POMS Reference

This change was made on Jan 10, 2018. See latest version.
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DI 26525.045: MINE or MINE-Equivalent Criteria

changes
*
  • Effective Dates: 11/02/2017 - Present
  • Effective Dates: 01/10/2018 - Present
  • TN 15 (12-04)
  • DI 26525.045 MINE or MINE-Equivalent Criteria
  • NOTE: Diary types are MIE, MIP, and MINE. All MINE criteria also apply to MINE-Equivalent cases.
  • A. Procedure - general
  • Generally, set a MINE diary when any criterion in DI 26525.045B is met.
  • CAUTION: When both a MIE and MINE criterion are met, set the MIE diary only if you are convinced that cessation under the MIRS is probable. For individuals who are older (i.e., 49 1/2 years of age or older at diary maturity), have been disabled for a considerable period of time (i.e., 7 or more years), have multiple severe impairments, or have undergone multiple CDRs, presume that cessation is extremely unlikely. In these cases, set the MIE diary only when the case facts strongly suggest that full recovery can be expected.
  • B. Procedure - MINE criteria
  • Set the MINE diary when any criterion in the 3 MINE categories below is met.
  • 1. Age 54 1/2 or older at MIE or MIP diary maturity
  • a. General
  • For individuals of advanced age, generally set a MINE diary. This category includes individuals whose MIE or MIP diaries will mature at age 54 1/2 or older. These individuals are currently:
  • * age 51 1/2 or older if a MIE criterion does not apply, and
  • * between ages 51 1/2 and 54 if a MIE criterion does apply.
  • b. Exceptions
  • Set the vocational diary, or the MIE or MIP diary to mature up to age 59 1/2 for individuals whose case facts indicate that recovery or remission is almost certain (e.g., recent or scheduled surgery which will resolve the impairment; current significant, sustained, and progressive improvement which will almost certainly result in full recovery). Examples include certain cases involving:
  • * cancer (see DI 26525.010), lymphoma, or leukemia (DI 26525.030C).
  • NOTE: In cancer cases, set a MINE diary only when the case facts indicate there is no possibility of remission.
  • * fractures, sprains, or dislocations
  • * title XVI statutory blindness which is expected to no longer meet the statutory blindness definition set the MIE diary to mature up to age 64 1/2 in these cases only.
  • 2. Under age 54 1/2 at MIP diary maturity
  • a. General
  • For individuals who will be under age 54 1/2 when a MIP diary would mature (i.e., the individual is currently under age 51 1/2), set a MINE diary when the case has the following characteristics:
  • * meets or equals a listing cited below.
  • * is allowed on a meets, equals, medical-vocational, or functional equals basis and meets the specified impairment, age, and/or onset criteria. (The specified age refers to age at the time of the current determination.)
  • b. Exceptions
  • When a MIE diary also applies:
  • * Age/Impairment/Onset MINE criteria met set the MIE diary.
  • * Cited Listing Met or Equaled or any polio residuals (1380), cerebral palsy (3430), or muscular dystrophy (3590) case set the MIE diary only when the MIRS criteria will almost certainly be met at the time of diary maturity. Program experience has demonstrated infrequent cessation under the MIRS for cases with these characteristics.
  • CAUTION: The criteria in this MINE category are organized by impairment codes. The relevant impairment codes are in numerical order in column 1. MINE criteria based on specific listings and MINE criteria related to age and/or onset for specific impairments are located across from the general impairment category to which they belong (i.e., under column 3, MINE Criteria).
  • Adjudicators must be sure that the primary impairment code, and age and onset entries on the SSA-831-C3/U3, SSA-832-C3/U3, or
  • SSA-833-C3/U3 are accurate: 1) to make correct determinations about whether a MINE criterion applies, 2) because this data may be used, along with the diary type and date, to determine the timing and type of the future CDR for a particular case (e.g., full-process CDR or mailer CDR.), and 3) to provide accurate data for program management purposes.
