TN 5 (06-15)

DI 28005.005 The Continuing Disability Review (CDR) Evaluation Process for Title II and Adult Title XVI Individuals

A. Introduction to the CDR evaluation process

Regulations require us to use an 8-step evaluation process for CDRs. For additional information on this process, see DI 28005.015. Do not use the 5-step initial claims sequential evaluation process discussed in DI 22001.001.

When processing CDRs for adults who were originally allowed as children and who attained age 18 before August 22, 1996, refer to DI 28005.016 and DI 28005.017.

B. Basic CDR evaluation

1. Development of medical evidence

Follow the development guides in DI 28030.020. Do not focus development on a particular impairment(s).

2. The CDR determination

Follow the CDR evaluation process in the order shown, in nearly every case. However, use a flexible approach as a way to facilitate appropriate continuances.

If the Disability Determination Services (DDS) receives evidence that clearly establishes continuing disability, stop development and process a continuance. Skip evaluation process steps as necessary to process a continuance, but do not skip steps in a cessation. Examiners must develop for all impairments and vocational issues prior to making a cessation determination (except for Group II exceptions).

Do not skip any step that could affect outcome, and do not use this flexibility as a way to routinely consider steps out of order.

3. After the determination

When handling any additional evidence (trailer material, or “trailer mail”) the DDS receives after processing the determination, follow DI 22520.001.

C. Skipping CDR evaluation steps

1. Skipping Medical improvement (MI), MI related to ability to work, or exceptions steps

If the DDS receives evidence that does not resolve issues of MI, MI related to ability to work, or exceptions to MI (CDR sequential evaluation steps 3 through 5), but a residual functional capacity (RFC) assessment clearly shows the individual cannot do past relevant work or other work, continue benefits on that basis. The steps not considered do not affect the outcome.

2. Skipping the “meets or equals” step

If the DDS receives evidence that does not show whether an additional impairment(s) meets or equals the listing requirements, but clearly shows no MI related to ability to work and no exception to MI, continue benefits on that basis. The step skipped does not affect the outcome.

D. When not to skip steps

If the DDS receives evidence that shows MI related to ability to work and shows that the individual cannot do other work, do not skip the past relevant work step. Doing so could affect the CDR outcome. Obtain any additional evidence neede