20 CFR 404.1519b
§ 404.1519b When we will not purchase a consultative examination.
United States · 20 CFR — Employees' Benefits · Status: effective
Cite this
- Citation
- 20 CFR 404.1519b, § 404.1519b When we will not purchase a consultative examination, United States, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/78727
- Permanent ID
ys:prov:78727@1- SHA-256
8fa3bc43aca2146f67f30d7bc080085df2d9bf2f914ae3d9648b655941c27f7d
The hash is SHA-256 of this version's text, with every run of whitespace collapsed to a single space and the ends trimmed. The ID always leads back here, and checking it says whether the text you cited is still the current version.
Full text
We will not purchase a consultative examination in situations including, but not limited to, the following situations:
(a) In period of disability and disability insurance benefit claims, when you do not meet the insured status requirement in the calendar quarter you allege you became disabled or later and there is no possibility of establishing an earlier onset;
(b) In claims for widow's or widower's benefits based on disability, when your alleged month of disability is after the end of the 7-year period specified in § 404.335(c)(1) and there is no possibility of establishing an earlier onset date, or when the 7-year period expired in the past and there is no possibility of establishing an onset date prior to the date the 7-year period expired;
(c) In disability insurance benefit claims, when your insured status expired in the past and there is no possibility of establishing an onset date prior to the date your insured status expired;
(d) When any issues about your actual performance of substantial gainful activity or gainful activity have not been resolved;
(e) In claims for child's benefits based on disability, when it is determined that your alleged disability did not begin before the month you attained age 22, and there is no possibility of establishing an onset date earlier than the month in which you attained age 22;
(f) In claims for child's benefits based on disability that are filed concurrently with the insured individual's claim and entitlement cannot be established for the insured individual;
(g) In claims for child's benefits based on disability where entitlement is precluded based on other nondisability factors.
Legislative history
This is a federal regulation, adopted through agency rulemaking under the Administrative Procedure Act — not enacted by a recorded vote of Congress.