  • IMPAIRMENT CODE
  • IMPAIRMENT
  • MINE CRITERIA
  • 1380
  • Polio
  • All adults and children with permanent residuals of polio
  • 2770
  • Cystic Fibrosis
  • Listing 3.04A or 103.04A -- cystic fibrosis
  • 2810
  • Deficiency Anemias
  • Deficiency Anemias, such as subacute combined cord degeneration
  • Listing 11.16 -- subacute combined cord degeneration
  • Listing 11.08, Spinal cord disorders
  • 2940
  • Organic Mental Disorders
  • * Listing 12.02 or 112.02 -- organic mental disorders with initial medical onset at least 2 years before the current determination, or
  • * Age 41 1/2 or older, or
  • * Age 27 or older with initial medical onset at least 10 years before the current determination
  • 2950
  • Schizophrenic, Paranoid, and Other Psychotic Disorders
  • * Listing 12.03C, or
  • * Age 46 1/2 or older with initial medical onset at least 5 years before the current determination, or
  • * Age 27 or older with initial medical onset at least 15 years before the current determination
  • 2960
  • Mood (Affective) Disorder
  • Age 46 1/2 or older impairment at a level of disabling severity beginning at least 10 years before the current determination
  • 2990
  • Autistic and Other Pervasive Developmental Disorders
  • Listing 12.10 or 112.10
  • 3180
  • Intellectual Disability
  • * Listing 12.05A or B, or
  • * Listing 112.05B, or
  • * Age 41 1/2 or older (see DI 26525.030C.1. for limited exceptions), or
  • * Age 18 or older when a secondary impairment(s) has been of disabling severity for at least 10 years before the current determination or when the secondary impairment(s) has resulted in permanent, irreversible structural damage or functional loss
  • 3300
  • Cerebral Degeneration of Childhood
  • Listing 110.08B
  • 3310
  • Other Cerebral Degenerations
  • * Listing 11.17 -- degenerative disease, such as Friedreich's Ataxia, and spinocerebellar degeneration, or
  • * Age 46 1/2 or older, or
  • * Age 27 or older with initial medical onset at least 5 years before the current determination
  • 3320
  • Parkinson's Disease
  • * Listing 11.06, or
  • * Age 41 1/2 or older
  • 3330
  • Huntington’s Disease
  • * Listing 11.17 – degenerative disease, Huntington's Disease
  • * Age 46 1/2 or older, or
  • * Age 27 or older with initial medical onset at least 5 years before the current determination
  • 3350
  • Anterior Horn Disease
  • * Listing 11.10 -- amyotrophic lateral sclerosis (ALS), or
  • * Age 41 1/2 or older
  • 3360
  • Other Diseases of Spinal Cord
  • Other Diseases of Spinal Cord, such as Syringomyelia
  • * Listing 11.08 -- spinal cord disorder resulting in markedly reduced function in two or more extremities for more than 6 months
  • * Listing 11.19 -- Syringomyelia, or
  • * Age 46 1/2 or older
  • 3400
  • Multiple Sclerosis
  • * Listing 11.09, or
  • * Age 46 1/2 or older
  • 3430
  • Cerebral Palsy
  • All adults and children, except those less than 1 year of age.
  • 3590
  • Muscular Dystrophy
  • All adults and children
  • 3650
  • Glaucoma
  • Listing 2.02 -- statutory blindness -- markedly reduced ability to see objects (not correctable by surgery, lenses, or medication)
  • 3680
  • Visual Disturbance
  • Listing 2.03 or 2.04 -- markedly reduced ability to see objects (not correctable by surgery, lenses, or medication)
  • 3690
  • Low Vision
  • * Listing 2.03B, 2.03C or 2.04 -- when not correctable by surgery or not due to a potentially treatable condition
  • * Listing 102.03B, 102.03C, or 102.04 -- markedly reduced ability to see objects (not correctable by surgery, lenses, or medication)
  • 3694
  • Statutory Blindness
  • * Listing 2.02 or 2.03A -- markedly reduced ability to see objects (not correctable by surgery, lenses, or medication), or
  • * • Listing 102.02A or 102.03A -- markedly reduced ability to see objects (not correctable by surgery, lenses, or medication)
  • 3890
  • Hearing Loss.
