Title XVI child CDR case - age specific period of disability at the CPD
CPD evidence: The child was 1 year and 5 months old at the CPD and met listing 105.10. Listing
105.10 requires the need for supplemental daily enteral feeding via a gastrostomy
due to any cause for children who have not attained age 3. The listing further designates
that after age 3, the evaluation is based on the residual impairment(s). The evidence
indicated that the child had an average of nine diarrhea episodes lasting one-to-two
days per month and was in the 10th percentile of weight-for-age.
CDR evidence: The child is age 3 years and 8 months at the time of the CDR. The child still receives
supplemental daily enteral feeding via a gastrostomy. The evidence indicates the child
is in the 30th percentile of weight-for age and has one-to-two episodes of diarrhea
per month lasting approximately one day per episode.
Discussion: Based on the evidence, a finding of MI is appropriate at Step 1. The evidence indicates
an increase from the 10th to the 30th percentile of weight for age and a reduction
of diarrhea episodes. The adjudicator must find that the child’s impairment(s) no
longer meets or medically equals the CPD listing (Step 2) because the child has passed
the age specified in the listing. In this example, it is important to note that, at
the time of the CDR, the continued presence of a gastrostomy after age 3 would not,
by itself, indicate that there has been no MI. A detailed analysis of symptoms, signs,
and laboratory findings is necessary, see DI 28010.015 for additional information.
The adjudicator must continue to Step 3 in the Title XVI child CDR sequential evaluation
process. Although the child still requires supplemental daily enteral feeding via
a gastrostomy, the listing specifies that the criteria only apply for children under
age 3 and directs evaluation after age 3 based on the residual impairment(s). The
adjudicator will evaluate any residual impairments, such as malnutrition under 105.08,
or other medical or developmental disorder(s) (including the disorder(s) that necessitated
gastrostomy placement) under the appropriate listing(s). Those impairment(s) and all
other current impairment(s) present at the CDR will be evaluated in whether a listing
is met or medically equaled.