Effective Dates: 3/23/2026 - Present

Identification Number:
DI 25230 TN 8
Intended Audience:See Transmittal Sheet
Originating Office:LP DP
Title:Childhood Disability Evaluation Form (SSA-538)
Type:POMS Full Transmittals
Program:All Programs
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM

Part DI – Disability Insurance

Chapter 252 – Title XVI Child Claims Based on Disability

Subchapter 30 – Childhood Disability Evaluation Form (SSA-538)

Transmittal No. 8, 03/20/2026

Audience

PSC: DE, DEC;
OCO-OEIO: CR, ERE, FDE, RECONE;
OCO-ODO: DE, DEC, DS, RECONE;
ODD-DDS: ADJ, DHU;

Originating Component

DP

Effective Date

03/23/2026

Background

Disability Policy revised this POMS section for consistency and clarity of prescribed forms used for disabled child (DC) claims, including forms within the Disability Case Processing System (DCPS). Additionally, on March 23, 2026 we published SSR 26-1p - Title XVI: Determining Continuing Disability at Step 2 and 3 of the Medical Improvement Review Standard Sequential Evaluation Process for Children Under Age 18 – Functional Equivalence; therefore, we updated when to complete more than one prescribed form.

Summary of Changes

DI 25230.001 Explaining Title XVI Childhood Disability Evaluation Determinations

Subsection B: updated for Prescribed Forms to:

  • •

    Add language to include the newer electronic processing system, Disability Case Processing System (DCPS);

  • •

    Identify differences between the SSA-538 Childhood Disability Evaluation Form (CDEF) and Childhood Domain Evaluation (CDE);

  • •

    Clarify when the SSA-538 form or CDE is required; and

  • •

    Remove DC Continuing Disability Review (CDR) from the list of when to complete more than one prescribed form.

DI 25230.001 Explaining Title XVI Childhood Disability Evaluation Determinations

CITATIONS:

20 CFR 416.924(g)

A. Introduction to Disabled Child (DC) Claims

All Title XVI childhood disability determinations or decisions require an explanation, documented in writing, of the findings of fact and any discussion of supporting evidence, in a manner that we prescribe. For the requirement of how we will explain,our findings, see DI 25201.015 .

B. Policy for Prescribed Forms

1. Where to document findings

The following prescribed forms are appropriate for documenting the childhood disability case explanation:

  • •

    SSA 538 - Childhood Disability Evaluation Form (CDEF)

  • •

    Childhood Domain Evaluation (CDE) for cases processed in the Disability Case Processing Systems (DCPS) or other electronic systems such as the Electronic Claims Analysis Tool (eCAT)

The SSA-538 or CDE must be used in all assessment scenarios that require a domain evaluation due to a severe impairment(s) that does not meet or equal a listing, or functionally equal a listing by example, see DI 25225.060 .

An SSA-416 may be used in lieu of the CDE in DC claims completed electronically, that do not require a domain evaluation and the findings of fact and supporting evidence results in the following scenario:

  • •

    Meets or equals a listing

  • •

    Functionally equals a listing based on example only, see DI 25225.060

  • •

    Insufficient evidence

  • •

    No severe impairment(s)

  • •

    No medically determinable impairment(s)

  • •

    No medical improvement (for Title XVI child continuing disability review (CDR) cases)

NOTE: For non-electronic claims, if the severe impairment(s) requires a domain evaluation, there must be one prescribed form in the case record that gives the disposition and clearly supports it.

For a detailed explanation of documenting the findings on DC prescribed forms refer to DI 25230.005 .

2. When to complete the prescribed form

The policies in this section apply to:

  • •

    Initial (DC) determinations

  • •

    Reconsideration DC determinations

  • •

    Initial level DC determinations for CDRs

  • •

    Reconsideration level DC determinations for CDRs unless a Disability Hearing officer (DHO) makes the determination

  • •

    Reopening determinations, if the determination being reopened is covered by these policies

3. When to complete more than one prescribed form

We require a second prescribed form for specific cases involving Drug Addiction or Alcoholism (DAA). In all DAA materiality determinations, apply the appropriate sequential evaluation process a second time considering whether the individual is disabled without DAA involvement.

