Federal quality reviewers must avoid substituting their judgment for the judgment
of the adjudicating component's physicians and examiners, when the adjudicating component's
disability determination is equally supportable, based on the evidence and documentation
in file and the examiner has fully documented the file. In such instances, the review
component will not cite a group I or group II decisional deficiency even though, after
considering all the facts, they believe that the evidence directs a different or opposite
determination than the adjudicating component's determination.
The intent of the SOJ policy is to ensure that review components do not cite decisional
deficiencies unless the adjudicating component has clearly not followed specific policy
or procedure or the evidence does not support the determination. If it is clear that
the determination at issue is not within disability program policy guidelines, then
the review component will cite a group I or group II decisional deficiency.
NOTE: The concept of SOJ applies only when determining whether a group I or group II decisional deficiency exists. SOJ does
not apply when determining whether a documentation deficiency exists.