Basic (03-86)

DI 43520.060 Completion Of The SSA-833-U5 (Cessation or Continuance Of Disability or Blindness Determination and Transmittal)

The SSA-833-U5 is used to prepare a determination as a result of continuing disability review (CDR). Initial and reconsideration medical CDR determinations should be prepared as described in DI 28065.035, with the following exceptions.

Item 6 (DO Address)

If CDB has DO jurisdiction, enter INTPSC, P.O. Box 17769, Baltimore, MD 21203.

If the Veterans Administration in Manila has DO jurisdiction, enter the Foreign Service Post in Manila, Philippines, APO San Francisco, Calif 96528.

Item 7 (DO/DDS Code)

Enter Q85 for CDB DO jurisdiction cases or 994 if the Foreign Service Post in Manila, Philippines has DO jurisdiction. Show DDS code 670.

Items 25 - 30A (Disability Examiner and Physician Identifications.)

Make no entries

Item 31 - 33 (SSA Representative Identification )

Enter the signature of the FDE or RECONE preparing the determination, INTPSC, and the current date. (See DI 13010.170 for SSA-833-U5 completing instructions in work issue cases.) In the event that a CDR determination must be prepared on a Title XVI case, use Form SSA-832-U5. See DI 13010.170 for complete instructions. The above exceptions also apply to the SSA-832-U5.