Basic (03-86)

DI 43525.001 Initial Claim - Work Issue Recognized Prior to Forwarding to the Examiner

If a claims development adjudicator (CDA) recognizes a work issue prior to forwarding a disability case to an examiner and medical evidence is in file, the examiner will be informally asked to review the claim to determine if there is sufficient medical documentation to prepare a substantive determination. If the examiner determines that there is not sufficient evidence in file for a medical or medical-vocational, denial or closed period, the CDA will forward the folder to the Substantial Gainful Activity (SGA) specialist for resolution of the SGA issue. (See DI 43505.020 for jurisdiction of initial SGA determinations.) The examiner will document the file using a Form SSA-5002 (Report of Contact) when assisting the CDA.