POMS Reference

DI 28010: Medical Improvement and Related Medical Issues

TN 2 (06-15)

A. Introduction to MRFCs in CDRs

This section discusses the need for an SSA-4734-F4-Sup (MRFC) assessment form in CDRs. The discussion focuses on steps in the CDR evaluation process. For more information on this process, see DI 28005.005.

B. Use of the MRFC

1. When not to use an MRFC

  1. Medical/vocational factors do not apply to the category of claim involved (e.g., Title XVI childhood cases).

  2. In cases where disability was continued on the basis of:

    • meeting/equaling a current listing (step 2), or

    • no medical improvement (MI) or exception (step 3 and 5). However, see DI 28015.850B.4. when a current residual functional capacity (RFC) assessment form is needed for future CDRs.

  3. In medical improvement not expected (MINE) continuances.

  4. In relating MI to ability to work, if the CPD used the Listing of Impairments as its basis (i.e., if the CPD found that an impairment met or equaled a listing and no longer does, MI is already considered related to the ability to work).

2. Relating MI to ability to work (step 4)

In cases where the CPD used a medical/vocational basis (i.e., a CPD RFC is in file):

  1. Prepare an MRFC assessment showing the current status of restrictions resulting from (only) the mental impairment(s) present at the time of the CPD. For more information on this MRFC assessment, the “MIRS RFC”, see DI 28015.850B.2.

  2. Do not prepare an MRFC assessment for the time of the CPD. However, if the medical/vocational decision should have included an RFC assessment but does not, a prior RFC may be prepared. For more information on the “prior RFC,” see DI 28015.315, DI 28015.850B.3., and DI 28015.855D.

  3. If the CPD used an obsolete mental RFC form, see DI 28010.140C.3.c. and DI 28015.320B.

3. Past work or other work (steps 7 and 8)

Prepare a current MRFC form considering all mental impairments. For more information on this MRFC assessment, the “CURRENT RFC,” see DI 28015.850B.4.b.

C. References

  • DI 28005.015 Step-by-Step Discussion of the Adult Continuing Disability Review (CDR) Evaluation Process

  • DI 28005.020 The CDR Evaluation Process -- Title XVI Child – General

  • DI 28015.850 Types of RFC Assessment(s) Needed