TN 11 (08-22)

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

A. Setting the cessation month

To set the cessation month in cases where disability ended, use the table in DI 28005.205C. Do not use this table in reopenings.

B. Cessation month procedure

The cessation month generally coincides with the month of the notice. When applicable, find retroactive cessation only in the situations outlined in DI 28005.205C, items 2-9, in this section.

C. Cessation month table

Use the following table to determine the cessation month in CDR cases: 

 

If Cessation is Based On:

Find that Disability Ended in the Month:

Reference:

1.

MEDICAL CESSATION - ANY SITUATION NOT COVERED BY 2-8 BELOW (most cessations)

The cessation notice is mailed to the individual (general rule).

DI 28005.205B.

2.

REPORT OF EARLIER MEDICAL CESSATION

The treating physician told the individual of regained capacity to engage in substantial gainful activity (SGA), or, in a Title XVI child case, told the child's representative payee that the child could return to normal activities.

DI 28005.205D.1.

3.

INDIVIDUAL HAS RETURNED TO WORK IN A MEDICAL IMPROVEMENT EXPECTED (MIE) CASE (referred to as a "clear-cut cessation")

The individual returns to full-time work with no significant medical restrictions.

DI 28030.035

4.

FAILURE TO COOPERATE

The individual fails, without good cause, to do what the Social Security Administration (SSA) or the Disability Determination Services (DDS) has requested and the individual was aware that they had to cooperate and the repercussions of failing to do so.

DI 28075.005K; DI 25205.020 for Title XVI child cases

5.

WHEREABOUTS UNKNOWN

SSA first knew that the individual's whereabouts are unknown but not earlier than the month a continuing disability issue arose.

NOTE: Title XVI benefits are suspended rather than ceased.

DI 28075.005G.

6.

FAILURE TO FOLLOW PRESCRIBED TREATMENT (FTFPT)

The evidence clearly establishes the individual's unjustified failure to follow prescribed treatment.

NOTE: If FTFPT is the basis for the cessation, the cessation date cannot be earlier than 30 days after the predetermination notice is sent.

DI 23010.040C1, DI 23010.013D

7.

WORK ACTIVITY ONLY

The individual first engages in SGA following completion of any applicable trial work period. DDSs do not decide this issue. Do not cease Title XVI cases on this basis.

DI 28050.000
DI 28075.600
SI 02302.001

8.

RECOVERY PRIOR TO INITIAL ALLOWANCE DECISION (closed period cases)

Shown by the evidence.

DI 25510.001

9.

FRAUD OR SIMILAR FAULT

When the individual is no longer disabled, if applicable, after the fraudulent evidence is disregarded during the determination.  Base this determination on sequential evaluation for CDRs; also consider the information listed in the “Reference” column.

DI 23025.000

D. Determining cessation months

1. Report of earlier medical cessations

The following situations involve the setting a cessation month earlier than what would normally be supported solely by medical evidence that results in a cessation.

  1. a. 

    Find retroactive cessation in cases where there is no doubt that the individual was aware that they were able to work. Alternatively, in a Title XVI child CDR case, find retroactive cessation when there is no doubt that the child's representative payee (or the child, if the child is their own payee) was aware that the child could return to normal activities, but failed to report this change. That is, find retroactive cessation only if:

    • the individual (or Title XVI child's representative payee) reports that at an earlier date the treating source informed the individual that they had regained the capacity to return to work or, in a Title XVI child case, had informed the child's representative payee that the child could return to normal activities; or

    • the treating source voluntarily reports the individual was informed at an earlier date that they had the capacity to return to work or, in a Title XVI child case, the child's representative payee was informed that the child could return to normal activities.

  2. b. 

    Set cessation as of the month the individual was made aware they had regained capacity to engage in SGA or, in a Title XVI child case, the child's representative payee was made aware that the child could return to normal activities.

  3. c. 

    Do not set this type of retroactive cessation date if:

    • there is substantial conflict between statements from the medical source and the individual (or, in a Title XVI child case, the medical source and the child's representative payee) concerning the individual's awareness of capacity to work, or the child's ability to return to normal activities; or

    • inadequate (or no) objective medical evidence supports the statement from the medical source establishing the retroactive cessation date.

2. Cessation month in error exception cases

In cessations that rely on the error exception to medical improvement (MI), as described in DI 28020.350, do not find retroactive cessation unless the conditions for reopening the prior decision are met.

3. Cessation month in low birth weight (LBW) infant cases

For LBW infants who are found no longer disabled, establish the cessation month no earlier than the month the baby attains age 1.

E. References

  • DI 25225.060 Examples of Impairments That Functionally Equal The Listings (Section 416.926a(m))

  • DI 25235.005 Medical Diary Criteria for Certain Title XVI Disabled Infants

  • DI 25235.006 Medical Diary Criteria for Low Birth Weight (LBW) Infants under Title XVI

  • DI 27501.001 Reopenings and Revisions: Pertinent Definitions and Related Policy

  • DI 28020.350 Group I Exception - Prior Error Overview

  • DI 23025.000 Fraud or Similar Fault


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0428005205
DI 28005.205 - Determining the Cessation Month in Continuing Disability Review (CDR) Cases - 08/08/2022
Batch run: 08/08/2022
Rev:08/08/2022