Effective Dates: 03/24/2017 - Present Previous | Next

Basic (03-17)

DI 24503.045 Evaluating Decisions by Other Governmental Agencies and Nongovernmental Entities

A. Definition of decisions by other governmental agencies and nongovernmental entities

A decision by another governmental agency or nongovernmental entity is any disability, blindness, employability, Medicaid, workers’ compensation, or other benefits decisions made by another governmental agency or nongovernmental entity for its program(s) using its own rules. This includes, but is not limited to, the Department of Veterans Affairs, the Department of Defense, the Department of Labor, the Office of Personnel Management, State agencies, and private insurers.

B. How we evaluate decisions by other governmental agencies and nongovernmental entities

We consider evidence of decisions by other governmental agencies and nongovernmental entities as evidence from a nonmedical source. We also consider all of the supporting evidence underlying the other governmental agency or nongovernmental entity’s decision that we receive according to the appropriate category of evidence in DI 24503.005 Categories of Evidence. We are not required to adopt a decision by any other governmental agency or a nongovernmental entity. The evaluation standard for decisions by any other governmental agency or nongovernmental entity is the same for claims filed before and after March 27, 2017.

REMINDER: Do not adopt a disability rating from the Department of Veterans Affairs (VA) as your own disability or blindness determination. The requirements for our programs differ from the requirements the VA uses.

C. Articulation requirements

1. Claim filed before March 27, 2017

Although such decisions are not binding on our determination, you should explain the consideration you gave to these decisions in the determination.

2. Claim filed on or after March 27, 2017

Do not provide written analysis about a decision by another governmental agency or nongovernmental entity. Those decisions are 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 not consider an entire document to be a decision by another governmental agency or nongovernmental entity simply because the document contains that decision. Instead, follow the evaluation and articulation requirements for the appropriate categories of evidence for the supporting evidence underlying that decision that we receive. For more information about the categories of evidence, see DI 24503.005 Categories of Evidence.

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DI 24503.045 - Evaluating Decisions by Other Governmental Agencies and Nongovernmental Entities - 03/24/2017
Batch run: 07/05/2017
Rev:03/24/2017