Generally, the CDR begins with the FO contacting the disabled individual/payee via
mail to complete all the necessary CDR forms.
An optional CDR procedure is applicable only in potential suicide/homicide cases.
In those cases, the FO may decide that contact should be made with the medical source
before the FO interview. This contact determines if the source can furnish information
on how the individual may react to the CDR. The regional policy will establish whether
this contact is made by the FO or a DDS physician. The FO forwards the folder to the
The name of the last known medical source is in the folder;
After a review of the evidence, the FO decides to follow the optional procedure; and
Regional policy requires the contact made by the DDS physician.
The DDS's inquiry to the medical source should be clear and concise, similar to the
example below, and released with the form SSA-1994 (Cover Sheet Confident Medical
“Our records show that you were the medical source for (Beneficiary’s Name) in (date).
(Beneficiary’s Name) case is scheduled for a continuing disability review. Because
of the individual's past medical history, if you continue to treat the individual,
we need your assessment as to what impact the initial interview and subsequent contacts
by SSA or State agency employees might have on (Beneficiary’s Name) mental status
or suicidal/homicidal potential. Please respond as soon as possible.”
The DDS checks the second block on Form SSA-1994 (Cover Sheet Confident Medical Info)
and follow up with the medical source if there is no response within 10 days. During
any telephone contact with the medical source, the DDS must emphasize that the inquiry
is due to our concern for the individual's health and well- being.
If the source states he cannot make this judgment, the DDS returns the folder to the
FO to proceed with the CDR in the usual manner. If the source says he is no longer
the medical source for the identified individual, the DDS should make one attempt
to contact a family member or community representative identified in the case folder
as having close contact with the individual. The DDS should limit the second effort
to an attempt to identify the individual's current medical source. If identified,
the DDS writes to this physician. Otherwise, no further attempts are made and the
folder is returned to the FO to schedule the face-to-face interview.
If the medical source indicates that the face-to-face interview would have negative
effects on the individual's mental health and/or increase suicide/homicide potential,
the DDS documents the case file, and contacts the regional office for guidance. In
life threatening situations, consideration should be given to deferring the CDR.
The face-to-face interview will be scheduled by the FO and the case processed as usual
under the following circumstances:
The medical source states that there is no current threat of suicide/homicide potential,
The medical source refuses to provide an opinion on the individual's suicide/homicide
The medical source states that the individual is no longer a patient and is not aware
of a current treating source.
NOTE: In all circumstances, the DDS will accurately document the case before returning
the case to the FO.
See DI 55025.010 for medical CDR processing instructions for beneficiaries with Tickets to Work.