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us/regulation/20/416/subpart-I — Subpart I - Determining Disability and Blindness · Axiom

Axiom
US Federal
Regulations
Title 20
Part 416

Subpart I - Determining Disability and Blindness

100 sections

Scope of subpart
Definitions for this subpart
Who makes disability and blindness determinations
Program integrity
Evidence from excluded medical sources of evidence
Decisions by other governmental agencies and nongovernmental entities
Basic definition of disability for adults
Basic definition of disability for children
Disability under a State plan
How long the impairment must last
Meaning of substantial gainful activity
Definition of disabling impairment
Responsibility for evidence
Categories of evidence
Evidence from our Federal or State agency medical or psychological consultants
When we will purchase existing evidence
Where and how to submit evidence
If you fail to submit medical and other evidence
Consultative examination at our expense
If you do not appear at a consultative examination
The consultative examination
When we will purchase a consultative examination and how we will use it
When we will not purchase a consultative examination
Type of purchased examinations
Who we will select to perform a consultative examination
Your medical source
Other sources for consultative examinations
Objections to the medical source designated to perform the consultative examination
Purchase of medical examinations, laboratory tests, and other services
Diagnostic tests or procedures
Informing the medical source of examination scheduling, report content, and signature requirements
When a properly signed consultative examination report has not been received
Reviewing reports of consultative examinations
Conflict of interest
Authorizing and monitoring the consultative examination
Consultative examination oversight
Evaluation of disability of adults, in general
Evaluation of mental impairments
How we consider evidence
How we consider and articulate medical opinions and prior administrative medical findings for claims filed on or after March 27, 2017
Establishing that you have a medically determinable impairment(s)
What we mean by an impairment(s) that is not severe in an adult
Multiple impairments
How we determine disability for children
Considerations in determining disability for children
Age as a factor of evaluation in the sequential evaluation process for children
Listing of Impairments in appendix 1 of subpart P of part 404 of this chapter
Medical equivalence for adults and children
Functional equivalence for children
Evaluating opinion evidence for claims filed before March 27, 2017
How we evaluate symptoms, including pain
Need to follow prescribed treatment
The meaning of presumptive disability or presumptive blindness
When presumptive payments begin and end
How we make a finding of presumptive disability or presumptive blindness
Impairments that may warrant a finding of presumptive disability or presumptive blindness
How we will determine whether your drug addiction or alcoholism is a contributing factor material to the determination of disability
Your residual functional capacity
Responsibility for assessing your residual functional capacity
When we will consider your vocational background
Medical-vocational profiles showing an inability to make an adjustment to other work
Your age as a vocational factor
Your education as a vocational factor
Your work experience as a vocational factor
Work which exists in the national economy
Physical exertion requirements
Skill requirements
Listing of Medical-Vocational Guidelines in appendix 2 of subpart P of part 404 of this chapter
Exertional and nonexertional limitations
General
What we mean by substantial gainful activity
General information about work activity
Evaluation guides if you are an employee
When and how we will average your earnings
Evaluation guides if you are self-employed
Impairment-related work expenses
Meaning of blindness as defined in the law
Blindness under a State plan
How we evaluate statutory blindness
If you are statutorily blind and still working
How we evaluate other visual impairments
Why and when we will find that you are no longer entitled to benefits based on statutory blindness
Disability redeterminations for individuals who attain age 18
Your responsibility to tell us of events that may change your disability or blindness status
We may conduct a review to find out whether you continue to be disabled
We may conduct a review to find out whether you continue to be blind
When and how often we will conduct a continuing disability review
If your medical recovery was expected and you returned to work
What happens if you fail to comply with our request for information
Medical evidence in continuing disability review cases
How we will determine whether your disability continues or ends, disabled adults
How we will determine whether your disability continues or ends, and whether you are and have been receiving treatment that is medically necessary and available, disabled children
If we make a determination that your physical or mental impairment(s) has ceased, did not exist or is no longer disabling (Medical Cessation Determination)
Continued disability or blindness benefits pending appeal of a medical cessation determination
If you become disabled by another impairment(s)
What is expedited reinstatement?
Who is eligible for expedited reinstatement?
How do I request reinstatement?
How do we determine provisional benefits?
How do we determine reinstated benefits?