Prehearing Procedure

• Author: Thomas E. Bush/David A. Morton III/David Traver/Sarah H. Bohr/Curtis J. Fisher/Kimberly V. Cheiken
• Pages: 126-574

2-126

Chapter 2

Prehearing Procedure

§200 Hearing Preparation — Theory of the Case

§201 Obtaining a Copy of the File and Submitting Evidence

§201.1 Obtaining a Copy of the File — Cases Below the Hearing Stage

§201.2 Submitting Evidence — Cases Below Hearing Stage

§201.3 Obtaining a Copy of the File — Cases at the Hearing Stage

§201.4 Submitting Evidence — Cases at the Hearing Stage

§201.5 Working With an Electronic Disability File

§201.6 Decrypting a CD-ROM Containing an Electronic Disability File

§202 Contents of the Disability File

§203 Section A: Payment Documents/Decisions

§203.1 Disability Determination and Transmittal

§203.2 Form: Disability Determination and Transmittal (SSA-831)

§203.3 Form: DI 26510.045 Completing Item 22 (Regulation Basis Code) on the SSA-831

§203.4 Chart: DDS Medical Specialty Codes

§203.5 eCAT: Disability Determination Explanation

§204 Section B: Jurisdictional Documents and Notices

§204.1 Denial Letters

§204.2 Request for Reconsideration and Hearing

§205 Section D: Non-Disability Development

§205.1 Application for Benefits

§205.2 Full DIB Review Sheet (DIBWIZ)

§205.3 Sample: Full DIB Review Sheet (DIBWIZ)

§205.4 Earnings Record and Insured Status

§205.5 Sample: Earnings Comp Determination

§205.6 Correcting an Earnings Record

§205.7 POMS RS 02201.008 — Exceptions to the Statute of Limitations

§205.8 Form: Request for Correction of Earnings Record (SSA-7008)

§206 Section E: Disability Related Development

§206.1 Disability Report

§206.2 Work History Report

§206.3 Disability Report — Appeal

§206.4 Daily Activities Questionnaire

§206.5 Form: Disability Report (SSA-3368)

§206.6 Form: Disability Report — Field Office (SSA-3367)

§206.7 Form: Work History Report (SSA-3369-BK)

§206.8 Form: Function Report — Adult (SSA-3373)

§207 Section F: Medical Records

§207.1 Residual Physical Functional Capacity Assessment

§207.2 Form: Residual Functional Capacity Assessment (SSA-4734)

§208 Analysis of Hearing Exhibit File

§209 Form: Initial File Review Action Sheet

§210 Obtaining Medical and Other Documentation

§211 Hospital Records

§211.1 Veterans Administration Hospital

§212 Doctors’ Records

§212.1 Physicians, Osteopaths, Podiatrists, Optometrists

§212.2 Psychologists

§212.3 Chiropractors

§213 Physical and Occupational Therapists

§214 Pharmacies

§215 Insurance Carriers

127 PREHEARING PROCEDURE

§216 Former and Current Employers

§216.1 Form: Employment Questionnaire

§216.2 Form: Monthly Wage Information

§216.3 Form: Monthly Income Worksheet

§217 Vocational Rehabilitation Agencies

§218 Law Enforcement Agencies

§219 Other Sources

§219.1 Social Welfare Agencies

§219.2 Other Attorneys

§219.3 Schools

§220 Obtaining and Dealing With Opinion Evidence

§221 The Claimant’s Doctor

§221.1 Hearing Testimony by the Treating Doctor

§221.2 Taking the Doctor’s “Deposition”

§221.3 Specific Questions

§221.4 General Medical Report

§221.5 Medical Opinion Forms

§221.6 Form: Medical Source Statement of Ability to Do Work-Related Activities (Physical) (HA-1151)

§221.7 Form: Medical Opinion Re: Ability to Do Work-Related Activities (Physical)

§221.8 Form: Letter to Treating Source Transmitting Medical Source Statement

§221.9 Form: Medical Opinion Regarding Physical Capacity for Work

§221.10 Memorandum: The Role of the Treating Doctor in Social Security Disability Determinations

§221.11 Form: Physical Medical Source Statement

§221.12 Form: Follow-up Medical Source Statement

§222 State Agency Doctors

§223 Consultative Doctors — Hired by SSA

§224 Consultative Doctors — Hired by You

§225 Vocational Experts — Hired by You

§226 Vocational Experts Called by the ALJ

§227 Medical Expert

§230 Analysis of Medical Impairments

§230.1 Form: Bladder Problem Medical Source Statement

§230.1.1 Form: Interstitial Cystitis Medical Source Statement

§230.2 Form: Lupus (SLE) Medical Source Statement

§230.3 Form: Chronic Fatigue Syndrome Medical Source Statement

§230.4 Form: Dizziness Medical Source Statement

§230.5 Form: Post Cancer Treatment Medical Source Statement

§231 Musculoskeletal System, Listings §§ 1.00-1.08

§231.1 Form: Listing § 1.04A — Spinal Nerve Root Compression

§231.1.1 Form: Listing § 1.02A — Major Dysfunction of a Weight-Bearing Joint

§231.1.2 Form: Listing § 1.02B — Major Dysfunction of a Major Peripheral Joint

§231.1.3 Form: Listing § 1.03 — Reconstructive Surgery or Surgical Arthrodesis of a Major

