When an individual is known to a State, or other accredited, VR agency at the time
of the CDR, contact the agency for a full report about the individual, including medical
reports relating to the individual’s current medical status and other data pertinent
to a determination. If data previously obtained from the agency (e.g., in connection
with the initial adjudication) indicated the case was closed and the individual states
the case has not been reopened, do not make further contact with the VR agency. Evidence
obtained from the individual’s medical sources, together with evidence available through
the VR agency, may be sufficient to permit a sound determination as to whether disability
continues. For procedures on VR involvement “301” cases, refer to DI 28001.040.
NOTE: If an individual is actively involved in VR type services, clarify through the FO
whether a “ticket to work” is in use. If so, this may negate the current CDR action.
Do not make a clear-cut cessation (cessation without current medical development,
on the basis that medical recovery is indicated by return to full-time work without
medical restrictions) when VR services are continuing because participation in VR
constitutes “evidence to the contrary.” When current medical evidence establishes
medical improvement and a present capacity for doing substantial gainful activity,
find that disability ceases despite the fact that the individual may be an active
participant in a State-sponsored VR program.
EXAMPLE: The individual was found disabled based on multiple fractures and complications that
indicated the disabling condition would meet the 12-month duration requirement. When
the medical diary came due, the CDR established that the individual was enrolled in
a two-year bookkeeping course under a State-sponsored VR program. The DDS obtained
evidence, from the VR agency, that stated one year of schooling remained. The DDS
then obtained current medical evidence that clearly established medical recovery.
Therefore, the DDS made a cessation determination.