When the claimant’s work activity since the prior favorable determination or decision
is vocationally relevant, the DDS must consider the basis for the prior favorable
determination or decision as follows:
-
a.
Meets or equals a listing
When the basis of the prior favorable determination or decision was meeting or equaling
a listing, the claimant does not have a changed vocational profile regardless of work
activity. Collateral estoppel applies when the listing has not substantially changed
or become more restrictive in accordance with DI 27515.005B. However, evidence of work activity may indicate medical improvement (MI). When a
CDR is required, see DI 27515.050B.1.
b. Medical-vocational rules
When the basis of the prior favorable determination or decision was medical-vocational
rules and the work activity since the prior determination or decision meets all relevancy
requirements in DI 25005.015, the claimant has a changed vocational profile. Collateral estoppel does not apply
and a new determination is required. In addition, evidence of work activity may indicate
MI. When a CDR is required, see DI 27515.050B.2.
c. CDR continuance
When the most recent favorable determination or decision was a CDR and the work activity
since that determination or decision meets all relevancy requirements in DI 25005.015, the DDS must determine the basis for the CDR continuance:
-
•
When the basis for the CDR continuance was meeting or equaling a listing, see DI 27515.010B2a.
-
•
When the basis for the CDR continuance was medical-vocational rules, see DI 27515.010B2b.
-
•
When the basis for the CDR continuance was no MI, the DDS must continue to review
earlier determinations or decisions to find the most recent favorable determination
or decision based on meeting or equaling a listing or medical-vocational rules and
follow the procedures described above in DI 27515.010B2a or DI 27515.010B2b.
d. Basis unknown
When it is not possible to determine the basis of the prior favorable determination
or decision, collateral estoppel does not apply and a new determination is required.