Effective Dates: 05/04/2022 - Present Previous | Next

TN 9 (05-22)

DI 28040.005 Referral of Medical Improvement Not Expected (MINE) or MINE-Equivalent Cases from the Field Office (FO) to the Disability Determination Services (DDS)

A. Overview of FO MINE or MINE-equivalent continuing disability review (CDR) referral procedures

The FO will determine whether MINE or MINE-equivalent procedures apply. If MINE or MINE-equivalent processing is appropriate, the FO does not need to conduct the SSA-454-BK (Continuing Disability Review Report) interview.

NOTE: Once an SSA-454-BK interview has been initiated, the MINE or MINE-equivalent procedures are no longer applicable, and the interview must be completed.

1. FO review of the case

Before determining whether MINE or MINE-equivalent processing is appropriate, the FO will:

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    Determine that no “screen out” conditions apply. The FO will stop the CDR if the case meets one or more "screen out" criteria.

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    Review the folder to determine that the comparison point decision (CPD) and medical evidence are in the folder.

NOTE: The screen-out instructions in DI 28003.005 apply to all cases, including MINE or MINE-equivalent cases.

Once the FO determines that the case cannot be screened-out, the FO then determines whether the case should be referred to the DDS as a MINE or MINE-equivalent case.

2. FO identifies a MINE or MINE-equivalent case

In addition to cases with a scheduled 5 to 7-year diary, the FO may consider cases previously assigned medical improvement expected (MIE) or medical improvement possible (MIP) medical reexamination diaries as "MINE or MINE-equivalent" cases for purposes of FO and DDS CDR processing. For more information on these FO considerations, see DI 13005.022.

The FO proceeds as follows upon identifying a MINE or MINE-equivalent case:

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    Do not send the notice of CDR or request completion of the SSA-454-BK.

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    Prepare an SSA-5002 (Report of Contact) to the DDS explaining the basis for the FO’s conclusion that the DDS should process the case under DI 28040.000 MINE or MINE-equivalent procedures. Ensure the SSA-5002 is associated with the folder

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    Include a reference to the SSA-5002 on the “Alerts/Messages” tab in the electronic folder, or on the cover or route sheet for paper folders.

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    Transfer the fully electronic CDR case in EDCS, or mail the paper folder to the servicing DDS.

B. DDS review of cases to identify screen out conditions

It is important that the DDS understands the criteria the FO follows to decide that MINE or MINE-equivalent procedures apply. Upon receipt of the case, the DDS conducts a screening similar to the FO, and, as appropriate, the CDR is processed or stopped. For additional information on the DDS screening, see DI 28003.005.

If the DDS determines the case is not a MINE or MINE equivalent, the DDS refers the case back to the FO for regular CDR development (a full SSA-454-BK interview or other development).

C. References

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    DI 13005.020 Field Office Actions for Processing and Screening Continuing Disability Review (CDR) Folders and Alerts

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    DI 13005.022 Field Office (FO) Overview of the Continuing Disability Review (CDR) Process for Medical Improvement Not Expected (MINE) or MINE-Equivalent cases

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    DI 13005.105 Field Office Overview of the Disability Determination Services (DDS) Procedures for Medical Improvement Not Expected (MINE) or MINE-Equivalent Cases.

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    DI 28001.003 An Overview of Processing Continuing Disability Review (CDR) Mailer Forms SSA-455 and SSA-455-OCR-SM

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    DI 28040.215 Full Continuing Disability Review (CDR) Required in Medical Improvement Not Expected (MINE) or MINE-Equivalent Cases

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    DI 32001.015 Disability Determination Services Systems Input and Clearance of Claims

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    DI 32005.020 Disability Determination Services “No Determination” Routing – Paper Case Only

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    DI 32010.005 Continuing Disability Review (CDR) 'Quality Assurance (QA) Review Cases

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    DI 80630.020 eView

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    DI 81020.205 Receipting an Electronic Continuing Disability Review (eCDR)

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    DI 81020.220 Electronic Continuing Disability Review (eCDR) Development

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0428040005
DI 28040.005 - Referral of Medical Improvement Not Expected (MINE) or MINE-Equivalent Cases from the Field Office (FO) to the Disability Determination Services (DDS) - 05/04/2022
Batch run: 05/04/2022
Rev:05/04/2022