DI 28015: Relating Medical Improvement to the Ability to Work - Title II and Adult Title XVI Beneficiaries
TN 3 (07-15)
A. Changes must be more than minor
Under this “listing section” mechanism, find medical improvement (MI) is related to the ability to work only where the changes in findings are more than minor. For the nature and quantity of change needed to find MI, see DI 28010.020A.
Do not use this mechanism and minor changes as a way to re-adjudicate the comparison point decision (CPD).
Resolve questions about the appropriateness of the CPD under the error exception located in DI 28020.350.
B. Explicit listing requirements
Find MI is related to the ability to work only if changes in findings are related to the explicit requirements of the prior listing.
C. Example where changes are more than minor
1. CPD
We allowed a claim for an overweight beneficiary with diabetes and a heart problem as equaling Listing 4.02 (congestive heart failure). The file indicates the prior adjudicator did not consider obesity in the “equals” decision.
2. Continuing disability review (CDR)
Weight loss shows MI, but no other changes occurred. The MI is not part of the explicit requirements of Listing 4.02. Find MI not related to ability to work. Do not use a belief that Listing 4.02 is not equaled (and was not equaled at the time of the CPD) as a basis for finding MI related to the ability to work.