Generally, the CDR begins with the FO contacting the disabled individual or representative
payee via mail to complete all the necessary CDR forms.
An optional CDR procedure is applicable only in potential suicide or homicide cases.
In those cases, the FO may decide that contact should be made with the medical source
before the FO interview. This contact determines if the source can furnish information
on how the individual may react to the CDR. The RO will establish whether this contact
is made by the FO or the DDS .
The FO forwards the folder to the DDS if:
The name of the last known medical source is in the folder;
After a review of the evidence, the FO decides to follow the optional procedure; and
Regional policy requires the contact made by the DDS .
The DDS's inquiry to the medical source should be clear and concise, similar to the
example below, and released with the form SSA-1994 (Cover Sheet Confidential Medical
“Our records show that you were the medical source for (Beneficiary’s Name) in (date).
(Beneficiary’s Name) case is scheduled for a continuing disability review. Because
of the individual's past medical history, if you continue to treat the individual,
we need your assessment. This assessment should include any impact the initial interview
and subsequent contacts by SSA or State agency employees might have on (Beneficiary’s
Name) mental status; including suicidal and homicidal potential. Please respond as
soon as possible.”
The DDS checks the second block on Form SSA-1994 (Cover Sheet Confident Medical Info)
and follow up with the medical source if there is no response within 10 days. During
any telephone contact with the medical source, the DDS must emphasize that the inquiry
is due to our concern for the individual's health and well- being.
If the source states the individual cannot make this judgment, the DDS returns the
folder to the FO to proceed with the CDR in the usual manner. If the source says the
individual is no longer the medical source for the identified individual, the DDS
should make one attempt to contact a family member or community representative identified
in the folder as having close contact with the individual. The DDS should limit the
second effort to an attempt to identify the individual's current medical source. If
identified, the DDS writes to this physician. Otherwise, no further attempts are made
and the folder is returned to the FO to schedule the face-to-face interview.
If the medical source indicates that the face-to-face interview would have negative
effects on the individual's mental health increasing suicide and homicide potential,
the DDS documents the folder, and contacts the regional office for guidance. In life
threatening situations, consideration should be given to deferring the CDR.
The face-to-face interview will be scheduled by the FO and the case processed as usual
under the following circumstances:
The medical source states that there is no current threat of suicide/homicide potential,
The medical source refuses to provide an opinion on the individual's suicide/homicide
The medical source states that the individual is no longer a patient and is not aware
of a current treating source.
In all circumstances, the DDS will accurately document the case before returning the
case to the FO.
See DI 55025.010 for medical CDR processing instructions for beneficiaries with Tickets to Work.