[Title 20 CFR 404.1503]
[Code of Federal Regulations (annual edition) - April 1, 1996 Edition]
[Title 20 - EMPLOYEES' BENEFITS]
[Chapter III - SOCIAL SECURITY ADMINISTRATION]
[Part 404 - FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- )]
[Subpart P - Determining Disability and Blindness]
[Sec. 404.1503 - Who makes disability and blindness determinations.]
[From the U.S. Government Publishing Office]




  20
  EMPLOYEES' BENEFITS
  2
  1996-04-01
  1996-04-01
  false
  
  404.1503
  Sec. 404.1503
  
    EMPLOYEES' BENEFITS
    SOCIAL SECURITY ADMINISTRATION
    FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- )
    Determining Disability and Blindness
  


Sec. 404.1503  Who makes disability and blindness determinations.

    (a) State agencies. State agencies make disability and blindness 
determinations for the Secretary for most persons living in the State. 
State agencies make these disability and blindness determinations under 
regulations containing performance standards and other administrative 
requirements relating to the disability and blindness determination 
function. States have the option of turning the function over to the 
Federal Government if they no longer want to make disability 
determinations. Also, the Secretary may take the function away from any 
State which has substantially failed to make disability and blindness 
determinations in accordance with these regulations. Subpart Q of this 
part contains the rules the States must follow in making disability and 
blindness determinations.
    (b) Social Security Administration. The Social Security 
Administration will make disability and blindness determinations for the 
Secretary for--
    (1) Any person living in a State which is not making for the 
Secretary any disability and blindness determinations or which is not 
making those determinations for the class of claimants to which that 
person belongs; and
    (2) Any person living outside the United States.
    (c) What determinations are authorized. The Secretary has authorized 
the State agencies and the Social Security Administration to make 
determinations about--
    (1) Whether you are disabled or blind;
    (2) The date your disability or blindness began; and
    (3) The date your disability or blindness stopped.
    (d) Review of State Agency determinations. On review of a State 
agency determination or redetermination of disability or blindness we 
may find that--
    (1) You are, or are not, disabled or blind, regardless of what the 
State agency found;
    (2) Your disability or blindness began earlier or later than the 
date found by the State agency; and
    (3) Your disability or blindness stopped earlier or later than the 
date found by the State agency.
    (e) Initial determinations for mental impairments. An initial 
determination by a State agency or the Social Security Administration 
that you are not disabled (or a Social Security Administration review of 
a State agency's initial determination), in any case where there is 
evidence which indicates the existence of a mental impairment, will be 
made only after every reasonable effort has been made to ensure that a 
qualified psychiatrist or psychologist has completed the medical portion 
of the case review and any applicable residual functional capacity 
assessment. (See Sec. 404.1616 for the qualifications we consider 
necessary for a psychologist to be a psychological consultant and 
Sec. 404.1617 for what we consider reasonable effort.) If the services 
of qualified psychiatrists or psychologists cannot be obtained because 
of impediments at the State level, the Secretary may contract directly 
for the services. In a case where there is evidence of mental and 
nonmental impairments and a qualified psychologist serves as a 
psychological consultant, the psychologist will evaluate only the mental 
impairment, and a physician will evaluate the nonmental impairment. The 
overall determination of impairment severity in combined mental and 
nonmental impairment cases will be made by a medical consultant and not 
a psychological consultant unless the mental impairment alone would 
justify a finding of disability.

[46 FR 29204, May 29, 1981, as amended at 52 FR 33926, Sept. 9, 1987]

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