federal register - U.S. Government Printing Office

6430 Federal Register / Vol. 62, No. 28 / Tuesday, February 11, 1997 / Rules and Regulations(ii) Who also were eligible for suchbenefits for the month before the monthin which they attained age 18.(2) When we make this determination,we will apply the rules in§§ 416.920(c)–(f); we will not apply therules in § 416.920(b) or § 416.994.(3) If you are an individual affected bythe provisions of this section, and youare disabled under § 416.920 (d) or (f),and you are working, we will apply therules in §§ 416.260 ff.(4) We will initiate this disabilityredetermination during the 1-yearperiod beginning on your 18th birthday.(5) If we find that you are not disabledunder the rules in § 416.920 (except§ 416.920(b)), your eligibility will end.The month in which we will find younot disabled is explained in paragraph(b)(6) of this section; the month yourbenefits will stop is explained inparagraph (b)(7) of this section.(6) If the evidence shows that you arenot disabled, we will find that yourdisability ended in the earliest of:(i) The month the evidence shows thatyou are not disabled under the rules setout in this section, but not earlier thanthe month in which we mail you anotice saying that you are not disabled.(ii) The first month in which youfailed without good cause to followprescribed treatment under the rules in§ 416.930.(iii) The first month in which youfailed without good cause to do what weasked. Section 416.1411 explains thefactors we will consider and how wewill determine generally whether youhave good cause for failure to cooperate.In addition, § 416.918 discusses how wedetermine whether you have good causefor failing to attend a consultativeexamination.27. Section 416.990 is amended byrevising paragraphs (b)(9) and (b)(10),adding paragraph (b)(11), and revisingthe first and second sentences of thedefinition of Permanent impairment inparagraph (c) to read as follows:§ 416.990 When and how often we willconduct a continuing disability review.* * * * *(b) * * *(9) Evidence we receive raises aquestion whether your disability orblindness continues;(10) You have been scheduled for avocational reexamination diary review;or(11) By your first birthday, if you area child whose low birth weight was acontributing factor material to ourdetermination that you were disabled;i.e., whether we would have found youdisabled if we had not considered yourlow birth weight.(c) * * *Permanent impairment—medicalimprovement not expected—refers to acase in which any medical improvementin a person’s impairment(s) is notexpected. This means an extremelysevere condition determined on thebasis of our experience in administeringthe disability programs to be at leaststatic, but more likely to beprogressively disabling either by itselfor by reason of impairmentcomplications, and unlikely to improveso as to permit the individual to engagein substantial gainful activity or, if youare a child, unlikely to improve to thepoint that you will no longer havemarked and severe functionallimitations. * * ** * * * *28. Section 416.994a is amended byremoving paragraphs (b)(4), (b)(5), (c)(4),(d) (f)(1), and (f)(2), redesignatingparagraphs (e) through (i) as paragraphs(d) through (h), redesignatingparagraphs (f)(3) and (f)(4) as paragraphs(e)(1) and (e)(2), adding paragraph (i),revising the section heading andparagraphs (a)(1), revising the firstsentence of the introductory text toparagraph (b), adding two sentencesbetween the first and second sentencesof the introductory text to paragraph (b),revising paragraphs (b)(1) through (b)(3),adding one sentence between the firstand second sentences of theintroductory text to paragraph (c),revising the third and fourth sentencesof redesignated paragraph (d), revisingthe introductory text to redesignatedparagraph (e), revising paragraph (e)(1),revising the second sentence of theintroductory text to redesignatedparagraph (f), and revising paragraphs(f)(4) and (g)(5) to read as follows:§ 416.994a How we will determine whetheryour disability continues or ends, andwhether you are and have been receivingtreatment that is medically necessary andavailable, disabled children.(a) * * *(1) We will first consider whetherthere has been medical improvement inyour impairment(s). We define ‘‘medicalimprovement’’ in paragraph (c) of thissection. If there has been no medicalimprovement, we will find you are stilldisabled unless one of the exceptions inparagraphs (e) or (f) of this sectionapplies. If there has been medicalimprovement, we will consider whetherthe impairments(s) you had at the timeof our most recent favorabledetermination or decision now meets ormedically or functionally equals theseverity of the listing it met or equalledat that time. If so, we will find you arestill disabled, unless one of theexceptions in paragraphs (e) or (f) of thissection applies. If not, we will considerwhether your current impairment(s) aredisabling under the rules in § 416.924.These steps are described in more detailin paragraph (b) of this section. Evenwhere medical improvement or anexception applies, in most cases, wewill find that your disability has endedonly if we also find that you are notcurrently disabled.* * * * *(b) Sequence of evaluation. To ensurethat disability reviews are carried out ina uniform manner, that decisions ofcontinuing disability can be made in themost expeditious and administrativelyefficient way, and that any decisions tostop disability benefits are madeobjectively, neutrally, and are fullydocumented, we follow specific steps indetermining whether your disabilitycontinues. However, we may skip stepsin the sequence if it is clear this wouldlead to a more prompt finding that yourdisability continues. For example, wemight not consider the issue of medicalimprovement if it is obvious on the faceof the evidence that a currentimpairment meets the severity of alisted impairment. * * *(1) Has there been medicalimprovement in your condition(s)? Wewill determine whether there has beenmedical improvement in theimpairment(s) you had at the time of ourmost recent favorable determination ordecision. (The term medicalimprovement is defined in paragraph (c)of this section.) If there has been nomedical improvement, we will find thatyour disability continues, unless one ofthe exceptions to medical improvementdescribed in paragraph (e) or (f) of thissection applies.(i) If one of the first group ofexceptions to medical improvementapplies, we will proceed to step 3.(ii) If one of the second group ofexceptions to medical improvementapplies, we may find that your disabilityhas ended.(2) Does your impairment(s) still meetor equal the severity of the listedimpairment that it met or equaledbefore? If there has been medicalimprovement, we will consider whetherthe impairment(s) that we considered atthe time of our most recent favorabledetermination or decision still meets orequals the severity of the listedimpairment it met or equalled at thattime. In making this decision, we willconsider the current severity of theimpairment(s) present and documentedat the time of our most recent favorabledetermination or decision, and the samelisting section used to make that