Effective Dates: 06/18/2019 - Present Previous | Next

TN 18 (04-21)

DI 26525.045 Medical Improvement Not Expected (MINE) or MINE-Equivalent Criteria

NOTE: Diary types are medical improvement expected (MIE), medical improvement possible (MIP), and medical improvement not expected (MINE). All MINE criteria also apply to MINE-Equivalent cases. See DI 13005.022 for more information on MINE-equivalent cases.

A. Procedure - general

  • •

    Generally, set a MINE diary when any criterion in DI 26525.045B is met.

  • •

    When both a MIE and MINE criterion are met, set the MIE diary only if you are convinced that cessation under the medical improvement review standard (MIRS) is probable as in DI 26525.020 or when the case facts strongly suggest that full recovery can be expected. See DI 28010.000 and DI 28015.000 for MIRS criteria. Presume that cessation is extremely unlikely when individuals who are older (i.e., 49 1/2 years of age or older at diary maturity) have:

    1. 1. 

      been disabled for a considerable period of time (i.e., 7 or more years),

    2. 2. 

      multiple severe impairments, or

    3. 3. 

      undergone multiple continuing disability reviews (CDR).

  • •

    Adjudicators must be sure that the primary impairment code, date of birth and date disability began entries on the SSA-831-C3/U3, SSA-832-C3/U3, or SSA-833-C3/U3 are accurate to:

    1. 1. 

      make correct determinations about whether a MINE criterion applies,

    2. 2. 

      provide data that may be used, along with the diary type and date, to determine the timing and type of the future CDR for a particular case (e.g., full-process CDR or mailer CDR.), and

    3. 3. 

      provide accurate data for program management purposes.

B. MINE criteria

Set the MINE diary when any criterion in one the three MINE categories below is met.

1. Age 54 1/2 or older at MIE or MIP diary maturity

a. Setting the MINE diary

Set a MINE diary for individuals whose MIE or MIP diaries will mature at age 54 1/2 or older. These individuals are currently age 51 ½ or older.

b. Exceptions

  1. 1. 

    Set the MIE diary to mature up to age 64 1/2 for individuals with Title XVI statutory blindness which is expected to no longer meet the statutory blindness definition.

  2. 2. 

    Set the vocational diary, or the MIE or MIP diary to mature up to age 59 1/2 for individuals whose case facts indicate that recovery or remission is almost certain (e.g., recent or scheduled surgery which will resolve the impairment; current significant, sustained, and progressive improvement which will almost certainly result in full recovery). Examples include certain cases involving:

2. Under age 54 1/2 at MIP diary maturity

a. Setting the MINE diary

For individuals who will be under age 54 1/2 when a MIP diary would mature (i.e., the individual is currently under age 51 1/2), set a MINE diary when the case:

  • •

    meets or equals a listing cited on the table in B2c below, or

  • •

    is allowed on a meets, equals, medical-vocational, or functional equals basis and meets the specified impairment, age, and/or onset criteria on the table in B2c below. The specified age refers to age at the time of the current determination.

b. Exceptions

There may be rare instances when an individual meets a MINE criterion, and also meets MIE diary criterion. Set the MIE diary when:

  • •

    the MINE criteria were satisfied as described the second bullet in B2a and the individual is currently demonstrating significant improvement, has no other impairments, and vocational factors are favorable.

  • •

    cited listing met or equaled based on any polio residuals (1380), cerebral palsy (3430), or muscular dystrophy (3590) and MIRS criteria will almost certainly be met at the time of diary maturity. Program experience has demonstrated infrequent cessation under the MIRS for cases with these characteristics. This exception should be applied with caution.

c. The MINE diary table

The criteria in this MINE category are organized by impairment codes. The relevant impairment codes are in numerical order in the first column. The MINE criteria based on specific listings and MINE criteria related to age or onset for specific impairments are located across from the general impairment category to which they belong (i.e., under third column , MINE Criteria).

