All the rationale elements described in DI 26515.001, DI 27020.001, and DI 28090.001. must be documented in all wholly unfavorable or partially favorable childhood disability
determinations. A full rationale is not required in fully favorable determinations.
Most rationales are completed on an SSA-4268-U4/C4. However, if the SSA-538 (Childhood
Disability Evaluation Form - see DI 25230.001) includes all the required rationale elements, it is not necessary to complete an SSA-4268-U4/C4.
If the SSA-538 does not contain all the required rationale elements and an SSA-4268-U4/C4
must be completed, the findings in the SSA-538 may be incorporated by reference in
the SSA-4268-U4/C4.