A rationale is required in all CDR determinations, whether the determination is a
continuance or cessation.
The technical rationale must contain six elements:
Citation of the evidence sources;
Basis for most recent favorable medical determination (comparison point decision (CPD))
and the reason for current medical review;
Summary of individual's reason(s) that they are still disabled;
Statement regarding nonmedical issues (e.g., substantial gainful activity (SGA), work
activity, vocational rehabilitation involvement (Section 301 cases), extended period
of eligibility (EPE) cases);
Discussion of the findings produced by the CDR evaluation process; and
Basis for the disability decision, the reason the individual's disability continues
(e.g., meets a listing)), or has ceased (e.g., medical improvement related to the
ability to work has occurred and the individual has the ability to perform SGA).
The rationale will include an accurate discussion of the medical findings. To ensure
clarity and conciseness, avoid using highly technical medical terminology unless rephrasing
would be misleading or would result in an incorrect medical conclusion.
It is appropriate to use accepted medical abbreviations such as FEV1 for "forced expiratory
volume in 1 second," ECG for "electrocardiogram," and terms common to the medical
improvement review standard (MIRS) and the CDR process, e.g., MI (medical improvement),
comparison point decision (CPD), and SGA (substantial gainful activity). However,
avoid excessive use of acronyms and abbreviations.