Basic (08-15)

DI 28091.001 Simplified Rationales

Disability work simplification initiatives were developed to improve productivity and maintain high quality in the disability program. One initiative allows disability examiners the option to prepare a supplemental determination rationale if there is duplicate information documented elsewhere in the file.

Adjudicators may prepare a simple “supplemental” rationale for issues not documented elsewhere in the file, instead of the “summary” rationales required in DI 28090.000.

NOTE: A summary rationale may still be prepared when required by Federal or State agency management, e.g., for training or other purposes.

The chart in DI 28091.005 presents the issues in the current disability decision-making process that require rationalization and where these issues are usually documented in the file. Specific instructions outlining these situations are in DI 28091.010.

NOTE: Some sites use the Electronic Claims Analysis Tool (eCAT) for documenting electronic continuing disability review (CDR) case analysis. In eCAT, users document each step of the CDR evaluation process. eCAT provides a complete claim explanation in one document, the Disability Determination Explanation (DDE), which is imaged to the electronic folder case documents (A. Payment Documents/Decisions (Yellow Front)). Adjudicators should follow the eCAT User Guide and their site’s business process to document information not contained elsewhere in the file or DDE. For additional guidance on eCDR rationales, see DI 81020.230

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DI 28091.001 - Simplified Rationales - 08/26/2015
Batch run: 08/26/2015