TN 3 (02-01)

DI 22505.010 Development Issues - Longitudinal Medical Evidence

A. Policy - General

Medical development should be aimed primarily at resolving questions of:

  • Onset;

  • Current severity; and

  • Whether the impairment can be expected to last 12 months or result in death.

B. Procedure - Specific Situations

1. Static Or Progressive Impairments

  1. a. 

    When significant improvement or change for the better within 12 months of onset is unlikely, the principal issue is, generally, documentation of severity.

    NOTE: The duration requirements must be met.

  2. b. 

    Discontinue development when:

    • The impairment(s) present at onset has been documented as being severe; and

    • It is of a chronic or progressive nature.

  3. c. 

    Determine the correct onset date when the date alleged by the claimant is inconsistent with the medical and other evidence of record.

2. Closed Period Cases

Unlike title XVI claimants, title II claimants need not still be disabled at the time of filing.

  1. a. 

    In determining the possibility of a closed period, consider:

    • Work activity;

    • The claimant's assertion of medical improvement; and

    • The medical evidence.

  2. b. 

    Direct development efforts at establishing:

    • Onset;

    • Past severity and duration of the impairment; and

    • The date medical improvement was demonstrated (see DI 28010.000 ff.).

  3. c. 

    Initiate any additional development needed.

NOTE: See DI 25510.001 ff. for technical requirements in closed period of disability cases.

3. No Waiting Period Cases

A title II claimant may qualify for benefits under a second period of disability beginning with the first full month of disability. Process such cases immediately.

4. Medically Deferred Development

  1. a. 

    Final adjudication of a case may need to be delayed because future medical evidence is needed, e.g., the claimant alleges recent major heart surgery (e.g., coronary bypass graft) and future evidence is needed to determine duration.

  2. b. 

    Make every reasonable effort to obtain existing medical evidence  from the claimant's medical source(s).

To Link to this section - Use this URL:
DI 22505.010 - Development Issues - Longitudinal Medical Evidence - 02/28/2001
Batch run: 04/25/2014