DI 40505: Medical Issues
A. Operating policy
A CDR may result if a third party reports the beneficiary is not disabled, is not following required treatment, or has returned to work if the report:
Is from someone in a position to know; and,
Indicates a real possibility of cessation.
B. Procedure
1. Third party medical issue report
a. Review file -
Determine if report raises a CDR issue (see DI 26525.015ff and DI 28005.001ff for guidance), and if there has been a medical CDR in the last 6 months.
b. Cessation unlikely -
Annotate the report “NAN - DI 40505.120.”
c. Medical CDR in the last 6 months -
Do not start CDR unless report indicates cessation is very likely, or case was diaried as a MIE. If there is a clear CDR issue, follow d. below.
d. CDR necessary -
If there is a medical issue and no recent CDR:
Extablish CDIOon SSA-3500-U2 (SM 01305.825).
Explain issueon SSA-847-U3, or on SSA-5526 if CDR interview not done; forward folderto DDS or FO for CDR.
2. Third party report of work
See DI 40510.040.