From 02/11/91 until the enactment of Public Law (P.L.104-193) on 08/22/96, the disability evaluation process for Supplemental Security Income (SSI) claimants under the age of 18 required an IFA for claimants whose impairment(s) was severe but did not meet, medically equal, or functionally equal a listed impairment. The IFA determined if the claimant's impairment(s) substantially reduced their ability to function independently, appropriately, and effectively in an age-appropriate manner and was therefore of “comparable severity” to an impairment(s) that would disable an adult.

P.L. 104-193 eliminated the IFA, and mandated disability redeterminations for adults originally allowed as children and who attained age 18 on or after August 22, 1996. However, per DI 28005.016, we will perform a continuing disability review (CDR), not a disability redetermination, for recipients who attained age 18 before August 22, 1996.

When we perform a CDR for one of these recipients, they are subject to the adult medical improvement review standard (MIRS). We must determine if the medical improvement (MI) is related to the ability to work, if the recipient's impairment is found not to meet or equal a current adult listing, and MI is established. If the CPD was not based on meeting or equaling a listing, this finding of fact is based on comparison of the RFC done at the CPD and a current RFC considering only the CPD impairments.

All references to “RFC” in this section are defined as what an individual can still do despite their limitations, in accordance with DI 24510.006B.1. “RFC assessment” refers to the annotation of this function on an SSA approved document. For preparation of the RFC Assessment, see DI 24510.001.

Because recipients for whom CPDs were based on an IFA will not have had an RFC assessment at the CPD, this section addresses how to make a finding of fact at the "MI-related” step of the adult CDR evaluation process.

To make a current decision it may be necessary to update evidence. For development of medical evidence, see DI 28030.020.

Affected recipients will meet the following criteria:

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  The recipient was allowed as a Title XVI child between 02/91 and 08/96; and

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  The allowance was based on an IFA; and

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  The recipient attained age 18 before 08/22/96; and

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  At CDR, the impairment(s) does not meet or equal an adult listing; and

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  There is MI in the impairment(s) that was present at the time of the CPD.

If a functional comparison is required, compare the CPD functioning to current functioning based on CPD impairments to determine whether the MI is related to the ability to work for the previously described adults described.

Prepare a CPD RFC based on an IFA if a CPD RFC assessment was required at the “MI related to the ability to work” step. Because there will be no CPD RFC assessment for adults originally found disabled on the basis of an IFA, it is necessary to prepare a special CPD RFC assessment for purposes of comparison with the MIRS RFC assessment. The CPD RFC assessment is for comparison purposes only and will not change any prior determination.

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  DI 28005.016 The Continuing Disability Review (CDR) Evaluation Process for Title XVI Adults Originally Allowed as Children Who Attained Age 18 before August 22, 1996

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  DI 28015.320 Residual Functional Capacity (RFC) Comparison and Examples of Medical Improvement (MI) “Related” or “Not related” to the Ability to Work