TN 15 (12-04)

DI 26525.030 MIE Examples

A. Introduction

DI 26525.030C. includes examples of impairments and their characteristics, which may warrant a MIE diary when:

  • one or more of the MIE criteria in DI 26525.025B. is met, and

  • MIRS criteria will probably be met by the proposed diary date.

B. Procedure

1. Judgment required

Use sound adjudicative judgment in setting the MIE diary.

  • Do not infer that the conditions in DI 26525.030C. are all inclusive.

  • Do not set a MIE diary only because an impairment is listed in DI 26525.030C.

2. Case evaluation

Consider all the case facts in determining whether to set a MIE diary (e.g., the presence of other chronic or progressive impairments, adverse vocational factors, and active participation in a therapeutic or treatment regime).

  • For adults, set the MIE diary only when there is good reason to expect cessation under the MIRS (see DI 28010.000 for MIRS guidelines).

  • For children, set the MIE diary with greater flexibility, since children may have a greater potential for improvement than do adults.

C. Examples

The following examples describe case facts, which may warrant a MIE diary.

NOTE: Since the appropriate reason code depends on the individual case facts, there are no reason codes provided in the examples.

1. Adults and children

The following examples apply to adults and children.

IMPAIRMENT

LISTING

CONDITION(S)

ACUTE LEUKEMIA OR ACCELERATED OR BLAST PHASE OF CHRONIC MYELOGENOUS LEUKEMIA (CML)

13.06A

13.06B1

113.06A

113.06B1

Meets or equals – diary no earlier than 24 months from the date of diagnosis or relapse, or 12 months from the date of transplantation, whichever is later.

ALLOGENEIC BONE MARROW OR STEM CELL TRANSPLANTATION

13.28A

Meets or equals – diary no earlier than 12 months from the date of transplantation.

HEMATOLOGICAL DISORDER TREATED WITH BONE MARROW OR STEM CELL TRANSPLANTATION

7.17

107.17

Meets or equals - diary no earlier than 12 months from the month of transplantation, unless an earlier onset date is appropriate and supported by the evidence in the case record.

AUTOLOGOUS BONE MARROW OR STEM CELL TRANSPLANTATION

13.28B

Meets or equals – diary no earlier than 12 months from the date of the first treatment under the treatment plan that includes transplantation.

BACK CONDITION

 

Chronic sprains and strains when:

  • medical onset is within 6 months of the current determination, and

  • severe, irreversible residuals are not confirmed, and the individual is undergoing physical or nonsurgical therapy, or

Back conditions of any medical onset:

  • in the post-surgical convalescent period, or

  • for which surgery is scheduled within 3 months.

CENTRAL NERVOUS SYSTEM TRAUMA

 

When medical onset is within 6 months of the current determination, and the evidence does not permit a reasonable medical judgment regarding an expected permanent level of functioning.

CHRONIC LIVER DISEASE

5.05A, 105.05A

Meets or equals - diary no earlier than 1 year from the date of the last documented transfusion (see DI 26525.015A.. when the initial allowance was before December 18, 2007).

CHRONIC PHASE OF CML WITH BONE MARROW OR STEM CELL TRANSPLANTATION

13.06B2a

113.06B2a

Meets or equals – diary no earlier than 12 months from the date of transplantation.

EPILEPSY

11.02

11.03

111.02

111.03

Meets or equals - a form which is likely to be controlled with a recent change in medication (i.e., a change in medication type or dosage level or a surgical procedure is planned).

FRACTURES

 

When severe, irreversible, disabling functional limitations are not expected after healing, or

In the post-surgical convalescent period, or for which surgery is planned within 3 months of adjudication.

NOTE: Unhealed fractures and dislocations will usually receive a MIE diary.

HEARING LOSS TREATED WITH COCHLEAR IMPLANTATION

2.11A

Meets or equals – medical review will be required 1 year following the date of implantation.

