POMS Reference

DI 27020: Reconsideration Rationale Preparation

BASIC (03-10)

A. Procedures for documenting the reconsideration rationale

Document the following in the reconsideration rationale as appropriate:

  • Cite new sources of evidence.

  • Review the claimant’s allegations, including the reason(s) for requesting reconsideration. Include worsening of documented impairment(s), new impairment(s), different onset date, etc.

  • Discuss any technical issues (e.g., eligibility, onset, work issues) that have arisen since the prior determination.

  • Discuss the findings produced by the sequential evaluation process.

  • Discuss your evaluation of the claimant’s symptoms.

  • Discuss medical and non-medical source(s) opinions.

  • Discuss drug addiction and alcoholism (DAA).

  • Discuss the findings of fact and the supporting evidence established at the time of the prior determination (e.g., relevant medical and non-medical evidence, duration, vocational issues, onset) which are being adopted without revision and adopted by specific reference.

  • State the basis for the revised determination.

NOTE: For claims filed before March 27, 2017 discuss controlling weight given to treating source(s) medical opinion(s).

B. Revision of a Prior Determination

1. Background

The Disability Determination Services prepares a new rationale when revising a prior determination. The criteria applicable to the initial case rationale are generally applicable to reconsideration rationales.

2. Documentation Procedure

The sources of evidence supporting the initial determination may be incorporated into the new rationale using the following introductory paragraph:

“The statement of evidence in the determination of (date)      , except as modified herein, is hereby incorporated by reference, but not the inferences, the findings or the conclusions based thereon”.