DI 28015: Relating Medical Improvement to the Ability to Work - Title II and Adult Title XVI Beneficiaries
TN 3 (07-15)
When an impairment(s) meets or equals the requirements of a listing in the Listing of Impairments, the beneficiary is deemed, in the absence of evidence to the contrary, to be unable to engage in gainful activity. The comparison point decision (CPD) on this basis does not include residual functional capacity (RFC) assessments. This prevents RFC comparisons in subsequent continuing disability reviews (CDRs) in these cases.
Certain cases require a disability redetermination instead of a CDR. If we originally allowed the beneficiary as a Title XVI child and there has been no age-18 disability redetermination, follow the instructions in DI 28005.003.
A. Prior listing no longer met or equaled
When the impairment(s) no longer meets or medically equals the CPD listing of impairments, as that listing appeared then, find medical improvement (MI) related to the ability to work.
B. Prior listing still met or equaled
When the impairment(s) still meets or medically equals the CPD listing of impairments, as that listing appeared then, find MI NOT related to the ability to work.
C. How to process a continuance
Determine that disability continues, when no exceptions apply and MI does not relate to the ability to work because the impairment(s) still meets or equals the CPD Listings of Impairments, as that listing appeared then.
To process a continuance:
Code the continuance determination “no MI (related) and no exceptions,” rather than “meets/equals,” and
Do not do a current RFC assessment.
D. Previous versions of Listings
DI 34100.000 Obsolete Versions of Part A, the Listing of Impairments
DI 34200.000 Obsolete Versions of Part B, the Listings of Impairments