“other medical sources” describes sources that may provide evidence to show the severity of a claimant’s impairment and how it affects his ability to work. Other sources include medical sources not listed in Box 1-1 (e.g., nurse practitioners, physicians assistants, naturopaths, chiropractors, audiologists, and therapists), educational personnel (e.g., school teachers, counselors, daycare center workers), and public and private social welfare agency personnel. Nonmedical sources such as spouses, parents and other caregivers, siblings, other relatives, friends, neighbors, and clergy may also be consulted.

If the treating source’s opinion is not given controlling weight, DDS personnel consider a number of factors in weighing evidence, whether from the treating source or others. For example, SSA may consider the existence of an examining relationship (i.e., evidence from a source who has examined the claimant has more weight than a source who has not), length of the treatment relationship, supportability, and other factors that support or contradict the opinion, when weighing evidence.


The Listings were first published as regulations in 1968. The first significant revision to the Listings regulations occurred in 1977, when SSA published a new set of listings criteria that would apply to children under age 18. In 1979, SSA comprehensively updated and revised all the adult listings. In 1984, Congress directed SSA to revise its mental disorders listing criteria, which it published in 1985. Later the same year, SSA updated listings for most of the other body systems. The 1985 regulations added expiration dates to all body systems. The law does not require SSA to periodically update the criteria in the Listings, but as SSA noted at the time, it would periodically review and update the Listings based on medical advancements in disability evaluation and treatment and program experience.

The 1985 updates were the last comprehensive revision to the Listings. Since then, SSA has focused on updates that are more targeted—addressing single body systems, or even individual listings. During the mid-1990s, SSA suspended listings revisions in anticipation of a fundamental redesign of the disability decision-making process; however, an internal reassessment of its disability initiatives led SSA to resume its efforts to update all body systems on a continuous basis.

Over time, SSA has added steps to the revision process to expand input from outside of the agency. Rather than beginning the revision process by issuing new draft rules in a Notice of Proposed Rulemaking (NPRM) in the Federal Register, SSA may begin by issuing an Advance Notice of Proposed Rulemaking (ANPRM), which announces its intention to update a specific body system and asks for suggestions from the public. SSA may

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