Basic (08-00)

DI 24515.050 Evaluation Of Specific Issues — Receipt Of Medical Evidence After Notification Of Claimant's Death

The receipt of evidence of the claimant's death will not necessarily warrant an allowance determination. For example, death resulting from a traumatic event such as an automobile accident ordinarily would not warrant revision; while death resulting from a sudden coronary thrombosis may or may not have some bearing on whether the claimant was unable to engage in SGA during the prior months. What is needed is the actual medical evidence from which to make the determination.

A. Impairment More Severe

The medical evidence obtained after death should be evaluated carefully to determine whether the impairment allegedly causing disability may have been more severe than shown by the evidence developed during the claimant's lifetime. The findings and diagnoses made earlier may have been incomplete or incorrect; the impairment may not have been diagnosed definitely; or an additional impairment not previously disclosed may be found, for example, a gastric ulcer which turned out to be malignant. The additional medical evidence, together with that previously in file, may justify a finding that disability existed during an earlier period of time, possibly into the time period of a prior denial or that disability continued in the case of a prior cessation even though the impairment did not appear to be severe enough previously.

B. Severe Impairment Previously Considered of Limited Duration

In some denied cases the evidence submitted before death may have supported a conclusion that the impairment, although incapacitating, was not expected to endure for a total of 12 months or to result in death. Death due to such an impairment may indicate the development of complications which changed the course of the disease so that the expected recovery was not realized. If the impairment resulted in death and was continuously severe enough to prevent the claimant from engaging in any substantial gainful activity, make a finding of disability. (For further details on death issues see DI 23510.000 ff.)

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DI 24515.050 - Evaluation Of Specific Issues — Receipt Of Medical Evidence After Notification Of Claimant's Death - 01/23/1990
Batch run: 04/25/2014