BASIC (12-10)

Citations:

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

A. Responsibilities for obtaining evidence

The claimant must furnish evidence to prove disability or blindness, provide sources of medical evidence, and cooperate in obtaining all necessary evidence. You must help the claimant obtain medical and other evidence of disability.

B. Introduction to failure and refusal

Refusal or failure situations arise when the claimant either cannot or will not cooperate with requests for him or her to provide needed evidence, perform a needed action, or attend a consultative examination (CE) appointment. This subchapter provides guidance in meeting your responsibility to help the claimant obtain medical and other evidence of disability or blindness. The purpose of these policies is to give guidance that encourages the claimant’s cooperation in providing or obtaining evidence.

In most situations, policy requires that you first attempt to contact the claimant by telephone, and if not successful, then by mail. If the claimant is homeless, alleges a mental impairment, or the evidence suggests a mental impairment, policy usually requires follow up and third party involvement. You should always consider the facts of each claim to determine the appropriateness of taking additional steps beyond what these policies require.

See details:

• DI 23007.004 - Refusal to Cooperate With Requests to the Claimant for Evidence or Action

• DI 23007.005 - Failure to Cooperate With Requests to the Claimant for Evidence or Action

• DI 23007.009 - Refusal to Attend a Consultative Examination Appointment

• DI 23007.010 - Failure to Attend a Consultative Examination Appointment

C. References