In order to apply this exception, all of the following criteria must be met:
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•
Medical improvement (MI) has NOT occurred or MI is NOT related to the ability to work.
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•
The new or improved diagnostic or evaluative technique must be generally available
after the most recent favorable medical determination or decision.
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•
The public has been notified of the new or improved technique.
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•
The current evidence shows the individual is capable of engaging in substantial gainful
activity
or in a Title XVI childhood disability case, the child does not have an impairment(s)
causing marked or severe limitations or that meets, medically equals, or functionally
equals the listings.
Based on the above criteria, there will be limited situations where the exception
applies. The diagnostic or evaluative procedure must be listed in the subchapter DI 33535.000.
1. New or improved techniques that may impact the disability determination
If a new or improved diagnostic or evaluative technique became generally available
after the comparison point decision (CPD), consider the explanation of the techniques
located in the appropriate section of DI 33535.000 and the impact of the technique on the disability determination.
2. Applying the exception
Decide whether the technique is the primary basis for showing the impairment(s) is
not as disabling as previously thought. Apply the exception if the new or improved
technique has an important impact on the determination as shown by the following:
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•
an individual (with otherwise unchanged findings, allowed under the listing requirements)
has no impairment(s) of listing severity;
or
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•
an individual has more functional capacity than previously thought (based on otherwise
unchanged findings).
3. Referrals for review of medical diagnostic or evaluative techniques
When evidence includes results of techniques that appear newly developed or newly
improved, which adjudicators have not encountered before, submit such cases (through
the usual regional office channels) for consideration of adding the new technique
to the cumulative list located in DI 33535.000. When submitting a technique for consideration, include a rationale explaining why
the new or improved technique shows that the impairment(s) is not as disabling as
previously determined.
4. Additional development
Apply the usual documentation requirements. Do not order a test or evaluation just
to apply this exception. A technique listed in DI 33535.000 may be requested in a consultative examination if it is part of the usual documentation
requirements for the impairment(s) involved and it is not received as part of the
medical evidence of record.