In an initial enrollment determination, apply the three criteria for determining “currently disabled” as set out in (DI
40510.040A.3.) to the impairments present at the most recent favorable medical determination, and
proceed per steps 1 through 3.
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a.
If the individual can be found currently disabled using these criteria, screen in
for Premium-HI, prepare an SSA-831-U3 permanent allowance (DI 40510.175) and establish a diary for future medical review per (DI 40510.160).
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b.
Route folder to the technician for necessary enrollment action prior to notice preparation.
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c.
Route the folder to the typist for preparation and release of the permanent award
notice per Exhibit 2, (DI 40510.185).
EXCEPTION: Prepare a temporary allowance and interim award notice for any case in which the
claimant alleges a new impairment, and it cannot be established that the previous
impairment is still disabling.
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a.
If the individual cannot be screened in per (DI 40510.155B.1.a.) above, apply the Medical Improvement Review Standard (MIRS) to the evidence currently
in file in accordance with (DI 28010.001).
NOTE: Under the MIRS, the focus of the review is the CPD (DI 28010.105). This may not be the same as the most recent favorable medical determination used
in (DI 40510.150) and (DI 40510.150B.1.) above.
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b.
In the absence of any indication of medical improvement (MI), screen in for Premium-HI.
Prepare an SSA-831-U3 permanent allowance and establish a diary for future medical
review per (DI 40510.160).
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•
Route the folder to the technician to process the enrollment prior to notice preparation.
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•
Request the typist to send the permanent award notice, Exhibit 2, (DI 40510.185).
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a.
If the individual still cannot be screened in, instruct the typist to send an interim
award notice per Exhibit 3, (DI 40510.185).
-
b.
Prepare an SSA-831-U3 interim allowance as required by (DI 40510.175).
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c.
Initiate a CDR on the DCF per CDR001.016 and follow the process outlined in (DI 40510.165).