Effective Dates: 06/02/2023 - Present Previous | Next

TN 18 (06-23)

DI 28005.210 New Impairments or Subsequent Disability in Continuing Disability Review (CDR) Cases

A. Role of comparison point decision (CPD) and new impairments in the continuing disability review CDR sequential evaluation process

1. When to consider CPD impairments only

For Title II and adult Title XVI cases, consider only the CPD impairment(s) at the following steps in the sequential evaluation process outlined in DI 28005.015:

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    Step 3, medical improvement (MI);

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    Step 4, MI related to the ability to work;

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    Step 5, exceptions to medical improvement.

For Title XVI child cases, consider only the CPD impairments at the following steps in the sequential evaluation process outlined in DI 28005.030:

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    Step 1, MI;

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    Step 2, CPD impairments still meet/equal prior listing.

Do not consider new impairments (impairments that began after the CPD) in deciding such steps in the CDR evaluation process.

2. When to consider all current impairments

For Title II and adult Title XVI cases, consider ALL impairments, including any new impairments, at the following steps in the sequential evaluation process outlined in DI 28005.015:

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    Step 2, meets/equals current listing;

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    Step 6, severe impairments;

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    Step 7, past work;

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    Step 8, other work.

For Title XVI child CDR cases, consider ALL impairments, including any new impairments, at the following steps in the sequential evaluation process outlined in DI 28005.030:

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    Step 3, severe impairments and meets or medically/functionally equals a current listing

B. Considering new impairments before cessation

1. Impairment duration

Consider new impairments even if they do not meet the duration requirements.

2. Possible period of non-disability

If the evidence shows a period of possible non-disability since the CPD but the current impairment(s) warrants a continuance, do not cease disability. Do not find that disability ceases in this instance, unless there is additional evidence to support a retroactive cessation, including reopening and revising a prior determination.

C. How we evaluate subsequent disability after the cessation month

1. Overview

If a new impairment(s) causes the individual to become disabled again after the cessation month (even within the 2-month period before benefits end), the original period of disability does not continue. The break in the continuity of disability requires establishing a new period of disability.

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    A new application is usually required for Title II individuals with subsequent disability after a disability cessation, unless the individual appeals the cessation decision and the impairment(s) is found to be disabling through the date of the appeal decision or determination.

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    This does not apply to reinstatement during the extended period of eligibility due to earnings below the substantial gainful activity level.

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    For additional information on appeals of an initial medical disability cessation determination or decision, see SSR-13-3p

2. Evaluation of subsequent disability

a. Correct cessation month

If the adjudicator determines the initial medical cessation determination was correct during the appeal, the adjudicator will then:

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    Determine if the individual has again become disabled at any time through the date of their determination or decision because of a worsening of an existing impairment or the onset of a new impairment(s), if all other requirements for a period of disability, including the duration and insured status requirements are met.

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    Evaluate severity and duration requirements for the new impairment(s) under the initial disability sequential evaluation process discussed in DI 22001.001.

If the adjudicator determines that the medical cessation date in a Title II case (or the Title II portion of a concurrent medical disability cessation case) was appropriate, but evidence also shows that the beneficiary had again become disabled at any time through the date of their determination or decision due to worsening of an existing impairment or by the onset of a new impairment, the adjudicator will evaluate disability through the date of the appeal determination or decision.

This eliminates the need for filing a new application for reentitlement in Title II cases. In Title XVI cases, a new application is not required if a Title XVI recipient again becomes disabled while an appeal is pending. See SSR 13-3p.

b. Incorrect cessation month

If the adjudicator determines that the initial disability cessation determination was not correct during the appeal, the adjudicator will then:

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    Determine if the evidence establishes medical improvement as a basis for cessation of disability at any time through the date of final determination or decision.

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    Evaluate all impairment(s) using the medical improvement review standard (MIRS).

D. References

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    DI 28005.205 Determining the Cessation Month in Continuing Disability Review (CDR) Cases

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    DI 28010.001 Medical Improvement (MI)

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    DI 28015.001 Context and Scope — Relating MI to Ability to Work

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    DI 28020.001 General - Groups I and II of Exceptions to Medical Improvement

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0428005210
DI 28005.210 - New Impairments or Subsequent Disability in Continuing Disability Review (CDR) Cases - 06/02/2023
Batch run: 10/23/2024
Rev:06/02/2023