TN 11 (08-22)

DI 28005.003 When to Complete an Age-18 Redetermination Instead of a Continuing Disability Review (CDR)

A. Background

P.L. 104-193, enacted August 22, 1996, changed the title XVI childhood definition of disability and the sequential evaluation process for children under title XVI. It required a disability redetermination for certain Title XVI childhood cases, for children allowed title XVI disability based on an individualized functional assessment or maladaptive behaviors. The change also requires redeterminations of individuals who were children when found disabled under title XVI and attained age 18 August 22, 1996 or later (see DI 23570.006). The age-18 redetermination is necessary because the title XVI childhood definition of disability does not apply to an adult.

P.L. 105-33, enacted August 5, 1997, modified the disability redetermination provisions to change certain time limitations, so that an age-18 disability redetermination may be initiated after the individual attains age 19, and childhood disability redeterminations may be initiated after August 22, 1996.

References:

DI 11070.001 Public Law (P.L.) 104-193--General

DI 23570.000 Title XVI Childhood and Age 18 Disability Redetermination Cases (Public Law (P.L.) 104-193 as Modified by P.L. 105-33) - DDS

DI 28005.016 The Continuing Disability Review (CDR) Evaluation Process for Title XVI Adults Originally Allowed as Children Who Attained Age 18 before August 22, 1996

DI 28005.017 Preparation of Comparison Point Decision (CPD) Residual Functional Capacity Assessments for Title XVI Adults Found Disabled before Age 18 Based on an Individualized Functional Assessment (IFA)

B. When to perform an age-18 disability redetermination

An age-18 disability redetermination is required for Title XVI recipients receiving disabled child (DC) benefits who are attaining age 18 on August 22, 1996 or later. See DI 23570.006 and DI 23570.010. If an age-18 disability redetermination has already been done, conduct a CDR following the sequential evaluation process in DI 28005.015.

A CDR will be performed for Title XVI adults who were originally allowed as children who attained age 18 before August 22, 1996. See DI 28005.016 and DI 28005.017.

C. How to evaluate age-18 disability redeterminations

The medical improvement review standard (MIRS) does not apply to an age-18 disability redetermination. Age-18 disability redeterminations follow the sequential evaluation process for Title II and adult Title XVI initial claims as outlined in DI 22001.001; however, the substantial gainful activity (SGA) step of the sequential evaluation process does not apply. For additional information about the development and evaluation of age-18 disability redeterminations, see DI 23570.020.


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DI 28005.003 - When to Complete an Age-18 Redetermination Instead of a Continuing Disability Review (CDR) - 08/08/2022
Batch run: 08/08/2022
Rev:08/08/2022