visit a U.S. office or frequently, Canadian or Mexican residents will come into a border DO. In these situations, the DO will offer all necessary assistance and conduct the face-to-face interview.

When a CDR is necessary for a resident of a foreign country, development will be initiated through the FSP/VARO. Before the FSP/VARO can begin specific medical development, a prereview notice must be sent to inform the beneficiary that a CDR is being conducted, as follows:

Accordingly prepare an SSA-433-U6/SSA-5526-U3 to the FSP/VARO instructing them to release the appropriate preview notice, an SSA-454-BK, several SSA-827's, and a preaddressed mailing envelope (with the FSP's/VARO’s return address) to the beneficiary. Include a copy of the appropriate preview notice, the SSA-454-BK, and several SSA-827's with your request to the FSP/VARO. Since INTPSC must take immediate action if the beneficiary cannot be located or fails to cooperate, instruct the FSP/VARO to maintain strict controls on the return of the SSA-454-BK. Also, advise the FSP/VARO that it should, upon receipt of the completed SSA-454-BK, solicit a detailed medical report and/ or copies of treatment records, from all foreign sources shown on the SSA-454-BK. Instruct the FSP/VARO that if a domestic source is shown on the SSA-454-BK, they should forward the SSA-827's and a photocopy of the SSA-454-BK to INTPSC as an interim reply. Advise the FSP/VARO to annotate such interim replies “SSA=454-BK returned for INTPSC development of domestic sources. SSA-827's attached. Development of foreign sources incomplete.” Initiate development of any domestic sources per DI 43510.015 upon receipt of the interim reply.

In addition to the above instructions regarding development of foreign medical sources, identify the disabling impairment(s), and, as much as possible, inform the FSP/VARO of the types of objective evidence you will need to document continuing severity. Include a statement that the medical sources who provide evidence will be paid a reasonable fee for the costs of preparing their reports. Advise the FSP/VARO to fully document its efforts to contact the beneficiary and to teletype to INTPSC a detailed history of their efforts, if the beneficiary cannot be located or fails to cooperate. Establish a 120-day diary for return of the completed development.

If review of returned development and/or a teletype message reveals that the FSP/VARO has exhausted all reasonable efforts to locate the beneficiary and /or obtain his cooperation, follow the procedure in DI 40525.001 and DI 40525.005. Since INTPSC functions as the DDS for foreign beneficiaries, prepare an SSA-833-U5 cessatin in medical issue cases. Afford due process per DI 40515.001.

NOTE: Benefit continuation does not apply to whereabouts unknown cases since they are not considered medical cessations.