TN 31 (04-21)

DI 22505.012 Development Issue - No Evidence Furnished from an Acceptable Medical Source

A. Policy - claimant protection

1. Safeguard against denial

To safeguard against the denial of claims solely because we are unable to obtain evidence and/or the claimant is unable to furnish evidence of disability from an acceptable medical source (see DI 22505.003A.) due to circumstances beyond the claimant's control, consider other methods of obtaining the necessary medical evidence.

2. Claimant unable to furnish evidence of disability

Obtain a consultative examination (CE) when clinical details are needed to establish:

  1. a. 

    The existence of a medically determinable impairment, and

  2. b. 

    The claimant's functional limitations and remaining abilities.

3. Mental impairments

  1. a. 

    The policy stated above also addresses cases involving mental impairments, including those for which there is no medical source.

  2. b. 

    When obtaining a CE, give the CE provider background information, including:

    • complete longitudinal functional information from the claimant, and, if necessary, other nonmedical sources (per DI 22511.011); and

    • other background information (e.g., field office (FO) observations) when available.

  3. c. 

    Develop evidence of functional limitations in accordance with DI 22511.007.

B. Policy - obvious impairments

1. Clinical details unnecessary

Normally, medical reports will be obtained from medical sources. There will be rare instances when

  • The claimant has an obvious impairment (see DI 22505.012B.2.b.); and

  • Has been unable to obtain a medical report even with assistance of the FO and disability determination services (DDS); and

  • No purpose would be served by purchasing an examination from a medical source solely to certify the existence of such an obvious impairment.

2. Obvious impairments

A determination of disability may be made without evidence from a medical source only when the FO or DDS has:

  1. a. 

    Seen the claimant; and

  2. b. 

    Described the existence of amputations of extremities identified in Listing 1.20A. or 101.20A., or total blindness due to the loss of both eyes.

To Link to this section - Use this URL:
DI 22505.012 - Development Issue - No Evidence Furnished from an Acceptable Medical Source - 03/02/2016
Batch run: 04/01/2021