TN 1 (02-01)

DI 25205.010 Development of Evidence of Functioning

A. Policy

1. When To Develop

Evidence of functioning should be developed in most cases, unless the claim can clearly be allowed on medical evidence alone. For example, evidence of functioning must be developed:

  1. To determine whether an impairment(s) is severe - i.e., causes no more than minimal functional limitations - when the medical evidence alone is insufficient. (See DI 25220.005.)

  2. To determine whether an impairment(s) meets or medically equals a listed impairment when the listing criteria include functioning. (See DI 25220.010.)

  3. To determine whether an impairment(s) functionally equals the listings. (See DI 25225.001 ff.)

2. History

Evidence of function should be sufficient to allow an assessment of the child's functioning on a longitudinal basis - that is, over time.

3. Evidence of Functioning

Evidence of the child's functioning may be requested from medical and other sources. See DI 22505.003 for potential sources of evidence of function.

Evidence must be sufficient to determine whether the child's impairment(s) (and related symptoms) is severe, and, if so, whether it meets or equals the listings.

4. Material Conflicts in Evidence

Material conflicts in the evidence must be resolved. The case record must be documented to show how they were resolved and the basis for any conclusions reached.

B. Procedure

1. General

Develop evidence of a child's functioning that will help to answer the following questions about whether the child's impairment(s) affects his or her functioning and whether the child's activities are typical of other children of the same age who do not have impairments.

  • What activities is the child able to perform?

  • What activities is the child not able to perform?

  • Which of the child's activities are limited or restricted compared to other children of the same age who do not have impairments?

  • Where does the child have difficulty with activities—at home, in childcare, at school, or in the community?

  • Does the child have difficulty independently initiating, sustaining, or completing activities?

  • What kind of help does the child need to do his or her activities, how much help does he or she need, and how often does he or she need it?

Formal answers to each of these questions are not required, but gathering the information will enable the adjudicator to make accurate findings about the child's functioning.

2. Interview Forms

The interview forms used for title XVI childhood disability claims (see DI 11005.016) are designed to elicit information about the child's functioning and to identify sources of information about a child's functioning from the applicant.

See DI 25205.025 for a discussion of the Function Report-Child forms, SSA-3375 through SSA-3379.

3. Contacting Sources of Evidence of Function

Where the extent to which the child's impairment(s) affects his or her functioning on a longitudinal basis cannot be determined based on information in the case record, or there is a conflict in the evidence in the case record that raises a question about the child's level of functioning, obtain additional or clarifying information about the child's functioning. Determine the best source(s) for the needed information on a case-by-case basis.

  1. If the FO has not already identified sources of evidence about the child's functioning (on the SSA-3820-F6 or elsewhere in the case record), contact the applicant to obtain the information.

    NOTE: Both the SSA-3820-F6 and the SSA-3881-BK (used in reconsiderations and continuing disability reviews) contain lists of potential sources of evidence and sample questions that the adjudicator can use to ask the applicant about potential sources.

  2. Contact the source(s). There is no set number of sources that must be contacted. Which source or how many sources to be contacted depends on the number and type of issues to be resolved.

  3. Follow the procedures in GN 03316.001 for Privacy Act considerations when a collateral source is contacted. See DI 22511.011D. when a mental diso