There is a prior uneffectuated medical cessation (UMC) or overdue medical cessation
(OMC).
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To process OMC and UMC cases, see DI 28075.200.
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The medical diary has not matured and will not mature in the next three months, and
there is no other reason (for example, a report of medical improvement) to complete
a CDR.
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NOTE: Determine the medical reexamination diary date based on the date provided on the
most recent CPD document(s).
For example, the most recent medical SSA-831-U3 (Disability Determination and Transmittal),
SSA-832 (Cessation or Continuance of Disability or Blindness Determination and Transmittal-Title
XVI),
SSA-833 (Cessation or Continuance of Disability or Blindness and Transmittal-Title II), or
disability decision from OHO.
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The disabled individual:
-
-
•
Has a medical improvement possible (MIP) (three year) or medical improvement not expected
(MINE) (five or seven year) diary; and
-
•
Has not completed a trial work period.
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If the DDS determines that the disabled individual is working and has a medical improvement
expected (MIE) diary, continue to process the CDR, if necessary as a medical or work
CDR, see DI 28050.010.
If FO assistance is necessary, return the folder to the FO for processing under DI 13010.000.
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The initial allowance has all of the following characteristics:
-
•
A primary impairment code of 0430 for Symptomatic HIV;
-
•
The claimant met or medically equaled listing 14.08, including any subparts of the
(now obsolete) listing; and
-
•
A final disability determination or decision exists and is dated before January 17, 2017.
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NOTE: In most cases a MINE diary is an indicator at CDR for cases initially allowed under
listing 14.08 before January 17, 2017.
NOTE: If the DDS confirms when reviewing the CPD that HIV was the primary impairment for
the initial allowance and it was miscoded, then screen-out the CDR. Within the medical
folder, the DDS must clearly document the screening out of the CDR referencing the
SSA-831 and any medical evidence showing the basis of meeting or equaling Listing
14.08.
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The disabled individual is in a foreign country and a border FO does not service the
individual's residence. The Office of Earnings and International Operations (OEIO)
will assume jurisdiction for the CDR.
The DDS should forward the case to:
(V22) OIO/IDO
PO Box 17787
Baltimore, MD 21235-7787
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The FO notifies the DDS that the claim is withdrawn or a request to withdraw the claim
is pending.
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For Title II cases, conversion to non-disability status has occurred or we expect
to occur in the next three months.
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For example, a disabled worker is within three months of attaining FRA or a disabled
surviving spouse who is within three months of potential conversion to a survivor
benefit that would be based solely on age and relationship, see RS 00615.004.
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Review of a query response and information received from the disabled individual or
other source (typically, the FO) shows:
a CDR mailer form SSA-455 (Disability Update Report) or SSA-455-OCR-SM, as described in DI 28001.003, was initiated after the date the case was alerted for a full medical review. This
includes “Incorrect and Accidental” alerts discussed in DI 28003.005E in this section.
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Review of a query response and other information received from the disabled individual
or other source shows:
-
•
The individual was using a ticket under the Ticket to Work Program; and
-
•
The ticket was in use before the case was selected for CDR mailer processing, or prior
to the initiation of a full medical CDR. For additional information on work incentives,
see DI 55000.000.
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NOTE: If the disability control file (DCF) or other record show the case was processed
as a CDR mailer and a subsequent full medical CDR was initiated, the date of notice
to the disabled individual and representative payee of initiation of the subsequent
full medical CDR is controlling.
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The disabled individual is deceased and there is no unresolved or pending fraud issue
requiring a determination as to whether disability ended prior to death.
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For instructions on processing special situations in work CDRs, see DI 13010.197.
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Miscellaneous reasons.
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Explain the reason on an
SSA-5002 (Report of Contact) or in the “Remarks” section of the SSA-5526-U3 (Request for Assistance - Disability).
NOTE: If the Title II portion of a concurrent (Title II and Title XVI) age-18 medical redetermination
is screened out, continue to process the Title XVI age-18 medical redetermination
if none of the screen-out criteria applies in DI 28003.005C.3.
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