 

 

 

IMPAIRMENT CODE

IMPAIRMENT

MINE CRITERIA
0430 Symptomatic Human Immunodeficiency Virus (HIV) infection
  • •

    Listing 14.11A or 14.11A - Multicentric (not localized or unicentric) Castleman disease

  • •

    Listing 14.11B or 114.11B – Primary central nervous system lymphoma

  • •

    Listing 14.11C or 114.11C – Primary effusion lymphoma

  • •

    Listing 14.11D or 114.11D – Progressive multifocal leukoencephalopathy

  • •

    Listing 14.11E or 114.11E – Pulmonary Kaposi sarcoma

1380

Polio

All adults and children with permanent residuals of polio

2770

Cystic Fibrosis

Listing 3.04A or 103.04A -- cystic fibrosis

2940

Organic Mental Disorders
  • •

    Listing 12.02 or 112.02 -- organic mental disorders with initial medical onset at least 2 years before the current determination, or

  • •

    Age 41 1/2 or older, or

  • •

    Age 27 or older with initial medical onset at least 10 years before the current determination

2950

Schizophrenic, Paranoid, and Other Psychotic Disorders
  • •

    Listing 12.03C, or

  • •

    Age 46 1/2 or older with initial medical onset at least 5 years before the current determination, or

  • •

    Age 27 or older with initial medical onset at least 15 years before the current determination

2960

Mood (Affective) Disorder

Age 46 1/2 or older impairment at a level of disabling severity beginning at least 10 years before the current determination

2990

Autistic and Other Pervasive Developmental Disorders

Listing 12.10 or 112.10

3180

Intellectual Disability
  • •

    Listing 12.05A or

  • •

    Listing 12.05B with Full Scale Intelligence Quotient (FSIQ) of 59 or below or

  • •

    Listing 112.05A, except when less than 6 years of age

3300

Cerebral Degeneration of Childhood

Listing 110.08B

3310

Other Cerebral Degenerations
  • •

    Listing 11.17 -- degenerative disease, such as Friedreich's Ataxia, and spinocerebellar degeneration, or

  • •

    Age 46 1/2 or older, or

  • •

    Age 27 or older with initial medical onset at least 5 years before the current determination

3320

Parkinson's Disease
  • •

    Listing 11.06, or

  • •

    Age 41 1/2 or older

3330

Huntington’s Disease
  • •

    Listing 11.17 – degenerative disease, Huntington's Disease

  • •

    Age 46 1/2 or older, or

  • •

    Age 27 or older with initial medical onset at least 5 years before the current determination

3350

Anterior Horn Disease
  • •

    Listing 11.10 -- amyotrophic lateral sclerosis (ALS), or

  • •

    Age 41 1/2 or older

3360

Other Diseases of Spinal Cord, such as Syringomyelia
  • •

    Listing 11.08 -- spinal cord disorder resulting in markedly reduced function in two or more extremities for more than 6 months, or

  • •

    Age 46 1/2 or older

3400

Multiple Sclerosis
  • •

    Listing 11.09, or

  • •

    Age 46 1/2 or older

3430

Cerebral Palsy

All adults and children, except those less than 1 year of age.

3590

Muscular Dystrophy

All adults and children

3650

Glaucoma

Listing 2.02 -- statutory blindness -- markedly reduced ability to see objects (not correctable by surgery, lenses, or medication)

3680

Visual Disturbance

Listing 2.03 or 2.04 -- markedly reduced ability to see objects (not correctable by surgery, lenses, or medication)

3690

Low Vision
  • •

    Listing 2.03B, 2.03C or 2.04 -- when not correctable by surgery or not due to a potentially treatable condition

  • •

    Listing 102.03B, 102.03C, or 102.04 -- markedly reduced ability to see objects (not correctable by surgery, lenses, or medication)

3694

Statutory Blindness
  • •

    Listing 2.02 or 2.03A -- markedly reduced ability to see objects (not correctable by surgery, lenses, or medication), or

