TN 3 (09-21)

DI 28090.001 Cessation or Continuance of Disability or Blindness Determination and Transmittal (SSA-832/833) Rationale

A. Technical Rationale

Adjudicators must prepare a rationale of the evaluation process used in adjudicating continuing disability review (CDR) cases whether the determination is a continuance or cessation. The rationale documents application of the medical improvement review standard (MIRS) required on all CDRs. When disability continues, the rationale establishes a basis for comparison in the subsequent CDR.

A technical rationale explains the complete documentation of the evaluation process used in CDR case adjudication. Previously, Disability Determinations Services (DDS) has used terms such as "technical," "supplemental," "modified ," and "summary" to describe types of rationales. Using these different terms sometimes caused confusion. Therefore, to avoid unnecessary confusion and with the implementation of the Disability Case Processing System (DCPS), the Social Security Administration(SSA) decided that adjudicators use only "technical" to describe a rationale. The technical rationale should include all aspects of the CDR case, including the step-by-step evaluation process.

The technical rationale for CDR determinations must:

  • Clearly reflect all applicable steps in the CDR evaluation process;

  • Present an explicit explanation of the decision, including the documentation used to support the decision, and

  • Incorporate the legislative requirements.

 

B. Content of rationales

The CDR rationale discusses the following, as needed:

  1. 1. 

    Evidence sources;

  2. 2. 

    Basis for the comparison point decision (CPD) and reason for current medical review;

  3. 3. 

    Individual's reason(s) for continued entitlement and eligibility (impairment allegation(s));

  4. 4. 

    Nonmedical issues;

  5. 5. 

    Medical findings;

  6. 6. 

    Meets or equals determinations;

  7. 7. 

    Medical improvement (MI);

  8. 8. 

    Whether medical improvement is related to ability to work;

  9. 9. 

    Exceptions;

  10. 10. 

    Non-severe impairment(s);

  11. 11. 

    Ability to do substantial gainful activity (SGA);

  12. 12. 

    Residual functional capacity (RFC);

  13. 13. 

    Ability to perform past relevant work (PRW);

  14. 14. 

    Ability to perform other work;

  15. 15. 

    Basis for the disability determination; and

  16. 16. 

    Special situations.

The DDS will discuss the rationale content for these 16 topics in DI 28090.015 through DI 28090.200.

NOTE: Some DDSs are still using the Electronic Claims Analysis Tool (eCAT) for documenting electronic CDR (eCDR) case analysis. However, DDSs are moving to the Disability Case Processing System (DCPS) to document each step of the adjudicative evaluation process. DCPS provides a complete claim explanation in one document, the Disability Determination Explanation (DDE), which is imaged to the electronic folder case documents (A. Payment Documents/Decisions (Yellow Front)). Adjudicators will follow the DCPS instructions and their site’s business process to document information. For additional guidance on eCDR rationales, see DI 81020.230.

 


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0428090001
DI 28090.001 - Cessation or Continuance of Disability or Blindness Determination and Transmittal (SSA-832/833) Rationale - 01/23/1990
Batch run: 09/29/2021
Rev:01/23/1990