The following types of decisions are CPDs (see DI 28010.020A) when they meet the following criteria:

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  Decisions (based on medical evidence that was current at the time of the decision) that the individual continues to have a disabling impairment, or

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  Adoption decisions (i.e., collateral estoppel decisions) that included consideration of current medical evidence, including consideration of medical, functional, or medical/vocational issues, or

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  The earlier favorable medical decision (usually under a different title) that was used as the basis for applying collateral estoppel

The following types of decisions do not involve consideration of medical issues. They are not appropriate CPDs because the supporting evidence for the decision does not provide a suitable basis for medical improvement review standard (MIRS) comparisons. Therefore, do not use the following types of decisions as CPDs:

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  Collateral estoppel adoption determinations without consideration of medical issues, including collateral estoppel adoptions completed by the field office (FO). Rather, the CPD is the decision that was the basis for collateral estoppel, such as the most recent prior favorable determination or decision based on meeting or equaling a listing (or functionally equaling a listing), an allowance based on medical-vocational rules, or a CDR related decision (such as a decision finding no MI).

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  SSA-899-U2's (Continuing Disability Review) categorizing individuals as permanently impaired, without evaluation of then-current medical evidence

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  Reinstatement under a CDR moratorium

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  Decisions based solely on work

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  Decisions not involving consideration of the issue of current disability (e.g., most decisions on appeals requesting an earlier onset)

If the appropriate CPD is unclear, the adjudicator must review any available documents from the prior favorable medical determination. For example, the SSA-831, SSA-832, or SSA-833 may contain the regulation basis code or vocational rule that was used to support the favorable determination if the medical assessments cannot be located.

If there is an inconsistency between the information entered on the SSA-831 and the medical assessment (e.g., the CPD medical assessment indicates the individual met listing 4.02 but the SSA-831 indicates the individual met listing 4.06), the adjudicator must carefully review the available evidence to determine the correct basis for the decision to follow the CDR sequential evaluation process and determine if medical improvement has occurred.

If the CPD folder is lost and the adjudicator cannot determine the CPD date or basis, the adjudicator must follow instructions in DI 28035.015A to attempt to identify the CPD date prior to reconstruction. After identifying the CPD, the adjudicator follows the instructions in DI 28035.020 to reconstruct the folder.

Queries may also be a useful tool to help determine the basis for the CPD (including application of a collateral estoppel adoption determination by the FO) or resolve inconsistencies, see DI 28035.015B.

The table contains examples of useful data to determine the CPD that may be found within common queries, such as the Supplemental Security Income Display (SSID), Full Account Query (FACT - Master Beneficiary Record or MBR display), Disability Determination Services Query (DDSQ), or Processing Center Action Control System (PCACS):