IMMUNE DEFICIENCY DISORDERS, EXCLUDING HIV INFECTION, WITH STEM CELL TRANSPLANTATION

14.07B

114.07B

Meets or equals - diary no earlier than 12 months from the date of transplantation.

INFECTIONS

 

E.G., tuberculosis, mycosis, leprosy, osteomyelitis - without severe, irreversible organ or structural damages and for which the claimant is undergoing a treatment that should resolves or improves the condition. Exclude symptomatic human immunodeficiency virus (HIV) infection and permanent residuals of polio cases.

KIDNEY TRANSPLANTATION

6.04

106.04

Meets - diary for no earlier than 12 months from the month of transplantation surgery.

LIVER TRANSPLANTATION

5.09

105.09

Meets or equals - medical review will be required 12 months following the month of the liver transplantation.

LUNG TRANSPLANTATION

3.11 and 103.11

Meets or equals - medical review will be required 3 years following the month of the lung transplantation.

LYMPHOMA WITH BONE MARROW OR STEM CELL TRANSPLANTATION

13.05C

113.05C

Meets or equals – diary no earlier than 12 months from the date of transplantation.

DEPRESSIVE, BIPOLAR, AND RELATED DISORDERS

12.04

112.04

Meets, equals, medical-vocational allowances when initial medical onset is within 12 months of the determination.

MULTIPLE MYELOMA WITH BONE MARROW OR STEM CELL TRANSPLANTATION

13.07B

Meets or equals – diary no earlier than 12 months from the date of transplantation

NEOPLASMS

 

When the individual:

  • meets or equals a cancer listing (13.00 or 113.00) other than 13.02E, 13.05C, 13.06A, 13.06B1, 13.06B2, 13.07B, 13.11D, 13.28, 113.03, 113.05C, 113.06A, 113.06B1, 113.06B2a, and

  • has been in a period of remission, which has already lasted 6 months or longer.

NOTE: See DI 26525.010 for additional guidance in the diary of cases involving cancer.

NEUROCOGNITIVE DISORDERS

12.02

112.02

Meets, equals, medical-vocational allowances when:

  • due to trauma, toxins, or infections, and

  • the current medical evidence does not permit a reasonable medical judgment regarding the permanent level of functioning.

SKELETAL SYSTEM TUMORS ORIGINATING IN BONE WITH MULTIMODAL ANTINEOPLASTIC THERAPY

13.11D

Meets or equals – diary for 12 months from the date of diagnosis

SOFT TISSUE TUMORS OF THE HEAD AND NECK WITH MULTIMODAL ANTINEOPLASTIC THERAPY

13.02E

Meets or equals – diary no earlier than 18 months from the date of diagnosis

2. Children only

The following examples apply to children only.

IMPAIRMENT

LISTING

CONDITION(S)

ANXIETY AND OBSESSIVE-COMPULSIVE DISORDERS

112.06

Meets or equals.

ATTENTION DEFICIT HYPERACTIVITY DISORDER

112.11

Meets or equals.

ENDOCRINE DISORDERS

109.08

Meets or equals - MIP diary if more than 3 years between adjudication and attainment of age 6 and MIE diary if less than 3 years between adjudication and attainment of age 6.

LOW BIRTH WEIGHT and FAILURE TO THRIVE

100.00

Meets or equals.

HEARING LOSS TREATED WITH COCHLEAR IMPLANTATION

102.11A

Meets or equals – medical review will be required 1 year following the date of implantation or age 5, whichever is later.

MALIGNANT SOLID TUMORS

113.03

Meets or equals - diary no earlier than 2 years from the date of diagnosis or recurrence of active disease, whichever is later.

PERSONALITY DISORDERS

112.08

Meets or equals, especially in very young children.

SOMATIC SYMPTOM AND RELATED DISORDERS

112.07

Meets or equals.

EATING DISORDERS

112.13

Meets or equals.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0426525030
DI 26525.030 - MIE Examples - 01/27/2017
Batch run: 01/27/2017