The disability examiner (DE) must consider vocational factors in Title II and adult Title XVI cases when a continuing disability issue cannot be resolved on medical factors alone. The guides for developing vocational information in initial cases apply to continuing disability review (CDR) cases. DEs should develop both education and training acquired after disability onset, as they may be relevant to the determination.

In certain cases:

• •

  A return to work, and substantial gainful activity, does not provide a basis for cessation in Title II cases.

• •

  A continuance or cessation determination cannot be made on medical grounds alone (including consideration of medical improvement).

In these cases it is necessary to determine whether individuals can perform past relevant work (PRW) and, if not, what other work they can do that exists in significant numbers in the national economy.

Many cases allowed based on medical considerations alone often show minimal vocational development. Therefore, it may be necessary to obtain a full description of the individual's work history for the 5 years prior to the date of CDR adjudication. If all of the individual’s PRW is either outside the 5-year relevant period or was performed during the time the individual was previously found disabled, it is not necessary to develop any work history.

Work performed during a period of disability cannot be considered PRW at steps 7 and 8 of the CDR sequential evaluation process, see DI 25005.015F and DI 28005.015A.7.

Vocational therapy is an exception to the medical improvement review standard (MIRS), see DI 28020.150. Consider whether additional education or training received since the comparison point decision (CPD) falls under the vocational therapy exception. Vocational development must be complete enough to determine whether the education or training focused on a specific type of job(s).

• •

  DI 25005.005 Expedited Vocational Assessment at Steps 4 and 5 of Sequential Evaluation

• •

  DI 25010.001 Medical-Vocational Profiles

• •

  DI 28020.100 Group I Exception - Advances in Medical or Vocational Therapy or Technology

• •

  DI 28020.150 Group I Exception - Vocational Therapy