Weight-Bearing Joint

§231.1.4 Form: Listing § 1.04B — Spinal Arachnoiditis

§231.1.5 Form: Listing § 1.04C — Lumbar Spinal Stenosis

§231.2 Form: Lumbar Spine Medical Source Statement

§231.3 Form: Fibromyalgia Medical Source Statement

§231.4 Form: Arthritis Medical Source Statement

§231.5 Form: Cervical Spine Medical Source Statement

§232 Special Senses and Speech, Listings §§ 2.00-2.09

§232.1 Form: Meniere’s Disease Medical Source Statement

§232.2 Form: Letter to Doctor re: Vision When Claimant Limited to Sedentary Work

§232.3 Form: Vision Medical Source Statement

§232.4 Form: Vision Impairment Medical Source Statement

§233 Respiratory System, Listings §§ 3.00-3.11

§233.1 Form: Pulmonary Medical Source Statement

§233.2 Form: Sleep Disorders Medical Source Statement

§234 Cardiovascular System, Listings §§ 4.00-4.12

§234.1 Dealing With Exercise Tolerance Test Results

§234.2 New York Heart Association Standards

§234.3 Form: Cardiac Medical Source Statement

§234.4 Form: Cardiac Arrhythmia Medical Source Statement

§235 Digestive System, Listings §§ 5.00-5.08

§235.1 Form: Crohn’s and Colitis Medical Source Statement

§235.2 Form: Hepatitis C Medical Source Statement

SOCIAL SECURITY DISABILITY COLLECTION 128

§236 Hematological Disorders, Listings §§ 7.00-7.17

§237 Skin Disorders, Listings §§ 8.00-8.08

§237.1 Form: Skin Disorders Medical Source Statement

§238 Endocrine Disorders, Listing § 9.00 and Obesity

§238.1 Form: Diabetes Mellitus Medical Source Statement

§238.2 Form: Obesity Medical Source Statement

§239 Neurological, Listings §§ 11.00-11.19

§239.1 Form: Seizures Medical Source Statement

§239.2 Form: Headaches Medical Source Statement

239.2.1 Q & A 09-036 Evaluation of Migraine Headaches

§239.3 Form: Stroke Medical Source Statement

§239.4 Form: Multiple Sclerosis Medical Source Statement

§239.5 Form: Myasthenia Gravis Medical Source Statement

§239.6 Form: Parkinsonian Syndrome Medical Source Statement

§239.7 Form: Peripheral Neuropathy Medical Source Statement

§239.8 Form: Postpolio Sequelae Medical Source Statement

§239.9 Form: Reflex Sympathetic Dystrophy (RSD)/Complex Regional Pain Syndrome (CRPS), Type 1

Medical Source Statement

§239.10 Form: Muscular Dystrophy Medical Source Statement

§240 Mental Impairments, Listings §§ 12.00-12.10

§241 Procedure for Evaluation of Mental Impairments

§241.1 Form: Psychiatric Review Technique (SSA-2506-BK)

§242 Mental Impairment “B Criteria” Outline

§242.1 Marked Restriction of Activities of Daily Living

§242.2 Marked Difficulties in Maintaining Social Functioning

§242.3 Marked Difficulties in Maintaining Concentration, Persistence or Pace

§242.4 Repeated Episodes of Decompensation, Each of Extended Duration

§243 Practice Tips — Meeting the Mental Listings

§243.1 Form: Mental Impairment Questionnaire (Listings)

§244 Intellectual Disability

§244.1 Onset Before Age 22

§244.2 An Additional Severe Impairment

§244.3 Equaling the Listings

§244.4 Borderline Intellectual Functioning

§245 Assessing Mental Residual Functional Capacity

§245.1 AM-13066: Global Assessment of Functioning (GAF) Evidence in Disability Adjudication

§245.2 Chart: DSM-IV Axis V

§245.3 Form: Medical Source Statement of Ability to Do Work-Related Activities (Mental) (HA-1152)

§245.4 Form: Mental Residual Functional Capacity Assessment (SSA-4734-F4-Sup)

§245.5 Form: POMS DI 24510.060 — DI 24510.065 Mental RFC Assessment

§245.6 Form: POMS DI 25020.010 — Mental Limitations

§245.7 Form: Medical Opinion Re: Ability to Do Work-Related Activities (Mental)

§245.8 Form: Mental Impairment Questionnaire (RFC and Listings)

§245.9 Form: Mental Medical Source Statement

§246 Evaluating Ability to Work Based on Mental RFC

§247 Stress and Mental Impairments

§248 Somatoform Disorders

§248.1 Form: Somatoform Impairment Questionnaire (RFC and Listings)

§249 Drug Addiction or Alcoholism

§249.1 Chart: Is Drug Addiction or Alcoholism a Contributing Factor Material to the Determination of Disability?

§250 Pain and Other Symptoms and Their Impact on Residual Functional Capacity

§251 Symptoms and the Severity Step

§252 Symptoms and the Listing of Impairments

§253 A Medically Determinable Impairment that Could Cause the Claimant’s Symptoms

§254 Evaluating the Intensity and Persistence of Symptoms — The Role of Objective Evidence and Other Evidence

§255 Issue: Is the Impairment Reasonably Consistent With the Objective Evidence?

§255.1 Form: Doctor’s Opinion re: Consistency of Symptoms and Limitations

§256 Evaluation of Medical Opinions

§257 Credibility of the Claimant

§258 Impact of Symptoms on RFC

§259 Summary: Proof of Pain or Other Symptoms

§260 Proving a Case for a Claimant Under Age 50

§261 Illiteracy

§262 Inability to Communicate in English