TN 2 (12-14)

DI 13001.010 Component Responsibilities for Continuing Disability Review (CDR) Cases

Successful development of a CDR case requires the coordinated efforts of the various offices involved in the process. More than one component may perform some of the functions. For example, the Office of Disability Operations (ODO) and the Program Service Center-Disability Processing Branch (PSC-DPB) develops work activity directly with an individual in some circumstances, while in other cases, the field offices (FO) develop the work activity. The following list of responsibilities highlights the major areas of each component’s involvement in CDR cases:

A. Field Office (FO)

The FO responsibilities include:

  1. Conduct CDR personal contacts.

  2. Accept voluntary reports of medical recovery.

  3. Determine payment status under Title II and Title XVI.

  4. Develop work activity.

  5. Alert the Disability Determination Services (DDS) of potential Section 301 involvement (DI 14505.001).

  6. Provide advance due process or notice of intended actions.

  7. Prepare and release Title XVI notices.

  8. Suspend and terminate benefits or payments.

  9. Maintain and update the Disability Control File (DCF).

  10. Identify situations that require a CDR, because of section 1619 eligibility and, in some cases, issue CDR informational notices (see SI 02302.310).

  11. Coordinate CDRs for 1619 eligible recipients with pending redeterminations.

  12. Issue initial and reconsideration substantial gainful activity (SGA) determinations, in Title II cases.

B. Disability Determination Services (DDS)

The DDS’ responsibility includes:

  1. Develop and adjudicate medical CDRs.

  2. Establish the type and date of medical improvement diaries.

  3. Issue medical determinations and notices.

C. Disability Hearing Unit (DHU)

The DHU’s responsibility includes:

  1. Schedule and hold hearings (unless the beneficiary waived the right to appear).

  2. Prepare decisions and medical determination forms based on evidence in file and findings at the hearing (if held).

  3. Issue decision notices.

D. Office of Disability Operations (ODO)

ODO has jurisdiction over Title II DIB cases when the number holder is under age 53. ODO will:

  1. Review and process Title II CDR Mailer PC review cases.

  2. Initiate medical and work activity CDRs.

  3. Determine payment status under Title II.

  4. Develop work activity.

  5. Establish work activity diaries.

  6. Screen work activity cases for possible medical improvement.

  7. Process Section 301 cases.

  8. Provide advance due process or notice of intended actions.

  9. Issue determination notices.

  10. Suspend and terminate benefits or payments.

  11. Update the Master Beneficiary Record (MBR) and (DCF).

E. Program Service Center- Disability Processing Branch (PSC/DPB)

The DPB responsibilities include:

  1. Has the same responsibilities as DDS examiners (DI 13001.010B. in this section).

  2. Has the same responsibilities as ODO examiners (DI 13001.010D. in this section).

  3. Review PSC jurisdiction cases, e.g., DIB age 53 and over, disabled widow(er) benefits, and childhood disability benefits.

  4. Review and process Title II and Title XVI CDR Mailer Processing Center review cases.

  5. Great Lakes PSC-DPB has jurisdiction of Railroad Retirement Board (RRB) cases, see DI 44001.140.

F. Office of International Operations (OIO)

Has jurisdiction of foreign disability claims. The components within OIO include:

1. International Benefits Office (IBO/FO)

  1. Initiates medical and work activity CDRs

  2. Conducts CDR personal contacts via the Foreign Service Post

  3. Accepts voluntary reports of medical recovery

  4. Determines payment status under Title II and Title XVI

  5. Develops work activity

  6. Provides advance due process or notice of intended actions

  7. Issues initial and reconsideration SGA determinations in Title II