TN 2 (08-15)

A. Documenting MI in the rationale

MI is any decrease in the medical severity of any one of the impairment(s) that was present at the time of the most recent favorable medical decision as evidenced by changes in symptoms, signs or laboratory findings.

Compare the severity of only the impairment(s) considered at the comparison point decision (CPD) with the current severity of the same impairment(s) to determine if there has been any medical improvement, and document the conclusion in the rationale. For a rationale example, see DI 28090.300G, DI 28090.300M, or DI 28090.300P. Consider any additional impairment(s) at a later step in the continuing disability review (CDR) evaluation process.

Discuss MI or the exceptions to MI in the rationale unless evidence received in a particular case clearly establishes continuing disability, without following every step in the CDR evaluation process. For more information on this flexible approach, see DI 28005.005B.2.

NOTE: If you did not formally consider the medical improvement review standard (MIRS) because benefits are continued based on consideration of residual functional capacity and vocational factors, the rationale must include an explanation why MI and the exceptions to MI have not been formally considered. No statement regarding MI and the exceptions is necessary if a listing is met or equaled.

B. References

• DI 28005.001 Legal Standard for Determining if Disability Continues

• DI 28010.010 Which Impairment(s) to Consider in Medical Improvement (MI)

• DI 28020.001 General - Groups I and II of Exceptions to Medical Improvement