1. Substantial gainful activity (SGA) – clear evidence the claimant is engaging in SGA

2. Impairment Severity

3. Duration

4. Medical improvement (MI) and whether MI affects the ability to work

5. MI exceptions, including :

• •

  Whether an individual is a beneficiary of advances in medical or vocational therapy or technology,

• •

  Whether an individual has successfully undergone vocational therapy,

• •

  Whether new or improved methods of diagnostics or evaluative techniques show that the individual’s impairment(s) is not as severe as it was previously determined in the most recent favorable determination,

• •

  Whether a prior determination was made in error, or

• •

  Whether the prior determination was based upon fraudulent circumstances.

6. Residual Functional Capacity (RFC)

7. Evaluation of vocational factors including age, education, transferable skills, ability to do past relevant work, or ability to do other work

8. Failure to follow prescribed treatment

9. Drug addiction and alcoholism (DAA) materiality

10. Onset of disability, relative to a Title II eligibility period

11. Incorrectly adopting, or not adopting a prior administrative law judge (ALJ) or appeals council (AC) finding when adjudicating a subsequent disability claim.

The medical documentation is insufficient to determine:

1a. Impairment severity

1b. Duration

1c. MI, including whether MI affects the ability to work

1d. MI exceptions including:

• •

  Whether an individual is a beneficiary of advances in medical or vocational therapy or technology, or

• •

  Whether new or improved methods of diagnostics or evaluative techniques show that the individual’s impairment(s) is not as severe as it was previously determined in the most recent favorable determination

1e. RFC

1f. Failure to follow prescribed treatment

1g. DAA materiality

The vocational documentation is insufficient to determine the effect of the following on an individual's ability to engage in SGA:

2a. Age

2b. Education or illiteracy

2c. Work history, including transferable skills, physical, mental, and environmental demands of past work and the relevance of past work

2d. Advances in medical or vocational therapy or technology when there is new medical evidence and a new RFC but no MI

The documentation is insufficient to show conformance to prescribed procedures for a determination based on the following:

4a. Work activity

4b. Failure to obtain a prior folder or copy of the ALJ/AC ruling under an acquiescence ruling

4c. The prior determination was in error

4d. Failure to follow prescribed treatment

4e. Whereabouts unknown

The case contains sufficient documentation to support a different:

1. Onset date

2. Ending date

The case contains insufficient documentation to support the:

1. Onset date

2. Ending date

3. Cessation date