POMS Reference

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.