  • Listing 2.10 – hearing loss not treated with cochlear implantation."
  • 4130
  • Angina
  • Age 46 1/2 or older
  • 4380
  • Cerebrovascular Disease -- Late Effects
  • * Listing 11.04 -- central nervous system vascular accident, with manifestations as required by the listing more than 3 months post-cerebral vascular accident, or
  • * Age 46 1/2 or older, or
  • * Age 26 1/2 or older with initial medical onset at least 15 years before the current determination
  • 4430
  • Peripheral Vascular (Arterial) Disease
  • Age 46 1/2 or older
  • 4510
  • Phlebitis
  • Listing 4.11, or
  • Age 46 1/2 or older
  • 4540
  • Varicose Veins
  • Listing 4.11 -- chronic venous insufficiency
  • 4960
  • Chronic Pulmonary Insufficiency
  • Listing 3.02 -- chronic pulmonary insufficiency
  • 5850
  • Chronic Kidney Disease with Dialysis
  • Listing 6.03 or 106.03 -- impaired renal function due to chronic progressive disease, incurable kidney disease (documented by persistent adverse objective findings) resulting in severely reduced function that may require dialysis.
  • 7100
  • Diffuse Disease of Connecting Tissue
  • Listing 14.04 -- scleroderma or progressive systemic sclerosis
  • 7140
  • Rheumatoid Arthritis
  • Age 46 1/2 or older
  • 7200
  • Spondylitis
  • * Age 46 1/2 or older
  • * Listing 14.09C -- inflammatory arthritis (ankylosing spondylitis or other spondyloarthropathy, with ankylosis (fixation) of the dorsolumbar or cervical spine at 45 degrees or more) that is not surgically treatable
  • 7400
  • Anencephalus and Catastrophic Congenital Anomality or Disease
  • Adults and children of all ages
  • 7410
  • Meningomyelocele
  • Listing 111.08B2 or C
  • Listing 111.08 A or B
  • 7580
  • Non-mosaic Down Syndrome
  • Listing 10.06
  • Listing 110.06
  • 8060
  • Fracture of Spine/Spinal Cord Lesion
  • Listing 11.08 -- spinal cord or nerve root lesion resulting in paraplegia or quadriplegia, damage to the spinal cord or major branches resulting in markedly reduced function in two or more extremities for more than 2 years.
  • 9050
  • Amputation
  • * Listing 1.05A both hands (amputation due to any cause), or
  • * Listing 1.05D hemipelvectomy or hip disarticulation (amputation due to any cause).
  • * Listing 101.05A both hands (amputation due to any cause), or
  • * Listing 101.05D hemipelvectomy or hip disarticulation (amputation due to any cause).
  • 9070
  • Late Effects of Injuries to the Nervous System
  • Age 46 1/2 or older
  • 7590
  • Xeroderma pigmentosum
  • Listing 8.07A or 108.07A listing for Xeroderma pigmentosum
  • 3. Other permanent disabilities
  • Set a MINE diary if the individual of any age has a chronic or progressive impairment, or combination of impairments:
  • * with permanent, irreversible structural damage, or functional loss, and
  • * for which there is no known effective therapy, treatment, or surgical intervention (i.e., an intervention that could result in medical improvement and the ability to perform SGA in adults, or no longer result in marked and severe functional limitations in children).
  • NOTE: Use this criterion to set the MINE diary for cases involving cancer which is certainly not remediable, i.e., cannot be controlled by treatment, therapy, or surgery (see DI 26525.010). The MINE diary should not be set in cases where there is any possibility of remission.