TN 27 (12-17)

DI 22501.001 Disability Case Development for Evidence

Citations:

Social Security Act - Sections 223(d), 1614(a), 1631(e)

Regulations - 20 CFR sections 404.1512 through 404.1516, 404.1520, 404.1520b, 416.912 through 416.916, 416.920, and 416.920b

A. Purpose of case development

We develop evidence from medical and nonmedical sources to establish:

• whether the claimant is disabled or blind,

• the date disability began, and

• the date disability ended, if applicable.

B. Definition of evidence

Evidence is anything the claimant or anyone else submits to us, or that we obtain, that relates to the claim for disability benefits.

For the categories of evidence, see DI 24503.005B.

For details on what is not considered evidence, see DI 24503.001B.

C. Evidence we consider for a disability determination

We consider all relevant evidence in the case record when making a disability determination. This includes the following evidence we have:

• in our records, including relevant evidence from available prior folders,

• received from medical sources, and

• received from nonmedical sources, including the claimant.

NOTE: When the adjudicator considers evidence from a prior folder(s), the relevant evidence from the prior folder(s) must be included in the current case folder.

For the definition of relevant evidence, see DI 24501.016B.2.

D. Completeness of medical and other evidence

The evidence we receive must be complete and detailed enough to permit an independent determination about whether the claimant is disabled or blind.

Therefore, the evidence must allow the adjudicator(s) to determine:

• the nature and severity of the claimant’s impairment(s),

• whether the 12-month duration requirement is met,

• the claimant’s residual functional capacity when steps 4 and 5 of sequential evaluation apply, and

• the established onset date, if applicable.

When there is enough evidence, the adjudicator should be able to understand how the claimant functions on a day-to-day basis.

NOTE: The adjudicator may discontinue development when the evidence is consistent and sufficient to make a fully favorable determination. For details, see Expedients to Evaluate and Develop Evidence for Potential Mental and Physical Impairments in section DI 24505.030.