Action Notes

In I-3-701:

• In the “Citations” section, add “404.1519f, 404.1519n,” after “404.977,” and add “416.919f, 416.919n,” after “410.665.”

On the page headed I-3-701 cont.:

• Delete “I-3-711 Remand for Medical Evidence” and all the text that follows to the end of the page.

On the page headed I-3-711 B. cont.:

• Delete the entire page.

Background

Section 9 of Public Law 98-460 (the Social Security Disability Benefits Reform Act of 1984) requires the Secretary to issue regulations establishing standards for Consultative Examinations (CEs). The Statute provides that the regulations must include standards for determining when to obtain a CE and the type of CE to be purchased, and monitoring procedures for both the purchase process and CE reports. Also, the regulations must reflect that the Secretary will make every reasonable effort to obtain necessary evidence from the claimant"s medical sources before obtaining medical evidence from another source on a consultative basis; develop a complete medical history covering at least 12 months if deciding that the claimant is not under a disability; and consider all the evidence in the claimant"s case record. The Social Security Administration published proposed rules in a Notice of Proposed Rulemaking in the Federal Register on April 20, 1987 (52 FR 13014). The final rules, published on August 1, 1991 (56 FR 36932), respond to comments, reflect and implement the statutory requirements, and clarify the Secretary"s policy on giving weight to treating source opinions.

This issuance updates Office of Appellate Operations procedures based on the new regulations.

Explanation of Content and Changes

In I-3-711:

• Subsections A. and B. now make a clearer distinction between remands for existing medical evidence and remands for consultative examinations or medical tests. Subsection B. also provides that remand for consultative examinations/tests is appropriate only if the necessary evidence does not appear to be available from the claimant"s medical sources.

• Subsection D. now reflects that, when requesting consultative examinations or tests, we will order only the specific examinations and/or tests needed to make a decision on the claim. We will not order a complete examination unless it is required (20 CFR §§ 404.1519f, 404.1519n(d), 416.919f and 416.919n(d)).

• Subsection D. also contains instructions for requesting medical tests or procedures and incorporates the regulatory prohibition from ordering tests or procedures which may involve significant risk to the claimant (20 CFR 404.1519m and 416.919m).

Personnel who have questions about this issuance should telephone the Office of Policy, Planning and Evaluation at 756-9254.

Insert

Insert in I-3-700:

I-3-711, dated October 18, 1991, through I-3-711 C. cont., dated October 18, 1991 (2 pages).

Date: October 18, 1991