BASIC (03-17)

DI 24503.040 Evaluating a Statement on an Issue Reserved to the Commissioner

A. Definition of a statement on an issue reserved to the Commissioner

A statement on an issue reserved to the Commissioner is a statement made by a medical source or a nonmedical source who is not part of the adjudicative team that would direct our determination or decision that the claimant is or is not disabled or blind within the meaning of the Social Security Act. This definition applies to claims filed before and after March 27, 2017. We are responsible for making the determination or decision about whether a claimant is disabled or blind.

B. Examples of statements on issues reserved to the Commissioner

While these examples do not include every possibility, consider the following statements to be on issues reserved to the Commissioner. A statement indicating whether:

  • the claimant is disabled, blind, able to work, or able to perform regular or continuing work,

  • the claimant has a severe impairment,

  • the claimant’s impairment(s) meets the duration requirement,

  • the claimant’s impairment(s) meets or medically equals any listing in the Listing of Impairments (Listings),

  • the claimant has a specific residual functional capacity (RFC) using our programmatic terms about the functional exertional levels in DI 24510.006 Assessing Residual Functional Capacity (RFC) in Initial Claims (SSR 96-8p),

  • the claimant’s RFC prevents him or her from doing past relevant work,

  • the claimant meets the requirements of a medical-vocational rule in DI 25025.035 Tables No. 1, 2, 3 and Rule 204.00,

  • the claimant’s disability continues or ends when we conduct a continuing disability review (CDR),

  • a claimant’s drug or alcohol addiction is material to his or her disability,

  • a claimant failed to follow prescribed treatment, or

  • In a title XVI child’s case, an impairment functionally equals the listings.

C. Consideration of the context of the statement

Determining whether a statement is on an issue reserved to the Commissioner involves a consideration about the context in which the source makes the statement.

EXAMPLE 1: If a medical source uses the diagnostic term “intellectual disability” to describe a claimant, the use of the word “disability” would not be a statement on an issue reserved to the Commissioner because this is a diagnosis.

EXAMPLE 2: If a nonmedical source says a claimant has a “sedentary lifestyle,” the use of the term “sedentary” would not be a statement on an issue reserved to the Commissioner because the use of the term “sedentary” is not synonymous with our definition of sedentary work.

D. How we evaluate a statement on an issue reserved to the Commissioner

We consider all evidence we receive, including a statement on an issue reserved to the Commissioner. If a medical source offers it, we categorize it as other medical evidence. If a nonmedical source offers it, we categorize it as evidence from a nonmedical source. However, we do not give any special significance to a statement on an issue reserved to the Commissioner because we are responsible for making the determination or decision about whether a claimant is disabled or blind. The evaluation standard for statements on issues reserved to the Commissioner is the same for claims filed before and after March 27, 2017.

E. Articulation requirements

1. Claim filed before March 27, 2017

Never give a medical source’s statement(s) on an issue reserved to the Commissioner controlling weight. The determination must explain the consideration given to the medical source’s statement even if it is on an issue reserved to the Commissioner. If the evidence does not support a medical source’s statement on an issue reserved to the Commissioner and the adjudicator cannot ascertain the basis of the statement from the case record, the adjudicator must make every reasonable effort to recontact the source for clarification of the reasons for the statement.

2. Claim filed on or after March 27, 2017

Do not provide written analysis about a statement on an issue reserved to the Commissioner. It is inherently neither valuable nor persuasive to us. When a document from a source contains multiple categories of evidence, consider each kind of evidence according to its applicable rules. Do