TN 4 (02-11)
DI 24535.020 Evaluating Continuing Disability Review (CDR) Claims for Beneficiaries with Cochlear Implants
20 CFR 404.1594, 416.994, and 416.994a
We evaluate hearing loss for people with cochlear implants under listings 2.11 and 102.11, which went into effect on August 2, 2010. Under listing 2.11, we consider an adult disabled for 1 year after the initial cochlear implantation. Under listing 102.11, we consider children disabled until the attainment of age 5 or for 1 year after the initial cochlear implantation, whichever is later. If more than 1 year has passed since the initial implantation or upon attainment of age 5, we require a word recognition score of 60 percent or less determined using the Hearing in Noise Test (HINT)
Before August 2, 2010, we did not have listings specifically for people with cochlear implants. Under our prior policy interpretation, we used the results of pre-implant hearing testing to evaluate hearing loss in people with cochlear implants for determining both initial and continuing disability.
B. How we evaluate the hearing loss of beneficiaries with cochlear implants
When evaluating the hearing loss of beneficiaries with cochlear implants the approach on CDR depends
on the date of the comparison point decision (CPD), and
when the beneficiary received the cochlear implant.
1. CPD before August 2, 2010, beneficiary had a cochlear implant(s) at the time of CPD, and the CPD was based on the results of pre-implant hearing testing
Use the results of the pre-implant hearing testing and find that no medical improvement (MI) occurred since CPD. Continue benefits on that basis if no exception to medical improvement (MI) applies.
2. All other cases of hearing loss for beneficiaries who currently have a cochlear implant(s)
Apply the appropriate medical improvement review standard for adults or SSI children to determine whether the person's hearing impairment has improved since the CPD, regardless of whether we made the CPD before August 2, 2010, or on or after August 2, 2010.
NOTE: In all cases, do not apply the Group I exception to medical improvement for advances in medical technology in any adult CDR. (See, Advances in Medical or Vocational Therapy or Technology DI 28020.100)
DI 28005.005 The CDR Evaluation Process - Title II and Adult Title XVI Beneficiary - General
DI 28005.020 The CDR Evaluation Process - Title XVI Child – General
DI 28010.015 Comparison of Symptoms, Signs, and Laboratory Findings
DI 34001.012 Special Senses and Speech - Adult
DI 34005.102 Special Senses and Speech - Child