One of the principles of the quality review is that federal quality reviewers, federal
MCs, and federal psychological contractors (PC) must not substitute their judgment
for that of the adjudicating component’s MCs, PCs, and adjudicators. Federal MCs and
PCs must be aware of SOJ as a review principle to ensure they do not perform a de
case review (see GN 04440.003D above for a definition of de novo review).
For a description of the medical contractors' review process, see GN 04440.130B.
Quality reviewers must be aware of SOJ as a review principle in decisional deficiency
If an adjudicator documented a case in accordance with SSA policy, the adjudicator's
assessment complies with SSA policy, and the preponderance of the evidence in file
supports the determination, the quality reviewer must not cite a deficiency even though
the reviewer may have arrived at a different, equally supportable conclusion (see
GN 04440.003G above for a definitio of preponderance of the evidence.
For a complete explanation of SOJ, see GN 04440.118.