TN 13 (12-10)

A. Policy for correcting cases with a capability development TCA

A capability development TCA exists in an allowance or continuance when there is no capability development in accordance with current procedure. This includes situations in which:

• Capability is unresolved, and the adjudicating component does not undertake the necessary development per DI 23001.015B.2; or

• Capability is resolved, and the adjudicating component incorrectly notifies the field office (FO) that capability development is necessary, either because they were unaware of, or overlooked, medical evidence in file indicating whether the claimant is capable.

For an explanation of the adjudicating component's responsibility in capability issues, see DI 23001.001 – DI 23001.015.

B. Procedure for correcting cases with a capability development TCA

1. Capability unresolved in a paper file

If you determine that capability development is necessary after correcting all TCAs:

1. Enter in the remarks section of the disability determination form:

   • Capability unresolved, or

   • Capability unresolved… review of medical evidence (identify by source and date) suggests claimant is capable/incapable).

2. Notify the FO to develop capability.

3. Do not release any notices.

4. Send the folder to the FO to process the determination.

For an explanation of the capability remarks and when to enter them on the determination form, refer to DI 23001.005 and DI 26510.095.

2. Capability unresolved in a certified electronic folder (CEF)

If you determine that capability development is necessary after correcting all TCAs:

1. Make a change in the Remarks section of the disability determination form:

   • Capability unresolved; or

   • Capability unresolved… review of medical evidence (identify by source and date) suggests claimant is capable/incapable).

2. Complete the FO Alert in the Office of Quality Review (OQR) legacy system indicating capability development is needed.

3. Do not release any notices.

4. Send the folder to the FO to process the determination.

See Details:

• For an explanation of the capability remarks and when to enter them on the determination form, refer to DI 23001.005 and DI 26510.095.

• For an explanation on how to make a change to the determination form, refer to GN 04440.237.

3. Capability resolved in a paper folder

If you determine that capability development is not necessary because either the file contains medical evidence of capability/incapability, or incapability can be presumed because Listing 12.05A is met, and the adjudicating component has notified the FO that capability development is necessary, take the following action:

1. Enter in the remarks section of the disability determination form:

   • Claimant (in)capable per Dr. __, report dated __; or

   • Claimant incapable – Listing 12.05 A met.

2. Notify the FO not to develop capability.

3. Send the folder to the FO to process the determination.

4. Capability resolved in a CEF

If you determine that capability development is not necessary because either the file contains medical evidence of capability or incapability, or presuming incapability is possible because of a meets Listing 12.05 A, and the adjudicating component has notified the FO that capability development is necessary, take the following action:

1. Make a change in the remarks section of the disability determination form:

   • Claimant (in)capable per Dr. __, report dated __; or

   • Claimant incapable – Listing 12.05 A met.

2. Complete the FO Alert in the OQR legacy system indicating no need for capability development.

3. Send the folder to the FO to process the determination.

For an explanation on how to make a change to the determination form, refer to GN 04440.237.