Step 3: Medical Improvement

Step 3 of the CDR evaluation process considers if there has been any medical improvement since the last Comparison Point Decision (CPD). The CPD is the most recent favorable medical decision that the individual was disabled or continued to be disabled. To assess medical improvement, the signs, symptoms and laboratory findings for the impairments at the CPD are compared to the current signs, symptoms and laboratory findings for the same impairments. Regarding the degree of medical improvement, the POMS states: “Although the decrease in severity may be of any quantity or degree, we will disregard minor changes in your signs, symptoms, and laboratory findings that obviously do not represent medical improvement and could not result in a finding that your disability has ended.”

4.	In your opinion, to what extent, if at all, does the standard of disregarding “minor changes” result in individuals being continued for benefits whereas under a de novo review, benefits would have been ceased? (Select one.)
	1.		To a very great extent – Continue.
	2.		To a great extent – Continue.
	3.		To a moderate extent – Continue.
	4.		To a minor extent – Continue.
	5.		Not at all (Click here to skip to question 6.)
	6.		No basis to judge or no opinion (Click here to skip to question 6.)

5.	In your opinion, why does the standard of disregarding “minor changes” result in individuals being continued for benefits whereas under a de novo review, benefits would have been ceased?

6.	Based on your experience, over the past 24 months, in about how many of the cases which were continued for benefits and in which some improvement in the impairment was found, were you unable to show medical improvement because the changes were considered minor? (Select one.)
	1.		All
	2.		Almost all
	3.		Most
	4.		About half
	5.		Some
	6.		Few
	7.		None
	8.		No basis to judge

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Full Report: GAO-07-8

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