Effective Dates: 10/08/2026 - Present Previous | Next

TN 8 (10-26)

DI 39563.905 Disability Examiner Decisional Authority (DEDA) — Extension to CDR Continuances, Fully Favorable Age 18 Redeterminations, and Expedited Reinstatement (EXR) Cases

CITATIONS:

Social Security Act §221(h)
SSR 17-2p, Titles II and XVI: Evidence Needed by Adjudicators at the Hearings and Appeals Council Levels of the Administrative Review Process to Make Findings About Medical Equivalence

A. Purpose

This section provides temporary instructions for extending Disability Examiner Decisional Authority (DEDA) to certain continuing disability review (CDR) continuances, fully favorable age 18 redeterminations, and expedited reinstatement (EXR) cases. Under this one year temporary initiative, a qualified disability examiner may complete the medical portion of eligible adult CDR continuance, fully favorable age 18 redetermination, and adult EXR cases based on physical impairments alone without medical review by a medical consultant (MC). The disability examiner may consult with an MC at the disability examiner’s discretion. This temporary extension applies for one year from [effective date] through [expiration date]. For the general DEDA policy, including requirements for adjudicating-site participation, MC recruitment, disability examiner qualifications, workload assistance, and SSA-831 completion, see DI 39563.900.

B. Background

DEDA temporarily permits qualified disability examiners to make fully favorable disability determinations in certain adult claims based on physical impairments alone without MC review. The initial DEDA initiative applies to eligible initial adult claims and excludes CDR cases, age 18 redeterminations, and EXR cases. This temporary extension permits qualified disability examiners to use DEDA authority in specified favorable CDR, age 18 redetermination, and EXR cases for a limited period of one year. The statutory requirement to make “every reasonable effort” to obtain MC services continues to apply. Adjudicating sites must meet and document the MC recruitment requirements in DI 39563.900C before using this authority.

C. DEDA-eligible cases under this extension

1. When DEDA applies

A disability examiner who meets the DEDA qualification requirements in DI 39565.900D may complete the medical portion of an eligible CDR continuance, fully favorable age 18 redetermination, or EXR case without an MC when all of the following apply:

  • •

    The adult initial sequential evaluation process (see DI 22001.001), the adult CDR sequential evaluation process (see DI 28005.015), or the EXR medical determination process (see DI 28057.015) applies;

  • •

    The medical assessment is based on physical impairment(s) alone;

  • •

    The evidence supports a favorable determination without a finding of medical equivalence; and

  • •

    No mental impairment was established in the CPD (or any filing prior to the CPD) – see DI 28010.001B for additional information about established impairments.

  • •

    The disability examiner determines that MC review is not needed.

IMPORTANT: If a mental impairment is newly alleged or discovered at CDR, and the evidence supports a favorable determination based only on physical impairment(s), discontinue development of the mental impairment after documenting the favorable determination based on physical impairment(s). See DI 24505.030E.1.

2. CDR continuances

DEDA applies to an adult CDR case when:

  • •

    The criteria in DI 39563.905C.1 in this section applies;

  • •

    The determination is a continuance.

Do not use DEDA to make a cessation determination.

3. Fully favorable age 18 redeterminations

DEDA applies to an age 18 redetermination when:

  • •

    The claimant is found disabled under the adult disability rules;

  • •

    The determination is fully favorable;

  • •

    The medical assessment supports the allowance based on physical impairment(s) alone; and

  • •

    The favorable determination does not require a finding of medical equivalence.

4. EXR cases

DEDA applies to an EXR case when:

  • •

    EXR claimant has a current medical impairment(s) that is the “same or related’ to the impairment(s) that led to the previous entitlement to benefits, using the CPD;

  • •

    The EXR claimant is approved for disability base on application of the medical improvement review standards (MIRS)

  • •

    The favorable determination is based on physical impairment(s) alone; and

  • •

    The favorable determination does not require a finding of medical equivalence.

D. When DEDA does not apply under this extension

Do not use DEDA authority for:

  1. 1. 

    CDR cessation determinations;

  2. 2. 

    Age 18 redeterminations that are a cessation;

  3. 3. 

    EXR cases that do not result in a favorable determination including being denied because the current medical impairment is not the “same or related” to the original impairment;

  4. 4. 

    Cases in which the evidence does not support the continuance or favorable determination based on physical impairment(s) alone;

  5. 5. 

    Cases requiring a finding of medical equivalence;

  6. 6. 

    Cases in which the disability examiner determines MC review is necessary;

  7. 7. 

    Cases involving reopening and revision of a prior administratively final determination or decision, when reopening and revision is required; or

  8. 8. 

    Cases where a mental impairment was established in the CPD (or any filing prior to the CPD)

  9. 9. 

    Cases where a Group I or Group II exception applies

  10. 10. 

    Cases where a Group I or Group II exception applies

  11. 11. 

    Potential drug/alcohol abuse (DAA) involvement identified that may have impacted the physical disabling impairment;

  12. 12. 

    Title XVI childhood disability (DC) claims;

  13. 13. 

    Any other case excluded from DEDA under DI 39563.900.

IMPORTANT:If DEDA does not apply, do not apply a medical assessment signed by an individual using DEDA signature authority to the Disability Determination Explanation (DDE).

E. MC recruitment standard requirements — “every reasonable effort”

Before using the authority in this section, the adjudicating site must demonstrate and document that it has met the MC recruitment “every reasonable effort” requirements in DI 39563.900C.

The site must continue to maintain documentation of its MC recruitment activities and any recruitment adversities, including documentation required by DI 39563.900C.

F. Disability examiner qualifications for DEDA

Only disability examiners who meet the DEDA qualification requirements in DI 39563.900 may use DEDA authority for cases under this section. The adjudicating component must document and maintain records showing that each disability examiner using authority under this section:

  • •

    Meets the DEDA minimum qualifications;

  • •

    Meets any additional State DDS or adjudicating-component requirements; and

  • •

    Has received supervisory or management approval or endorsement for DEDA authority.

G. Case processing assistance

An adjudicating site assisting another DDS with CDR, age 18 redetermination, or EXR case processing must:

  1. 1. 

    Verify that the assisted State DDS has met the MC recruitment “every reasonable effort” standard in DI 39563.900E; and

  2. 2. 

    Determine that its disability examiners meet the DEDA qualification requirements in DI 39565.900D.

The assisting adjudicating site must document and maintain records showing how its disability examiners meet the DEDA qualification requirements.

H. Documentation and form completion

Prepare the SSA-832 (Cessation or Continuance of Disability or Blindness Determination and Transmittal - Title XVI) and SSA-833 (Cessation or Continuance of Disability or Blindness Determination and Transmittal - Title II) following the instructions in DI 28084.000, and:

  • •

    Item 24 (Remarks) - Indicate “Disability Examiner Decisional Authority.”

  • •

    Items 27, 28, 30, and 30A (MC or PC signature, specialty code, and date) - leave blank

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0439563905
DI 39563.905 - Disability Examiner Decisional Authority (DEDA) — Extension to CDR Continuances, Fully Favorable Age 18 Redeterminations, and Expedited Reinstatement (EXR) Cases - 10/08/2026
Batch run: 10/08/2026
Rev:10/08/2026