TN 3 (09-21)

DI 28090.005 Overview of Rationales

A. Character of a rationale

The purposes of the rationale are to:

  • Identify all of the medical and nonmedical factors that have been considered (e.g., evidence requested and evidence used);

  • Explain the thought process used to make the determination;

  • Provide a permanent evidentiary record of the reasoning for the conclusion; and

  • Inform subsequent reviewers, including quality assessment components, of the basis for the determination.

Rationales must:

  • Be complete, accurate, logical, and legally supportable;

  • Be based on substantial evidence;

  • Show clearly and persuasively how substantial evidence leads to the conclusion(s);

  • Address and resolve all allegations made by the individual and other reporting sources that may be in conflict with determination conclusions; and

  • Describe in a complete and concise manner the importance attributed to each of the various factors of the case.

A sound rationale can result only from a well-developed and well-documented case file. It is essential to show all information pertinent to the relevant medical and nonmedical issues and demonstrate that the adjudicator followed the continuing disability review (CDR) evaluation process.

B. References

  • DI 28005.015 Step-by-Step Discussion of the Adult Continuing Disability Review (CDR) Evaluation Process

  • DI 28090.005 Evidence and Basis for Determination by a Disability Determination Services (DDS) Team

  • DI 81020.230 Documenting Comparison Point Decision (CPD) Evidence and Preparing the Electronic Continuing Disability Review (eCDR) Rationale

 


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0428090005
DI 28090.005 - Overview of Rationales - 09/22/2021
Batch run: 09/22/2022
Rev:09/22/2021