4. Required elements in the explanation

A complete explanation includes the following elements:

  • •

    Identifying information (name, SSN, date of birth), filing date, level of determination

  • •

    Established and alleged impairments

  • •

    Disposition

  • •

    Explanation for all the dispositions, except “meets listing”

  • •

    Consultant (MC/PC/non-physician) statement that all relevant factors and evidence have been considered

  • •

    Signature of Consultant with overall responsibility for evaluating the case

  • •

    Signatures of additional MC/PC/non-physician participating in the evaluation

5. Factors and evidence

The Consultant with overall responsibility for the findings in the determination, affirms on the SSA-538 or within the electronic Claims Analysis that they considered the following:

  1. a. 

    All relevant factors

  2. b. 

    All relevant evidence in deciding if:

    • •

      The child has a severe impairment(s)

    • •

      An impairment(s) meets or medically equals a listing, or

    • •

      An impairment(s) functionally equals the listings

The affirmation statement on the SSA-538 or within the electronic Claims Analysis does not mean that the consultant needs to explicitly address each of these factors in every case. It means, the consultant has considered whether the factors apply; and has properly considered those that are relevant. The factors and evidence serve as a reminder to the consultants.

6. Affirmation of the initial level findings at the reconsideration level

The medical or psychological consultant(s) may affirm the initial prescribed form without fully completing a new prescribed form if the following conditions are satisfied:

  • •

    There is no allegation of a worsening of any previously documented impairments;

  • •

    There is no allegation of any new impairment(s);

  • •

    There has been no treatment for any impairment(s) since the prior determination;

  • •

    The prior determination was substantively and technically correct and the prior decision rationale correctly presented and resolved all pertinent issues to be adjudicated; and

  • •

    There are no changes in the functional limitations

The reconsideration determination can reference the initial determination with a remark noting, “I have reviewed all the evidence in the file and the assessment of (date) is affirmed as written. The medical or psychological consultant(s) must sign and date this statement.

7. Responsibility for the required explanation

a. Consultant with overall responsibility

The medical, psychological or non-physician consultant has overall responsibility for the content of the form and must sign the form to attest that it is complete and that they are responsible for its content, including the findings of fact and any discussion of supporting evidence.

Any additional consultants who provide input must also sign and date the form. The disability examiner may assist in preparing the form.

If a signed prescribed form reflects that the medical or psychological consultant's findings complete the medical portion of the determination, the consultant is not required to sign the Disability Determination and Transmittal form (SSA-831 or SSA-832). For a detailed explanation regarding signature requirements see DI 26510.090C.

NOTE: Non-physician medical or psychological consultants are limited to evaluating the effects of impairments within their disciplines.

b. Disability Examiner (DE)

A DE alone may be responsible for the required explanation if:

  • •

    There is no medical evidence in the current file or in any prior files, or the DDS is unable to obtain any medical evidence that may exist, despite making every reasonable effort, and

  • •

    The claimant refuses or fails, without a good reason, to attend a CE

C. References

  • •

    DI 24501.001 The Disability Determination Services (DDS) Disability Examiner (DE), Medical Consultant (MC), and Psychological Consultant (PC) Team

  • •

    DI 24510.066B Adoption of Initial Level RFC Assessment.

  • •

    DI 28005.030 The CDR Evaluating Process – Title XVI – Step-by-Step Discussion

  • •

    DI 81020.025 Processing Electronic Reconsideration Cases

  • •

    DI 90070.041 Evaluating Cases Involving Drug Addiction and Alcoholism (DAA) SSR 13-2p


DI 25230 TN 8 - Childhood Disability Evaluation Form (SSA-538) - 3/23/2026