TN 23 (09-14)

GN 04440.916 Form SSA-1047 (Vocational Consultant Case Analysis)

Social Security Administration

ISSUE STATEMENT:

VOCATIONAL CONSULTANT CASE ANALYSIS

______________________________________________________________________

Claimant Name:

_______________________________________________________________________

SSN:

______________________________________________________________________

Adjudicating Component:

______________________________________________________________________

VOCATIONAL FACTORS:

  • Date of birth/current age:

  • Age at AOD/EOD:

  • Education (and/or ability to communicate in English):

  • PRW:

    

ADJUDICATING COMPONENT PHYSICAL AND MENTAL RFC ASSESSMENTS:

    

    

    

OQR PHYSICAL AND MENTAL RFC ASSESSMENTS:

    

    

    

OQR VOCATIONAL ANALYSIS:

Step four assessment with policy citations:

      

    

Step five assessment with policy citations:

    

ADDITIONAL DISCUSSION IF NECESSARY:

    

    

    

    

______________________________________________________________________

Signature:

xxx, Vocational Consultant

______________________________________________________________________

Date:                              Reviewing Component:

                                      OQR-[field site designation]

______________________________________________________________________

Form SSA-1047 (01-2013)


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0204440916
GN 04440.916 - Form SSA-1047 (Vocational Consultant Case Analysis) - 12/31/2014
Batch run: 12/31/2014
Rev:12/31/2014