TN 23 (09-20)
Use the following guidelines to provide the minimum content in a CE report for a child
disability case. Each Disability Determination Service (DDS) will notify medical sources
of any additional requirements.
The CE report content guidelines in this section are in addition to the general pediatric
CE report content guidelines in DI 22510.035. For additional CE policy in a child’s case, also see DI 25205.015.
Use the specific requirements below to complete the CE report for a hematological
The CE provider will describe and discuss, as appropriate:
Weight loss or gain;
Frequency of hospitalizations;
Frequency of red blood cell (RBC) or other blood component transfusions or infusions.
Any apparent abnormalities such as enlarged lymph nodes, edema, fatigue level, abnormal
bruising, pallor, scleral icterus, and jaundice;
Evidence of bleeding – ecchymoses, petechiae, and hemarthrosis;
Liver and spleen size; and
Abnormal neurological findings.