Identification Number:
DI 25501 TN 17
Intended Audience:See Transmittal Sheet
Originating Office:ORDP ODP
Title:Onset
Type:POMS Transmittals
Program:Disability
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part DI – Disability Insurance
Chapter 255 – Onset/Duration/Closed Period
Subchapter 01 – Onset
Transmittal No. 17, 12/06/2018

Audience

PSC: DE, DEC, RECONR;
ODD-DDS: ADJ, DHU;
OCO-OEIO: CR, ERE, FCR, FDE, RECONE;
RO: Center for Disability Programs;
OCO-ODO: CTE, CTE TE, DE, DEC, DS, RECONE;
OQR: DE, PA, PE, TL;
OHO/OAO: Hos;

Originating Component

ODP

Effective Date

Upon Receipt

Background

The Social Security Administration published notice in the Federal Register August 25, 2016 Modifications to the Disability Determinations procedures; Extension of Testing of Some Disability Redesign Features. The Office of Disability Policy revised the instructions due to the elimination of, Single Decisionmaker (SDM), and Disability Examiner (DE) Authority for Compassionate Allowances (CAL) and Quick Disability Determinations (QDD).

Summary of Changes

DI 25501.430 Medical Consultant, Psychological Consultant, and Disability Examiner Roles in Determining Onset for the Established Onset Date

We changed the title. We removed instructions related to SDM and DE autthority for CAL/QDD.

DI 25501.430 Medical Consultant, Psychological Consultant, and Disability Examiner Roles in Determining Onset for the Established Onset Date

This section explains our policy regarding the medical consultant (MC), psychological consultant (PC), and the disability examiner (DE) roles in determining the established onset date (EOD).

REMINDERS:

  • The onset date is the first day the claimant meets the definition of disability or statutory blindness as defined in the Act and regulations.

  • The EOD is the date that a claimant meets the definition of disability and all the relevant entitlement or eligibility factors.

A. MC, PC, and DE roles in determining onset for the EOD

The MC or PC role in determining onset for the EOD is to prepare a severity assessment(s) for the relevant period(s).

The DE has the final responsibility for the accuracy of the EOD determination. The DE establishes an EOD based on pertinent medical, technical, and vocational factors.

We must assess the severity of the claimant’s condition(s) from the claimant’s alleged onset date (AOD) or potential onset date (POD), if different from the AOD through all relevant periods. An MC and PC prepares a Residual Functional Capacity (RFC), Mental Residual Functional Capacity (MRFC), a Childhood Disability Evaluation Form, or other severity assessment document each time the severity of the claimant’s condition changes and subsequently results in work related changes in the claimant’s functional capabilities.

The DE may assist in preparing all assessment documents including the SSA-538.

B. Component roles concerning the MC or PC responsibility for determining onset

1. Field office (FO)

The FO does not have a role in implementing this policy.

2. Disability Determination Services (DDS)

The DE is responsible for establishing the EOD and advising the MC and PC about non-medical factors affecting the EOD. The MC and PC is responsible for assessing the severity of the claimant’s condition for the relevant period(s), depending on the claim type.

C. DDS instructions concerning the MC, PC and DE responsibility for assessing the severity of the claimant’s condition

Assess the severity of the claimant’s condition(s) from the claimant’s POD through all relevant periods. An MC and PC prepares an RFC, MRFC, or other severity assessment, to address each time the severity of the claimant’s condition changes, resulting in work related changes in the claimant’s functional capabilities. Both the MC and PC and the DE ensure the time frame for the severity assessment is clearly annotated on the assessment document.

1. DE instructions

  • Notify the MC and PC of the timeframes to be assessed.

  • Ensure the MC and PC has assessed all pertinent periods, when the MC and PC returns the claim to you.

  • Consider the RFC, MRFC, Childhood Disability Evaluation Form, or other severity assessment, together with other technical and vocational factors, to determine if the claimant is disabled for that period, starting from the earliest RFC, MRFC, Childhood Disability Evaluation Form, or other severity assessment form period.

  • Consider each assessment period to determine if the RFC, MRFC, Childhood Disability Evaluation Form, or other severity assessment, together with other technical and vocational factors, results in a finding that the claimant is disabled for that period.

  • Select the earliest date that is consistent with insured status, SGA, the claimant’s protective filing date, and other non-medical factors, for the claimant’s EOD.

The DE should be alert to variances in severity assessments from POD to present, as they could result in closed period allowance(s).For more information on closed period decisions, see DI 25510.010 through DI 25510.015.

2. MC and PC instructions

Prepare a severity assessment(s) for the timeframe(s) requested by the DE.

It is the DE’s responsibility (not the MC/PC’s) to establish the EOD.


DI 25501 TN 17 - Onset - 12/06/2018