DI 28084: Completion of Continuing Disability Review Determination Forms (SSA-832 and SSA-833)
BASIC (10-15)
A. Introduction to completing Items 25 to 28 and Items 30 to 33
Follow these instructions to complete Items 25 through 28, and Items 30 through 33, when processing a continuing disability review (CDR) on the Forms SSA-832 (Cessation or Continuance of Disability or Blindness Determination and Transmittal –Title XVI) or SSA-833 (Cessation or Continuance of Disability or Blindness Determination and Transmittal – Title II).
B. Item 25 - disability examiner signature
The disability examiner (DE) will sign the form here.
C. Item 26 - date
Enter the date of the current determination.
D. Item 27 -- physician or medical specialist, signature
For instructions on signature requirements and documentation of the medical consultant's (MC) or psychological consultant's (PC) determination, see DI 26510.090.
E. Item 28 – date
If the MC or PC only signed a medical evaluation document(s), the DE will enter the date the MC or PC signed that document(s). Otherwise, the MC or PC must enter the date the SSA-832 or SSA-833 is signed. For MC or PC signature requirements, see DI 26510.090.
F. Items 30 and 30A - physician or medical specialist name and specialty code
1. When to complete Items 30 and 30A
The DE (or the MC/PC, if signing the SSA-832 or SSA-833) must follow these procedures to complete Items 30 and 30A. For the MC or PC signature requirements, see DI 26510.090.
2. Procedure for completing Items 30 and 30A
a. Item 30
Type or print the MCs or PCs name.
b. Item 30A
Enter the MCs or PCs medical specialty code from the list below. If a MC has multiple specialties (internist and rheumatologist), enter the code most closely related to the case:
MC/PC Specialty | Code |
---|---|
Anesthesiology |
01 |
Ambulatory Medicine |
02 |
Audiology |
03 |
Cardiology |
04 |
Cardiopulmonary |
05 |
Dermatology |
06 |
Eye, Ear, Nose, and Throat |
07 |
Ear, Nose, and Throat |
08 |
Ear and Throat |
09 |
Emergency Room Medicine |
10 |
Endocrinology |
11 |
Family or General Practice |
12 |
Gastroenterology |
13 |
Geriatrics |
14 |
Gynecology |
15 |
Hematology |
16 |
Industrial Medicine |
17 |
Infectious Diseases |
18 |
Internal Medicine |
19 |
Neurology |
20 |
Neuro-Ophthalmology |
21 |
Neuro-Psychiatry |
22 |
Neonatology |
23 |
Nephrology |
24 |
Obstetrics |
25 |
Occupational Medicine |
26 |
Oncology |
27 |
Ophthalmology |
28 |
Orthopedics |
29 |
Osteopathy |
30 |
Pathology |
31 |
Pediatrics |
32 |
Physiatry |
33 |
Physical Medicine |
34 |
Plastic Surgery |
35 |
Preventative Medicine |
36 |
Psychiatry |
37 |
Psychology |
38 |
Public Health |
39 |
Pulmonary |
40 |
Radiology |
41 |
Rehabilitative Medicine |
42 |
Rheumatology |
43 |
Special Senses |
44 |
Surgery |
45 |
Urology |
46 |
Other |
47 |
Speech Language Pathology |
48 |
Child and Adolescent Psychiatry |
49 |
G. Items 31 through 33
Procedure for completing Items 31 through 33
An adjudicator or reviewer may use Items 31 through 33 in the CDR process not identified elsewhere. Enter in Item 32, the appropriate code from this list:
Destination | Code |
---|---|
DPB-NEPSC |
01 |
DPB-MATPSC |
02 |
DPB-SEPSC |
03 |
DPB-GLPSC |
04 |
DPB-WNPSC |
05 |
DPB-MAMPSC |
06 |
ODCO (other than DAP) |
07 |
OEIO |
08 |
DQB-Boston |
10 |
DQB-Philadelphia |
11 |
DQB-Chicago |
12 |
DQB-Kansas City |
13 |
DQB San Francisco |
14 |
DQB-New York |
15 |
DQB-Atlanta |
16 |
DQB-Dallas |
17 |
DQB-Denver |
18 |
DQB-Seattle |
19 |
Administrative Law Judge |
20 |
Appeals Council |
21 |
Other |
22 |