Public Law 104–193 (the Personal Responsibility and Work Opportunity Reconciliation Act of 1996) amended
Section 1614(a)(3) of the Social Security Act.
The law requires the agency to do CDRs on all non-permanently disabled children under
age 18 at least once every three years.
The Commissioner may review Title XVI child cases involving a permanent impairment
at such times that the Commissioner deems appropriate.
The law also directs when a CDR is required for cases in which low birth weight is
a contributing factor material to the disability determination.
In addition, the law requires that an eligible Supplemental Security Income (SSI)
individual found disabled before age 18 must be subject to a review upon attaining
age 18.
In these cases, the medical improvement review standard (MIRS) does not apply. Instead,
the age-18 medical redetermination applies the disability evaluation process used
for an initial Title XVI adult claim, see DI 13005.020D in this section. A future medical reexamination date may warrant screening out and
discontinuing a CDR, pending maturation of the medical reexamination review date.
See DI 13005.020D in this section.
Do not screen out a CDR based on the future medical diary date on the Supplemental
Security Record (SSR).
If the medical diary on the current SSR displays a future diary date based on a system
limitation (such as a start date record), review the medical diary date established
on the last favorable medical determination.
If the medical diary date has expired, complete the CDR.
Do not screen out a case that involves the following:
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•
A Title XVI age-18 medical redetermination case with a future medical reexamination
diary,
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•
A Title XVI low birth weight (LBW) case with a future medical reexamination diary,
or
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•
A Title XVI disabled child case with a future medical reexamination diary.
EXCEPTION:
Screen out a Title XVI disabled child (not LBW) case if the case meets both of the following conditions:
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•
The DDS or OHO made a fully developed decision (initial claim, or CDR, but not a modified
decision) within the last 12 months; and
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•
The medical diary has not matured and will not mature in the next three months.