388-449-0050  <<  388-449-0060 >>   388-449-0070

Sequential evaluation process step IIHow does the department review medical evidence to determine if I am eligible for benefits?

When we receive your medical evidence, we review it to determine if it is sufficient to decide whether your circumstances meet disability requirements.
(1) We require written medical evidence to determine disability. The medical evidence must:
(a) Contain sufficient information as described under WAC 388-449-0015;
(b) Be written by an acceptable medical source or treating provider described in WAC 388-449-0010;
(c) Document the existence of a potentially disabling condition by an acceptable medical source described in WAC 388-449-0010; and
(d) Document the impairment has lasted or is expected to last twelve continuous months or more with available treatment, or result in death.
(2) If the information received isn't clear, we may require more information before we determine whether you meet ABD disability requirements. As examples, we may require you to get more medical tests or be examined by a medical specialist.
(3) We deny disability if:
(a) We don't have evidence that your impairment is of at least moderate severity as defined in WAC 388-449-0035, 388-449-0040, 388-449-0045, or 388-449-0050;
(b) Your impairment hasn't lasted or isn't expected to last twelve or more months with available treatment or result in death; or
(c) We have evidence drug or alcohol abuse or addiction is material to your impairment(s).
[Statutory Authority: 2014 c 218, 2011 1st sp.s. c 15, RCW 74.04.005, 74.04.050, 74.04.055, 74.04.057, 74.08.090, 74.08A.100, 74.04.770, 74.62.030, 41.05.021, 74.09.035, and 74.09.530. WSR 15-03-031, § 388-449-0060, filed 1/12/15, effective 2/12/15. Statutory Authority: RCW 74.04.005, 74.04.050, 74.04.055, 74.04.057, 74.08.090, 74.08A.100, 74.04.770, 74.62.030, and 2013 2nd sp.s. c 10. WSR 13-24-040, § 388-449-0060, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 74.04.005, 74.04.050, 74.04.055, 74.04.057, 74.04.510, 74.08.090, 74.08A.100, 74.04.770, 74.04.0052, 74.04.655, 74.08.043, 74.08.335, and 2011 1st sp.s. c 36. WSR 12-10-042, § 388-449-0060, filed 4/27/12, effective 6/1/12.]
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