Subpart I. Subpart I—Determining Disability and Blindness

• General

  • SECTION § 416.901 - Scope of subpart.
  • SECTION § 416.902 - Definitions for this subpart.

• Determinations

  • SECTION § 416.903 - Who makes disability and blindness determinations.
  • SECTION § 416.903a - Program integrity.
  • SECTION § 416.903b - Evidence from excluded medical sources of evidence.
  • SECTION § 416.904 - Decisions by other governmental agencies and nongovernmental entities.

• Definition of Disability

  • SECTION § 416.905 - Basic definition of disability for adults.
  • SECTION § 416.906 - Basic definition of disability for children.
  • SECTION § 416.907 - Disability under a State plan.
  • SECTION § 416.908 - [Reserved]
  • SECTION § 416.909 - How long the impairment must last.
  • SECTION § 416.910 - Meaning of substantial gainful activity.
  • SECTION § 416.911 - Definition of disabling impairment.

• Evidence

  • SECTION § 416.912 - Responsibility for evidence.
  • SECTION § 416.913 - Categories of evidence.
  • SECTION § 416.913a - Evidence from our Federal or State agency medical or psychological consultants.
  • SECTION § 416.914 - When we will purchase existing evidence.
  • SECTION § 416.915 - Where and how to submit evidence.
  • SECTION § 416.916 - If you fail to submit medical and other evidence.
  • SECTION § 416.917 - Consultative examination at our expense.
  • SECTION § 416.918 - If you do not appear at a consultative examination.

• Standards To Be Used in Determining When a Consultative Examination Will Be Obtained in Connection With Disability Determinations

  • SECTION § 416.919 - The consultative examination.
  • SECTION § 416.919a - When we will purchase a consultative examination and how we will use it.
  • SECTION § 416.919b - When we will not purchase a consultative examination.

• Standards for the Type of Referral and for Report Content

  • SECTION § 416.919f - Type of purchased examinations.
  • SECTION § 416.919g - Who we will select to perform a consultative examination.
  • SECTION § 416.919h - Your medical source.
  • SECTION § 416.919i - Other sources for consultative examinations.
  • SECTION § 416.919j - Objections to the medical source designated to perform the consultative examination.
  • SECTION § 416.919k - Purchase of medical examinations, laboratory tests, and other services.
  • SECTION § 416.919m - Diagnostic tests or procedures.
  • SECTION § 416.919n - Informing the medical source of examination scheduling, report content, and signature requirements.
  • SECTION § 416.919o - When a properly signed consultative examination report has not been received.
  • SECTION § 416.919p - Reviewing reports of consultative examinations.
  • SECTION § 416.919q - Conflict of interest.

• Authorizing and Monitoring the Referral Process

  • SECTION § 416.919s - Authorizing and monitoring the consultative examination.

• Procedures To Monitor the Consultative Examination

  • SECTION § 416.919t - Consultative examination oversight.

• Evaluation of Disability

  • SECTION § 416.920 - Evaluation of disability of adults, in general.
  • SECTION § 416.920a - Evaluation of mental impairments.
  • SECTION § 416.920b - How we consider evidence.
  • SECTION § 416.920c - How we consider and articulate medical opinions and prior administrative medical findings for claims filed on or after March 27, 2017.
  • SECTION § 416.921 - Establishing that you have a medically determinable impairment(s).
  • SECTION § 416.922 - What we mean by an impairment(s) that is not severe in an adult.
  • SECTION § 416.923 - Multiple impairments.
  • SECTION § 416.924 - How we determine disability for children.
  • SECTION § 416.924a - Considerations in determining disability for children.
  • SECTION § 416.924b - Age as a factor of evaluation in the sequential evaluation process for children.

• Medical Considerations

  • SECTION § 416.925 - Listing of Impairments in appendix 1 of subpart P of part 404 of this chapter.
  • SECTION § 416.926 - Medical equivalence for adults and children.
  • SECTION § 416.926a - Functional equivalence for children.
  • SECTION § 416.927 - Evaluating opinion evidence for claims filed before March 27, 2017.
  • SECTION § 416.928 - [Reserved]
  • SECTION § 416.929 - How we evaluate symptoms, including pain.
  • SECTION § 416.930 - Need to follow prescribed treatment.

