DI 22501.001: Disability Case Development for Evidence
Effective Dates: 03/02/2016 - Present TN 23 (11-12) DI 22501.001 Disability Case Development for Medical and Other Evidence
- Social Security Act - Sections 223(d), 1614(a), 1631(e)
Regulations - 20 CFR sections 404.1512 through 404.1516, 404.1520, 416.912 through 416.916, and 416.920
- A. Purpose of case development
We develop medical and other evidence to establish:
- * whether the claimant is disabled or blind,
and as needed,
- * the date disability began, and
* the date disability ended.
- B. Definition of evidence
Evidence is any medical or non-medical information the claimant or anyone else submits, or we obtain, that relates to the disability claim. At each level of adjudication, evidence may include, but is not limited to: * Objective medical evidence: * medical signs, and * laboratory findings. * Narrative medical records from medical sources: * medical history, and * treatment records. * Medical source opinions and statements, including those from: * state agency and regional medical consultants (MC) or psychological consultants (PC) and other program health care professionals, and * consultative examination (CE) sources. * Statements from the claimant or others about the claimant’s: * impairment(s), * restrictions, * daily activities, and * efforts to work. * Any relevant statements the claimant makes: * to medical sources, during the course of examination or treatment, or * to the field office (FO) or Disability Determination Services (DDS), during face-to-face or telephone interviews, on applications or other forms such as function reports or work history, in letters, and in testimony during an administrative hearing. * Information from other sources, including: * educational personnel, * social welfare agency personnel, and * other medical and non-medical sources. For examples of medical sources and non-medical sources, see DI 22505.003B.3. * Decisions by any government or non-government agency about whether the claimant is disabled or blind. * A report of investigation (ROI) prepared by the Office of the Inspector General or Cooperative Disability Investigations Unit; see DI 23025.020A.2.
- C. Evidence we consider for a disability determination
We consider all relevant evidence in the case folder when making a disability determination. This includes relevant evidence we: * have in our records, including relevant evidence from available prior folders, * receive from the claimant, and * develop from medical and other sources. For a definition of relevant evidence, see DI 20503.001B.2. D. Completeness of medical and non-medical evidence Case evidence must be complete and detailed enough to permit an independent determination about whether the claimant is disabled or blind. The evidence must allow adjudicator(s) to determine: * the nature and limiting effects of the claimant’s impairment(s), * whether the 12-month duration requirement is met or is expected to be met, * the claimant’s residual functional capacity (RFC) to do work-related physical and mental activities at Steps 4 and 5 of sequential evaluation, and * the established onset date (EOD). When there is enough evidence, the adjudicator should be able to picture how the claimant functions on a day-to-day basis.
x← This means that the line was removed and was added – in other words, the "Effective Dates" line at the top of the document has been updated to reflect that the new version is effective as of the date the change was made.