This category is restricted to claims that require a medical determination for statutory blindness only, and the review indicates all of the following:

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  Statutory blindness is not supported;

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  The adjudicating component issued a favorable determination for reasons other than statutory blindness;

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  The FO determined the claimant is currently performing non-blind SGA; and

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  The adjudicating component should have denied the claim for non-blind SGA, in accordance with DI 26001.015A.2. and DI 26001.015D.2.

The adjudicating component based the determination on medical considerations alone (i.e., the impairment is not severe, or the impairment meets, medically equals, or does/does not functionally equal the listings). However, the evidence does not support the adjudicating component’s determination and an opposite determination is appropriate.

The adjudicating component based the determination on the severity of the disabling impairment that did not meet policy requirements for 12-month duration.

The adjudicating component incorrectly determined MI or MI related to the ability to work, in a Continuing Disability Review (CDR).

The adjudicating component applied, or should have applied, the MI exception in a CDR regarding significant MI due to medical or vocational therapy or technology.

The adjudicating component applied, or should have applied, the MI exception in a CDR regarding the individual’s successful completion of vocational therapy.

The adjudicating component applied, or should have applied, the MI exception in a CDR regarding new or improved diagnostic techniques that demonstrate an individual’s impairment(s) is not as disabling, as it was at the time of the most recent prior favorable medical determination.

The adjudicating component applied, or should have applied, the MI exception in a CDR regarding a prior determination made in error, due to:

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  error on the face of the record,

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  missing required and material evidence , or

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  new evidence related to the prior determination or decision.

The adjudicating component applied, or should have applied, the MI exception in a CDR regarding a prior determination made in error based on documentation of fraud and similar fault.

The adjudicating component based the determination on an RFC assessment. However, the evidence does not support the adjudicating component’s RFC and an opposite determination is appropriate.

The adjudicating component determined, or should have determined, disability based on one or more of the following vocational factors:

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  Age

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  Education (including illiteracy)

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  Transferability of skills

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  Ability to perform past relevant work (PRW)

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  Ability to perform other work

The adjudicating component:

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  allowed or continued disability for a claimant who should have been denied or ceased because the individual failed, without good cause, to follow prescribed treatment, or

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  denied or ceased disability for a claimant who should have been allowed or continued because the individual had good cause for FTFPT.

The adjudicating component:

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  allowed or continued disability despite evidence that DAA is material to the determination, or

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  denied or ceased disability on the basis that DAA is material, despite evidence that DAA is not material to the determination.

The adjudicating component allowed a title II disability claim despite:

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  an established onset date (EOD) after the date last insured (DLI) for a Title II disabled worker, after the end of the prescribed period for a disabled widow(er), or after the attainment of age 22 for a childhood disability claim,

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  the field office (FO) documenting the certified electronic folder (CEF) with the correct DLI, prescribed period, or childhood disability claimant's date of birth, and

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  evidence indicating an earlier onset date is not supported.

The adjudicating component erroneously adopted, or should have adopted, a prior ALJ or AC disability decision or specific finding (e.g., impairment severity, RFC, demands of PRW) based on an AR.

The adjudicating component:

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  incorrectly adopted a prior final determination and disability cannot be established based on the current evidence in file, or

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  incorrectly denied a claim when adoption of a prior favorable determination or decision was warranted.