Listing 4.04B (three separate ischemic episodes within a consecutive 12-month period,
each episode either requiring revascularization or documented as not amenable to revascularization)
was cited as the reason for the medical decision at the CPD.
Although listing 4.04B criteria required an angioplasty or bypass surgery with the
aforementioned ischemic episodes, the DDS never received records from Hospital C,
the hospital where the third episode occurred.
The claimant’s cardiologist referenced stent placement in a follow up visit after
the discharge from Hospital C and what appeared to be the third episode.
The disability determination services (DDS) medical consultant rationalized that the
impairment met the listing, despite lacking Hospital C's records, since the hospitalization
(presumably) for the third episode was referenced in the records of the individual's
own medical source.
CDR decision: During the CDR, DDS receives Hospital C's records that were missing from the CPD.
The hospital records from the third episode referenced at the CPD indicate that there
was no angioplasty or bypass surgery at that time.
DDS reviewed the cardiologist’s records cited in the CPD decision rationale and determined
that the cardiologist referred to stent placement as part of the claimant’s history.
The records show the impairment did not meet listing 4.04B at the time of the prior
determination, nor were any of the subsections of the listing met.
Explanation: Because disability would not have been found if Hospital C's records had been received,
indicating that only two angioplasty procedures were completed within the 12-month
period at the CPD, find the error exception met.