PH reviewers should do the following:

1. 1. 

   Review the reasons the individual is appealing the disability cessation determination. These reasons may appear on the following:

   • •

     SSA-789 (Request for Reconsideration-Disability Cessation Right to Appear),

   • •

     SSA-3441-BK (Disability Report - Appeal), or

   • •

     Other documentation in the case folder.

2. 2. 

   Review the initial case to ensure development and the determination were complete and conform to the Social Security Administration’s (SSA) policy on developing evidence and addressing the individual's alleged impairment(s) and work history.

3. 3. 

   Review any additional information submitted with the request, including the SSA-3441-BK (Disability Report- Appeal).

4. 4. 

   Develop evidence related to new allegations or the individual’s worsening condition(s). For additional information on developing evidence, see DI 22505.006.

5. 5. 

   Send evidence requests to sources that were contacted but did not submit MER at the initial case level, see DI 27001.010.

6. 6. 

   Determine the need for additional medical or vocational information, e.g., medical evidence of record, or consultative examinations (CE). For information on vocational evidence, see DI 22515.001, and for information on CE and medical evidence, see DI 28030.020.

7. 7. 

   Develop additional pertinent evidence including medical sources where the individual received an examination or treatment since the initial determination. For additional information on evaluation, development, and documentation, see DI 28030.020.

8. 8. 

   Resolve all conflicts and discrepancies.

9. 9. 

   Prepare the case for medical consultant (MC) or psychological consultant (PC) review and completion of medical assessment forms. The MC or PC must sign the form to attest that the MC or PC is responsible for its content, see DI 24501.001. For additional information on preparation of the assessment forms, see DI 29025.001.

10. 10. 

    For claims with a filing date on or after March 27, 2017 ensure that the assessment articulates consideration of prior medical administrative findings as in DI 24503.005B.6. For a reconsideration of a CDR, these are the MC/PC findings from the CDR cessation determination under appeal. To determine filing date for CDRs and appeals, see DI 24503.050D.7.

When the DDS identifies the individual as working and the work has not been addressed:

• •

  Send an assistance request (AR) to the field office (FO) requesting substantial gainful activity (SGA) development. The DDS may continue evidence development; however, the DDS adjudicator cannot make a favorable determination until the work issue is resolved.

• •

  If the DDS evidence development is complete and the evidence does not support a fully favorable determination, the DDS does not hold the case until FO completes the work development. The DDS forwards the case to the DHU following instructions in DI 29025.001.

If the evidence supports a fully favorable determination, do not send the case to the DHU. The DDS adjudicator will:

1. Prepare an SSA-832, SSA-833 (Cessation or Continuance of Disability or Blindness Determination and Transmittal) or SSA-831 (Disability Determination and Transmittal). On the SSA-832 or SSA-833, be sure to check item 8, block ‘B’ of the form(s). For additional information on completing the forms, see DI 28084.000, DI 27015.001, and DI 27530.000.

2. Prepare the Notice of Favorable Determination as appropriate:

· SSA-L1412-U2 (Retirement, Survivors, and Disability Insurance Notice of Reconsideration) - for a fully favorable determination before a disability hearing

· SSA-L1414-U2 (Retirement, Survivors, and Disability Insurance Notice of Reconsideration) - for a fully favorable determination after a disability hearing followed by additional development

· SSA L1438-U2 (SSI Notice of Reconsideration) - for a fully favorable determination after a disability hearing followed by additional development

· SSA L1439-U2 (SSI Notice of Reconsideration) - for a fully favorable determination before a disability hearing

3. Route all fully favorable cases to the servicing FO. See instructions in DI 32010.060 through DI 32010.075 and DI 81020.255.

If the evidence does not support a fully favorable determination, follow the guidelines in DI 29025.001.

• •

  DI 10005.010 Field Office (FO) and Disability Determination Services (DDS) Exchange of Information and Coordination of Actions

• •

  DI 10501.025 Clearly Not SGA