MI is any decrease in the medical severity of the impairment(s) that was present at
the time of the most favorable medical determination that the individual was disabled
or continued to be disabled as evidenced by changes in symptoms, signs, or laboratory
The adjudicator will compare the severity of only the impairment(s) considered at the comparison point decision (CPD) with the current
severity of the same impairment(s) to determine if there has been any MI. The adjudicator
will document the conclusion in the rationale. For a rationale example, see DI 28090.300G, DI 28090.300M, or DI 28090.300P. The adjudicator will consider any additional or new impairment(s) at a later step
in the continuing disability review (CDR) evaluation process.
The adjudicator will discuss MI or the exceptions to MI in the rationale unless evidence
received in a particular case clearly establishes continuing disability, without following
every step in the CDR evaluation process. For more information on this flexible approach,
see DI 28005.005B.2.
If the adjudicator did not formally consider the medical improvement review standard
(MIRS) because benefits are continued based on consideration of residual functional
capacity and vocational factors, the rationale must include an explanation why MI
and the exceptions to MI have not been formally considered. No statement regarding
MI and the exceptions is necessary if a listing is met or equaled.