TN 2 (06-15)
DI 28010.020 Nature and Quantity of Change Needed to Find Medical Improvement (MI)
20 CFR 416.994a(c)
A. Minor changes
1. Minor changes that do not represent MI
Although the decrease in severity may be of any quantity or degree, we will disregard minor changes in an individual’s symptoms, signs, and laboratory findings that obviously do not represent medical improvement and could not result in a finding that disability has ended. This guidance applies to adults as well as to children.
2. Example of minor change (obesity with weight loss)
An obese individual with a back problem is 72 inches tall and weighed 338 pounds at the time of the comparison point decision (CPD) (Listing 9.09A). He now weighs 334 pounds and other findings have not changed. Since the weight loss obviously does not affect functioning, find no MI and do not consider the issue of relating MI to ability to work.
B. Test error
1. Disregard changes within standard error of measurement (SEM)
The adjudicative team will disregard changes within the SEM of the particular test involved.
If questions arise, a Disability Determination Service (DDS) medical or psychological consultant with the appropriate specialty should analyze the SEM of the test or equipment used.
If necessary, the DDS will re-contact the source(s) of the evidence for clarification as needed.
2. Intelligence quotient (IQ) scores
For procedures on test error of IQ scores, see DI 24515.055 and DI 28010.150.