Interpretation/Implementation of the Medical Improvement Review Standard

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The Social Security Administration establishes regulations and guidelines (the Program Operations Manual System or POMS) to implement the MIRS. We want to better understand these SSA guidelines and the effect they may have on the outcomes of CDRs. The POMS requires that certain sequential steps be followed when determining if medical improvement exists, as outlined in the following CDR Evaluation Process Chart: ~For Title XVI (SSI) beneficiaries, Substantial Gainful Activity (SGA) may not be considered and the CDR Evaluation Process is started at Step 2. Instructions for SGA consideration differ for individuals in a Trial Work Period or an Extended Period of Eligibility. ~~If a Group 2 Exception applies, cease benefits immediately without a medical determination. ~~~Consider age and time on the disability rolls.

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Full Report: GAO-07-8

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