TN 70 (07-19)

GN 04440.524 Completing the SSA-392, Medical Consultant's Review of Physical Residual Functional Capacity Assessment

A. Background on using the SSA-392

Federal review medical contractors (MC) use the SSA-392 to record their agreement or disagreement with the adjudicating component SSA-4734-BK, Physical Residual Functional Capacity Assessment (RFC).

Use the SSA-392 to:

  • Identify findings of physical capacity and restrictions that are the same as, or different from, those of the adjudicating component,

  • Cite and discuss the evidence supporting the different finding(s),

  • Discuss specific problems with the adjudicating component's completion of the SSA-4734-BK, and

  • Record conclusions as to whether the adjudicating component’s findings on physical RFC are reasonable, consistent with program policy, and supported by the evidence.

For an exhibit of the SSA-392, see GN 04440.929.

B. Policy for completing the SSA-392

Reviewing MCs complete the SSA-392 to record agreement or disagreement with the physical RFC assessment established by the adjudicating MC on an SSA-4734-BK. The MC completes the SSA-392 only when there is an SSA-4734-BK in file.

1. When to complete an SSA-392

The MC completes an SSA-392 when:

  • An SSA-4734-BK is in file, and

  • A physical impairment of less than listing. level severity requiring an RFC assessment is present.

For further explanation of when to use the SSA-392, see GN 04440.135.

NOTE: When an RFC is not in the file, but one is required, the reviewing MC will prepare the assessment on an SSA-4734-BK. The reviewing MC should not use the SSA-392 to prepare an RFC assessment..

2. When not to complete an SSA-392

The MC does not complete an SSA-392 when:

  • The adjudicating component prepared an SSA-4734-BK, but MC review establishes that the adjudicating component should have made the disability determination on a medical basis only (i.e., the impairment is a “not severe”physical impairment, or the impairment is of listing-level severity), or

  • The disability determination is not supported by sufficient evidence and additional medical evidence is needed (i.e., a medical documentation deficiency), regardless of whether the adjudicating component decided the case on a medical-vocational basis.

NOTE: For situations in GN 04440.524B2, the MC records case analysis and disagreement(s) with the RFC determination on an SSA-416, Case Analysis.

C. Procedure for completing the SSA-392

1. Heading

The items in the heading are self-explanatory. In the field, “Date(s) SSA-4734-BK Applicable”, enter the RFC date(s) or date range, as documented by the adjudicating component.

2. Part A – Evaluation

After review of all the evidence, complete Part A.

  • Indicate whether you agree or disagree with the adjudicating component's RFC conclusion, considering reasonableness and evidence support.

  • If you disagree with any of the adjudicating component's findings, proceed to Part B; or

  • If you agree with all the adjudicating component's findings, proceed directly to Part C.

3. Part B – Discussion and/or Comments

Cite the section and number of each item in dispute.

For each disputed item:

  • Explain why particular findings are inconsistent with policy.

  • Show how the adjudicating component drew erroneous conclusions from the facts.

  • Describe your findings, and include additional limitations or restrictions, if applicable.

  • Cite the facts and discuss how and why the evidence supports your conclusions.

  • As appropriate, evaluate and discuss limitations imposed by symptoms, such as pain or fatigue.

  • Resolve all inconsistencies in the evidence when the adjudicating component failed to do so.

4. Part C – Conclusion

  • If you agree with all the adjudicating component's findings in Part A, check 1, “AGREE”; or

  • If you disagree with any of the adjudicating component's findings in Part A, and provide a discussion in Part B, check 2, “DISAGREE”.

NOTE: See GN 04440.524B2 for disagreement involving insufficient evidence or support for medical assessment other than RFC.

5. MC signature

Sign, date, and enter the MC code.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0204440524
GN 04440.524 - Completing the SSA-392, Medical Consultant's Review of Physical Residual Functional Capacity Assessment - 07/03/2019
Batch run: 07/03/2019
Rev:07/03/2019