TN 1 (07-11)

Citations:

20 CFR 404.1512 through 20 CFR 404.1519t , and 20 CFR 416.912 through 20 CFR 416.919t

A. Exceptions to instructions in this section

B. Refusal to cooperate with requests to the claimant for evidence or action

Refusal to cooperate with a request to the claimant for evidence or action means that the claimant states orally or in writing that he or she WILL NOT provide the needed evidence or perform the needed action, and the claimant does not provide a good reason why he or she will not cooperate with the request. If the claimant provides a good reason for not cooperating, give the claimant another opportunity to provide the needed evidence or perform the needed action.

C. Special efforts required for title XVI childhood disability claims

For instructions on Failure Issues for title XVI childhood disability cases, see DI 25205.020.

D. Good reasons for refusal to provide needed evidence or perform a needed action

Examples of good reasons include:

• personal illness,

• death or serious illness in the family, and

• transportation problems.

NOTE: The items in this list are only examples. You must exercise judgment and take into account the facts of each claim.

E. Review and documentation of the claim

Regardless of the nature of the claimant’s impairment(s), if the claimant refuses to provide the needed evidence or perform the needed action, you may discontinue development that requires claimant action (e.g., consultative examinations and claimant forms completion).

You must:

• review the file again to determine if you need the requested evidence;

• develop medical evidence of record (MER) from other medical sources;

• make every reasonable effort as explained in DI 22505.001A.2;

• complete development of functional evidence indicated by the facts of the case, if the available MER substantiates a mental impairment; and

  See details:

  DI 22511.007, Sources of Evidence

  DI 22511.009, Sufficiency of Evidence

  DI 22511.011, Contacting Claimants and Collateral Sources

• document the case development summary worksheet with the details of the development undertaken; see case development summary instructions in DI 20503.001E. NOTE: If the claimant explained why he or she would not provide the needed evidence or perform the needed action, include the reason.

NOTE: Medical consultant or psychological consultant review is not necessary if there is no medical evidence.

F. Process for refusal to cooperate determinations

After you review and document the claim, make a disability determination based on the evidence in file.

If you cannot make a fully favorable determination, send a personalized disability notice (PDN). The PDN must include that the claimant refused to cooperate with the request to provide evidence or to perform a needed action and must state that we made a determination based on evidence on file.