Federal quality reviewers make POR determinations in deciding whether a case has sufficient
medical or vocational documentation to support the disability determination.
Federal review physicians may offer opinions on the potential effect of missing documentation
on impairment severity or residual functional capacity, but these opinions are not
binding on the Federal quality reviewer.
Federal quality reviewers are responsible for the final POR determination, subject
to discretionary review by review component management.
For an explanation of who is a Federal quality reviewer, see GN 04440.003.
For a further explanation of the reviewing physician's role in POR determinations,
see GN 04440.135B.3.
NOTE: The adjudicating component may not use POR to determine whether to make an initial
request for required medical or vocational documentation or as the basis for rebuttal.
However, adjudicators may process a fully favorable allowance determination without
awaiting receipt of, or continuing to follow up on development of, required evidence
that should not, in the judgment of the adjudicative team, affect the allowance determination.
For a complete explanation of expedients for evaluating evidence, refer to DI 24515.001 and DI 24515.020.