  • •

    Listing 102.02A or 102.03A -- markedly reduced ability to see objects (not correctable by surgery, lenses, or medication)

3890

Hearing Loss

Listing 2.10 – hearing loss not treated with cochlear implantation

4130

Angina

Age 46 1/2 or older

4380

Cerebrovascular Disease -- Late Effects
  • •

    Listing 11.04 -- central nervous system vascular accident, with manifestations as required by the listing more than 3 months post-cerebral vascular accident, or

  • •

    Age 46 1/2 or older, or

  • •

    Age 26 1/2 or older with initial medical onset at least 15 years before the current determination

4430

Peripheral Vascular (Arterial) Disease

Age 46 1/2 or older

4510

Phlebitis

• Listing 4.11, or

• Age 46 1/2 or older

4540

Varicose Veins

Listing 4.11 -- chronic venous insufficiency

4960

Chronic Pulmonary Insufficiency

Listing 3.02 -- chronic pulmonary insufficiency

5850

Chronic Kidney Disease with Dialysis

Listing 6.03 or 106.03 -- impaired renal function due to chronic progressive disease, incurable kidney disease (documented by persistent adverse objective findings) resulting in severely reduced function that may require dialysis

7100

Diffuse Disease of Connecting Tissue

Listing 14.04 -- scleroderma or progressive systemic sclerosis

7140

Rheumatoid Arthritis

Age 46 1/2 or older

7200

Spondylitis
  • •

    Listing 14.09C -- inflammatory arthritis (ankylosing spondylitis or other spondyloarthropathy, with ankylosis (fixation) of the dorsolumbar or cervical spine at 45 degrees or more) that is not surgically treatable, or

  • •

    Age 46 1/2 or older

7400

Anencephalus and Catastrophic Congenital Abnormality or Disease

Adults and children of all ages

7410

Meningomyelocele

Listing 111.08 A or B

7580

Non-mosaic Down Syndrome

Listing 10.06 or 110.06

8060

Fracture of Spine/Spinal Cord Lesion

Listing 11.08 -- spinal cord or nerve root lesion resulting in paraplegia or quadriplegia, damage to the spinal cord or major branches resulting in markedly reduced function in two or more extremities for more than 2 years

9050

Amputation
  • •

    Listing 1.20A-- both upper extremities, occurring at any level at or above the wrists (carpal joints), up to and including the shoulder (glenohumeral) joint (amputation due to any cause), or

  • •

    Listing 1.20B-- hemipelvectomy or hip disarticulation (amputation due to any cause), or

  • •

    Listing 101.20A-- both upper extremities, occurring at any level at or above the wrists (carpal joints), up to and including the shoulder (glenohumeral) joint (amputation due to any cause), or

  • •

    Listing 101.20B-- hemipelvectomy or hip disarticulation (amputation due to any cause)

9070

Late Effects of Injuries to the Nervous System

Age 46 1/2 or older

7590

Xeroderma pigmentosum

Listing 8.07A or 108.07A listing for Xeroderma pigmentosum

3. Other permanent disabilities

Set a MINE diary if the individual of any age has a chronic or progressive impairment, or combination of impairments:

  • •

    with permanent, irreversible structural damage, or functional loss, and

  • •

    for which there is no known effective therapy, treatment, or surgical intervention (i.e., an intervention that could result in medical improvement and the ability to perform substantial gainful activity (SGA) in adults, or no longer result in marked and severe functional limitations in children).

NOTE: Use this criterion to set the MINE diary for cases involving cancer which is certainly not remediable, i.e., cannot be controlled by treatment, therapy, or surgery. The MINE diary should not be set in cases where there is any possibility of remission. See DI 26525.010.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0426525045
DI 26525.045 - Medical Improvement Not Expected (MINE) or MINE-Equivalent Criteria - 06/18/2019
Batch run: 04/01/2021
Rev:06/18/2019