TN 11 (11-12)

This section explains our policy regarding our policy for determining an onset date and an established onset date in cases when a claimant has an exacerbating and remitting condition.

REMINDER:

• The onset date is the first day the claimant meets the definition of disability or statutory blindness as defined in the Act and regulations.

• The established onset date (EOD) is the date that a claimant meets the definition of disability and all the relevant entitlement or eligibility factors.

A. Determining onset when a claimant has an exacerbating and remitting condition

Certain types of diseases and conditions may diminish and intensify in severity over time. For example, symptoms of multiple sclerosis vary from person to person and may change over time in the same person. Some symptoms will come and go over the course of the disease, while others may be more permanent. Determining onset in these cases can be difficult because of the variation in severity. When determining onset, the adjudicator considers the history of the disease process, the length of the exacerbations and remissions and the severity of the signs and symptoms, in conjunction with medical evidence, vocational history, and other evidence about the severity of the impairment.

B. Component roles for determining onset when a claimant has an exacerbating and remitting condition

1. Field office (FO)

The field office does not have a role in administering this policy.

2. Disability Determination Services (DDS)

When determining onset in cases where there is an exacerbating and remitting impairment, the adjudicator considers:

• the history of the disease process, including whether the condition has developed a specific course, and

• the length of the exacerbations and remissions and the severity of the symptoms and signs, which occur in both phases that could affect onset.

C. Component instructions for determining onset when a claimant has an exacerbating and remitting condition

Disability Determination Services (DDS)

• Apply the policy outlined above to establish the EOD.

• Explain why you chose this date.