Notice2026-01154
Social Security Ruling, SSR 26-1p; Title XVI: Determining Continuing Disability at Steps 2 and 3 of the Medical Improvement Review Standard Sequential Evaluation Process for Children Under Age 18-Functional Equivalence
Primary source
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Published
January 22, 2026
Issuing agencies
Social Security Administration
Abstract
We are providing notice of SSR 26-1p. This SSR simplifies our process for determining continuing disability at steps 2 and 3 of the medical improvement review standard for children under age 18 who receive Supplemental Security Income (SSI) under title XVI of the Social Security Act.
Full Text
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<title>Federal Register, Volume 91 Issue 14 (Thursday, January 22, 2026)</title>
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[Federal Register Volume 91, Number 14 (Thursday, January 22, 2026)]
[Notices]
[Pages 2820-2821]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-01154]
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SOCIAL SECURITY ADMINISTRATION
[Docket No. SSA-2024-0020]
Social Security Ruling, SSR 26-1p; Title XVI: Determining
Continuing Disability at Steps 2 and 3 of the Medical Improvement
Review Standard Sequential Evaluation Process for Children Under Age
18--Functional Equivalence
AGENCY: Social Security Administration (SSA).
ACTION: Notice of Social Security Ruling (SSR).
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SUMMARY: We are providing notice of SSR 26-1p. This SSR simplifies our
process for determining continuing disability at steps 2 and 3 of the
medical improvement review standard for children under age 18 who
receive Supplemental Security Income (SSI) under title XVI of the
Social Security Act.
DATES: We will apply this notice on March 23, 2026.
FOR FURTHER INFORMATION CONTACT: Michael J. Goldstein, Disability
Policy, Social Security Administration, 6401 Security Boulevard,
Baltimore, MD 21235-6401, telephone: (410) 965-1020.
SUPPLEMENTARY INFORMATION: Although 5 U.S.C. 552(a)(1) and (a)(2) do
not require it, we are publishing this SSR in accordance with 20 CFR
402.160(b)(1). Although SSRs do not have the same force and effect as
statutes or regulations, they are binding on all components of SSA (20
CFR 402.160(b)(1)).
We use SSRs to make available to the public precedential final
opinions, orders, and statements of policy and interpretation relating
to the Federal old-age, survivors, disability, supplemental security
income, and special veterans benefits programs. We may base SSRs on
determinations or decisions made at all levels of our administrative
review process, Federal court decisions, decisions of our Commissioner,
opinions from our Office of the General Counsel, or other
interpretations of the law and regulations.
This SSR will remain in effect until we publish a notice in the
Federal Register that rescinds it, or we publish a new SSR that
replaces or modifies it.
(Federal Assistance Listings No. 96.006--Supplemental Security
Income.)
Mark A. Steffensen,
General Counsel, Social Security Administration.
Policy Interpretation Ruling
SSR 26-1p: Title XVI: Determining Continuing Disability at Steps 2
and 3 of the Medical Improvement Review Standard Sequential Evaluation
Process for Children Under Age 18--Functional Equivalence.
This SSR rescinds and replaces SSR 05-03p.
Purpose: This SSR simplifies the way we determine continuing
disability at steps 2 and 3 of the medical improvement review standard
(MIRS) sequential evaluation process for children under age 18
described in 20 CFR 416.994a(b)(2). It also demonstrates how to apply
functional equivalence at steps 2 and 3.
Citations (Authority): 42 U.S.C. 1382c (a)(3), (a)(4), and (c) of
the Social Security Act; 20 CFR 416.924, 416.925, 416.926, 416.926a,
and 416.994a.
Dates: We will apply this notice on March 23, 2026.
Introduction
A child under age 18 is disabled under title XVI of the Social
Security Act if they have a medically determinable impairment or
combination of impairments that results in marked and severe functional
limitations and lasts or can be expected to last for at least 12 months
or is expected to result in death.\1\ We will find that an
impairment(s) causes marked and severe functional limitations if it
meets or medically equals the requirements of a listing, or if it
functionally equals the listings (20 CFR 416.924(d)).
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\1\ 42 U.S.C. 1382c(a)(3)(C)(i).
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We periodically conduct a continuing disability review (CDR) to
determine whether a child's disability continues. We will find a child
is no longer disabled if their impairment(s) has medically improved and
no longer results in marked and severe functional limitations.\2\ We
use a three-step sequential evaluation process to determine whether a
child's disability continues or ends, as outlined in 20 CFR
416.994a(b). This process is known as the medical improvement review
standard (MIRS). As part of the MIRS process, we again consider whether
a child's impairment(s) meets, medically equals, or functionally equals
the listings (20 CFR 416.994a(a)(1) and 416.994a(b)(3)).
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\2\ Certain exceptions to medical improvement may apply, under
which disability can be found to have ended even though medical
improvement has not occurred. 42 U.S.C. 1382c(a)(4)(B), (C). Those
exceptions are not relevant here.
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Effective January 2, 2001, we revised our rules to simplify the
evaluation of functional equivalence.\3\ Following that change, we
issued SSR 05-03p to instruct adjudicators on how to apply the revised
functional equivalence rule in the CDR process for children under age
18. SSR 05-03p included two sets of instructions, to be applied to CDRs
for children depending on whether the most recent favorable
determination or decision (comparison point decision (CPD)) was issued
before January 2, 2001, or on or after this date. There is no longer a
population for whom a CPD issued before January 2, 2001 could apply
because such an individual would have attained an age greater than 18
(the youngest of which would be at least age 24). Since, by definition,
there are no longer any child cases with a CPD before January 2, 2001,
we no longer need instructions for those types of cases. Consequently,
it is appropriate for us to remove the obsolete text in SSR 05-03p and
simplify our subregulatory guidance by including only relevant
material.