• Presumptive Disability and Blindness

  • SECTION § 416.931 - The meaning of presumptive disability or presumptive blindness.
  • SECTION § 416.932 - When presumptive payments begin and end.
  • SECTION § 416.933 - How we make a finding of presumptive disability or presumptive blindness.
  • SECTION § 416.934 - Impairments that may warrant a finding of presumptive disability or presumptive blindness.

• Drug Addiction and Alcoholism

  • SECTION § 416.935 - How we will determine whether your drug addiction or alcoholism is a contributing factor material to the determination of disability.
  • SECTION § 416.936 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to the determination of disability.
  • SECTION § 416.937 - What we mean by appropriate treatment.
  • SECTION § 416.938 - What we mean by approved institutions or facilities.
  • SECTION § 416.939 - How we consider whether treatment is available.
  • SECTION § 416.940 - Evaluating compliance with the treatment requirements.
  • SECTION § 416.941 - Establishment and use of referral and monitoring agencies.

• Residual Functional Capacity

  • SECTION § 416.945 - Your residual functional capacity.
  • SECTION § 416.946 - Responsibility for assessing your residual functional capacity.

• Vocational Considerations

  • SECTION § 416.960 - When we will consider your vocational background.
  • SECTION § 416.962 - Medical-vocational profiles showing an inability to make an adjustment to other work.
  • SECTION § 416.963 - Your age as a vocational factor.
  • SECTION § 416.964 - Your education as a vocational factor.
  • SECTION § 416.965 - Your work experience as a vocational factor.
  • SECTION § 416.966 - Work which exists in the national economy.
  • SECTION § 416.967 - Physical exertion requirements.
  • SECTION § 416.968 - Skill requirements.
  • SECTION § 416.969 - Listing of Medical-Vocational Guidelines in appendix 2 of subpart P of part 404 of this chapter.
  • SECTION § 416.969a - Exertional and nonexertional limitations.

• Substantial Gainful Activity

  • SECTION § 416.971 - General.
  • SECTION § 416.972 - What we mean by substantial gainful activity.
  • SECTION § 416.973 - General information about work activity.
  • SECTION § 416.974 - Evaluation guides if you are an employee.
  • SECTION § 416.974a - When and how we will average your earnings.
  • SECTION § 416.975 - Evaluation guides if you are self-employed.
  • SECTION § 416.976 - Impairment-related work expenses.

• Blindness

  • SECTION § 416.981 - Meaning of blindness as defined in the law.
  • SECTION § 416.982 - Blindness under a State plan.
  • SECTION § 416.983 - How we evaluate statutory blindness.
  • SECTION § 416.984 - If you are statutorily blind and still working.
  • SECTION § 416.985 - How we evaluate other visual impairments.
  • SECTION § 416.986 - Why and when we will find that you are no longer entitled to benefits based on statutory blindness.

• Disability Redeterminations for Individuals Who Attain Age 18

  • SECTION § 416.987 - Disability redeterminations for individuals who attain age 18.

• Continuing or Stopping Disability or Blindness

  • SECTION § 416.994 - How we will determine whether your disability continues or ends, disabled adults.
  • SECTION § 416.994a - How we will determine whether your disability continues or ends, and whether you are and have been receiving treatment that is medically necessary and available, disabled children.
  • SECTION § 416.995 - If we make a determination that your physical or mental impairment(s) has ceased, did not exist or is no longer disabling (Medical Cessation Determination).
  • SECTION § 416.996 - Continued disability or blindness benefits pending appeal of a medical cessation determination.
  • SECTION § 416.998 - If you become disabled by another impairment(s).
  • SECTION § 416.999 - What is expedited reinstatement?
  • SECTION § 416.999a - Who is eligible for expedited reinstatement?
  • SECTION § 416.999b - How do I request reinstatement?
  • SECTION § 416.999c - How do we determine provisional benefits?
  • SECTION § 416.999d - How do we determine reinstated benefits?
  • SECTION § 416.988 - Your responsibility to tell us of events that may change your disability or blindness status.
  • SECTION § 416.989 - We may conduct a review to find out whether you continue to be disabled.
  • SECTION § 416.989a - We may conduct a review to find out whether you continue to be blind.
  • SECTION § 416.990 - When and how often we will conduct a continuing disability review.
  • SECTION § 416.991 - If your medical recovery was expected and you returned to work.
  • SECTION § 416.992 - What happens if you fail to comply with our request for information.
  • SECTION § 416.992a - [Reserved]
  • SECTION § 416.993 - Medical evidence in continuing disability review cases.