TN 20 (09-90)

DI 28055.015 Disabling Impairment Requirement and When to Address the Issue

A. Definition

Disabling impairment - an impairment or combination of impairments which, of itself, is so severe that it meets or equals the Listing of Impairments or which, when considered with the person's vocational factors, would result in a finding that the person continues to be disabled under the medical improvement review standard (DI 28005.001.) were it not for his or her earnings.

B. Policy

1. When DDS Review is Required

The issue of whether a person continues to have a disabling impairment arises when a person is about to or has already completed the TWP. The case must be sent to the DDS to resolve the medical issue if the medical folder review in ODIO/PSC-DRS does not establish the person to be currently disabled according to screening criteria in DI 28055.020.

The medical review is not limited to cases in which the person is in payment status during the EPE. If the person is eligible for any work incentive benefits (e.g, reinstatement if work ends, Medicare), the issue must  be resolved, i.e, the EPE medical review/disabling impairment CDR must be made.

2. Age Screenout Criteria

  • No age screenout criteria apply to the initiation or completion of the review.

  • Applicable age screenout criteria do apply to any subsequent
    matured MIE, MIP, or MINE diary established as a result of a medical continuance decision.

To Link to this section - Use this URL:
DI 28055.015 - Disabling Impairment Requirement and When to Address the Issue - 09/27/1991
Batch run: 04/14/2014