TN 1 (07-11)
DI 23007.004 Refusal to Cooperate With Requests to the Claimant for Evidence or Action
20 CFR 404.1512 through 20 CFR 404.1519t , and 20 CFR 416.912 through 20 CFR 416.919t
A. Exceptions to instructions in this section
Claimant fails to cooperate with a request for evidence or action.
Claimant refuses to attend a consultative examination (CE) appointment
Claimant fails to attend a CE appointment
Applicant requests withdrawal of the application.
Claimant does not wish to pursue the claim
Claimant fails or refuses to cooperate with a request for work history evidence
B. Refusal to cooperate with requests to the claimant for evidence or action
Refusal to cooperate with a request to the claimant for evidence or action means that the claimant states orally or in writing that he or she WILL NOT provide the needed evidence or perform the needed action, and the claimant does not provide a good reason why he or she will not cooperate with the request. If the claimant provides a good reason for not cooperating, give the claimant another opportunity to provide the needed evidence or perform the needed action.
C. Special efforts required for title XVI childhood disability claims
For instructions on Failure Issues for title XVI childhood disability cases, see DI 25205.020.
D. Good reasons for refusal to provide needed evidence or perform a needed action
Examples of good reasons include:
NOTE: The items in this list are only examples. You must exercise judgment and take into account the facts of each claim.
E. Review and documentation of the claim
Regardless of the nature of the claimant’s impairment(s), if the claimant refuses to provide the needed evidence or perform the needed action, you may discontinue development that requires claimant action (e.g., consultative examinations and claimant forms completion).
review the file again to determine if you need the requested evidence;
develop medical evidence of record (MER) from other medical sources;
make every reasonable effort as explained in DI 22505.001A.2;
complete development of functional evidence indicated by the facts of the case, if the available MER substantiates a mental impairment; and
DI 22511.007, Sources of Evidence
DI 22511.009, Sufficiency of Evidence
DI 22511.011, Contacting Claimants and Collateral Sources
document the case development summary worksheet with the details of the development undertaken; see case development summary instructions in DI 20503.001E. NOTE: If the claimant explained why he or she would not provide the needed evidence or perform the needed action, include the reason.
NOTE: Medical consultant or psychological consultant review is not necessary if there is no medical evidence.
F. Process for refusal to cooperate determinations
After you review and document the claim, make a disability determination based on the evidence in file.
If you cannot make a fully favorable determination, send a personalized disability notice (PDN). The PDN must include that the claimant refused to cooperate with the request to provide evidence or to perform a needed action and must state that we made a determination based on evidence on file.