Last Update: 9/2/05 (Transmittal I-2-63)
When a claim for disability benefits is denied initially and on reconsideration in those states which issue reconsideration determinations because a nondisability factor of entitlement (or SSI eligibility) is not met and the State agency has not made a disability determination, the ALJ must decide whether to issue a decision on the disability issue, depending upon the circumstances in the case.
If the ALJ finds favorably on the nondisability issue and the medical evidence in the file warrants a fully favorable decision on the issue of disability, the ALJ will issue a decision addressing all issues.
If there is insufficient evidence in the record to make a finding on the issue of disability, or if the available evidence indicates that a less than fully favorable decision is warranted, the ALJ will state in the decision that a finding on the issue of disability is not being made, and that the case will be returned to the State agency for a disability determination. Refer to the Directory of State Agencies for the appropriate State agency and address.