20 C.F.R. § 416.904

Decisions by other governmental agencies and nongovernmental entities

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Other governmental agencies and nongovernmental entities—such as the Department of Veterans Affairs, the Department of Defense, the Department of Labor, the Office of Personnel Management, State agencies, and private insurers—make disability, blindness, employability, Medicaid, workers' compensation, and other benefits decisions for their own programs using their own rules. Because a decision by any other governmental agency or a nongovernmental entity about whether you are disabled, blind, employable, or entitled to any benefits is based on its rules, it is not binding on us and is not our decision about whether you are disabled or blind under our rules. Therefore, in claims filed (see § 416.325) on or after March 27, 2017, we will not provide any analysis in our determination or decision about a decision made by any other governmental agency or a nongovernmental entity about whether you are disabled, blind, employable, or entitled to any benefits. However, we will consider all of the supporting evidence underlying the other governmental agency or nongovernmental entity's decision that we receive as evidence in your claim in accordance with § 416.913(a)(1) through (4).

[82 FR 5874, Jan. 18, 2017, as amended at 82 FR 15132, Mar. 27, 2017]

Notes of Decisions

Cited in 57 cases (25 in the last 5 years), 1980–2025 · leading case: Grogan v. Barnhart

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Grogan v. Barnhart (2005) ca10 “Although another agency’s determination of disability is not binding on the Social Security Administration, 20 C.F.R. § 416.904 , it is evidence that the ALJ must consider and explain why he did not find it persuasive.”

Donna J. Clifford v. Kenneth S. Apfel, Commissioner of Social Security (2000) ca7 “See 20 C.F.R. § 416.904 . As we stated earlier, the ALJ must independently determine if a claimant is “disabled” as defined solely in the Social Security Act.”

Gary Allord v. Jo Anne B. Barnhart, Commissioner of Social Security (2006) ca7 “But between then and 1999 he received 200 hours of therapy from Dr.”

Marcia C. BUNNELL, Plaintiff-Appellee, v. Louis W. SULLIVAN, Secretary of Health and Human Services, Defendant-Appellant (1990) ca9 “1985); see also 20 C.F.R. § 416.904 (1989) (“[A] determination made by another agency that you are disabled .”

Stieberger v. Sullivan (1990) nysd “Moreover, 20 C.F.R. §§ 416.904 , 404.1504 (1989) stipulate: A decision by any other governmental agency about whether you are disabled or blind is based upon its rule and is not our decision about whether you are disabled or blind.”

Walker v. Harris (1980) ksd “See 20 C.F.R. §§ 416.904 -.913. In the instant case, the ALJ proceeded to the last inquiry.”

Cornett v. Astrue (2008) ca5 “20 C.F.R. § 416.904 (“[A] determination made by another agency that you are disabled or blind is not binding on [the Commissioner].”

Walters v. Colvin (2015) ca10 “2005) (citing 20 C.F.R. § 416.904 ). The ALJ considered the VA’s assessment but gave it no weight, explaining that it was based on time periods — and medical records — before and after the relevant time period here.”

Stacy Perkins v. Carolyn Colvin (2015) ca7 “See 20 C.F.R. § 416.904 ; Allord v. Barnhart, 455 F.”

Zebley ex rel. Zebley v. Bowen (1988) ca3 “May 6, 1977) (remand because of exclusive application of listed impairment test — Secretary failed to consider whether child might be disabled under language in regulations to effect that medical equivalence determination must give "appropriate consideration of the particular…”

Caenen v. Secretary of Health and Human Services (1989) nvd “Such a disability determination by an agency other than Health and Human Services is not binding on the Secretary, see 20 C.F.R. 416.904 (1988), and it may be given “as much or as little weight as [the Secretary] deems appropriate.”

Alan Wood v. Nancy Berryhill (2017) ca9 “ALJs are not bound by the decisions of other government agencies, see 20 C.F.R. § 416.904 , and it is not error for an ALJ to afford less weight to the opinion of a reviewing physician than to the opinions of examining physicians, see Holohan v.”

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