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\3\ 65 FR 54747 (September 11, 2000).
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We are also simplifying the instructions for considering functional
equivalence in cases with a CPD on or after January 2, 2001. For those
cases, SSR 05-03p instructed adjudicators to consider functional
equivalence twice in the CDR process and we are eliminating that
redundancy. For these reasons, we are rescinding SSR 05-3p.
Policy Interpretation
When we conduct a CDR for children under age 18, we use a three-
step MIRS sequential evaluation process outlined
[[Page 2821]]
in 20 CFR 416.994a(b). Below, we explain how we are simplifying that
process.
Step 1 of the MIRS Sequential Evaluation Process
At step 1, we determine whether there has been medical improvement
in the impairment(s) that was present at the time of the most recent
favorable determination or decision (20 CFR 416.994a(b)(1)). We refer
to the impairment(s) that was present at the time of the most recent
favorable determination or decision as the CPD impairment(s). If there
has been no medical improvement in the CPD impairment(s), we find that
the child's disability continues.\4\ If there has been medical
improvement, we proceed to step 2 (20 CFR 416.994a(b)(2)).
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\4\ As noted, certain exceptions to medical improvement may
apply, under which disability can be found to have ended even though
medical improvement has not occurred. See 20 CFR 416.994(a)(1), (e),
and (f).
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Step 2 of the MIRS Sequential Evaluation Process
At step 2, we determine whether the CPD impairment(s) still meets
or medically equals the severity of the listed impairment that it met
or equaled at the time of the CPD. We consider the listing as it was
written at the time of the CPD, even if the listing has since been
revised or removed (20 CFR 416.994a(b)(2)).
If the CPD impairment(s) met or medically equaled a listing: If our
determination or decision at the time of the CPD was that the child's
impairment(s) met or medically equaled a listing, we consider whether
the CPD impairment(s) now either meets or medically equals that same
listing. If it does, we find that the child is still disabled.
To determine that the CPD impairment(s) currently meets or
medically equals the CPD listing, we do not have to make the same
finding we made at the CPD. For example, if we found at the CPD that
the child's impairment(s) met a listing, and now the CPD impairment(s)
no longer meets that listing, but it medically equals that listing, we
find that the child's disability continues. Similarly, if the CPD
impairment(s) met or equaled a specific subsection of the CPD listing
(e.g., 103.04B) and now meets or equals a different subsection of that
listing (e.g., 103.04A), we will find that the child is still disabled.
If the CPD impairment(s) does not currently meet or medically equal the
CPD listing, as that listing was written at the time of the CPD, we
proceed to step 3 (20 CFR 416.994a(b)(3)).
If the CPD impairment(s) functionally equaled the listings: If our
determination or decision at the time of the CPD was that the child's
impairment(s) functionally equaled the listings, there is no CPD
listing for comparison at step 2. Therefore, we will not make a finding
at step 2 but will continue to step 3.
Step 3 of the MIRS Sequential Evaluation Process
At step 3, we consider all current impairments, including the CPD
impairment(s), any new impairments, and impairments not considered at
the time of the CPD (20 CFR 416.994a(b)(3)). We first determine whether
the current impairment(s) is severe (20 CFR 416.994a(b)(3)(i)). If so,
we determine whether the current impairment(s) meets or medically
equals a current listing or functionally equals the listings. If the
impairment(s) is severe and meets or medically equals a listing, or
functionally equals the listings, we will find that the child is still
disabled. If the impairment(s) is not severe, or the impairment(s) is
severe but does not meet or medically equal a listing and does not
functionally equal the listings, we will find that the child's
disability has ceased (20 CFR 416.994a(b)(3)(i)-(iii)).
Why We No Longer Consider Functional Equivalence at Step 2 of the MIRS
Sequential Evaluation Process
Consistent with 20 CFR 416.994a(a)(1), which states that we will
consider whether the CPD impairment(s) ``now meets or medically or
functionally equals the severity of the listing it met or equaled at
that time,'' SSR 05-03p instructed that adjudicators consider if the
CPD impairment(s) functionally equaled the listings at step 2 of the
CDR sequential evaluation.
Step 2 of the CDR evaluation ensures an individual's CPD
impairments continue to be evaluated based on the listing requirements
that existed at the time of the CPD--even if that listing was later
removed or revised. Considering functional equivalence at step 2 was
appropriate for cases in which the CPD was prior to January 2, 2001,
because functional equivalence in such cases was linked to the severity
of a specific listed impairment that included a disabling limitation(s)
in its criteria (20 CFR 416.926a(a) (2000)).
Effective January 2, 2001, functional equivalence is no longer
linked to the disabling limitation(s) in the criteria of a specific
listed impairment.\5\ Beginning January 2, 2001, considering the CPD
impairment(s) at step 2 of the CDR process is unnecessary and
redundant. The step 3 functional equivalence analysis considers the
interactive and cumulative effects of all the child's current
impairments, including both new and CPD impairments. For these reasons,
we are eliminating the redundancy created by considering functional
equivalence for the CPD impairment(s) at both steps 2 and 3 of the CDR
process.
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\5\ 65 FR 54747 (September 11, 2000).
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Cross-References: SSR 09-1p: Title XVI: Determining Childhood
Disability Under the Functional Equivalence Rule--The ``Whole Child''
Approach; and Program Operations Manual System DI 25225.015, DI
25225.020, DI 25225.025, and DI 28005.030.
[FR Doc. 2026-01154 Filed 1-21-26; 8:45 am]
BILLING CODE 4191-02-P
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</html>Indexed from Federal Register on January 22, 2026.
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