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a.
When a claimant with DAA (including a child under SSI) is found disabled considering
the effects of DAA, a determination must then be made excluding the effects of DAA
to determine whether DAA is material to the finding of disability. For more information,
see DI 90070.050 and sections 20 CFR 404.1535 and 416.935 of the regulations. Adjudicators must use
a two-part process. Part 1, follow the sequential evaluation process, considering
all of a claimant’s impairments, including DAA, to determine whether the claimant
is disabled. Part 2, if the claimant is found disabled under the first part of the
process, adjudicators must again follow the sequential evaluation process, but without
considering the effects of DAA, to determine whether the claimant would be found disabled
if the claimant was no longer using drugs or alcohol. If the claimant would not be
found disabled under Part 2 of the process, DAA is material to the determination of
disability. If the claimant would be found disabled, DAA is not material.
Thus, when there is a prior final decision in which:
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•
An ALJ or the AC made findings required at steps in the sequential evaluation process
and found that a claimant with DAA is disabled, considering the effects of DAA, and
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The ALJ or AC made separate findings following the steps in the sequential evaluation
process by considering the claimant’s condition without the effects of DAA to decide
whether DAA was material to the determination of disability,
the adjudicator(s) must consider the findings from both parts of the DAA process when
adjudicating a DAA case (applying the same two-part process) under the requirements
of AR 24-1(6).
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b.
If the ALJ or AC has stated a conclusion in the prior decision that DAA was material,
or that DAA was not material, to the determination of disability, but has not set
out findings showing how this conclusion was reached under the second part of the
process, there will be no findings that are relevant to the decision of whether a
claimant’s DAA is material to the determination of disability.
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c.
In adjudicating the subsequent claim, consider the prior findings described in this
section at DI 52707.010B.1 from the ALJ's or AC's decision about whether the claimant is disabled under Part
1 of the DAA process. Treat such prior findings as evidence to be considered along
with the other evidence in the subsequent claim in determining disability under the
first part of the DAA process. If the claimant is determined to be disabled under
Part 1 of the DAA process, consider prior findings described in this section at DI 52707.010B.1 from the ALJ's or AC's decision about whether the claimant is disabled under the
second part of the DAA process. Treat such prior findings as evidence to be considered
along with the other evidence in the subsequent claim in determining disability under
the second part of the DAA process.
EXAMPLE: The claimant alleged disability due to a heart condition and alcohol dependence
and was found disabled in a final decision by an ALJ. The ALJ first considered all
of the claimant's impairments, including his alcoholism, under the 5-step sequential
evaluation process. The ALJ found the claimant's impairments to be severe but not
listing level. The ALJ found that the claimant was unable to do any PRW and that based
on his age, education, work experience, and RFC, the claimant was disabled at step
5 of the sequential evaluation process. The ALJ then applied the second part of the
DAA process and made findings under the sequential evaluation process considering
the claimant's heart condition, but not his alcohol dependence. The ALJ determined
that in the absence of the claimant's alcoholism, his heart condition was by itself
not disabling. Therefore, DAA was material to the determination of disability.
When adjudicating the subsequent claim, the adjudicator will consider the findings
described in this section at DI 52707.010B.1 which were made by the ALJ in the decision regarding disability under Part 1 of the
DAA process. Treat such a prior finding as evidence to be considered along with the
other evidence in the subsequent claim in making a determination regarding disability
under the Part 1 of the DAA process. If the claimant is determined disabled under
Part 1 of the DAA process, the adjudicator will consider the findings described in
this section at DI 52707.010B.1 from the ALJ's disability decision under Part 2 of the DAA process. Treat such a
prior finding as evidence to be considered along with other evidence in the subsequent
claim in making the disability determination under Part 2 of the DAA process. Under
the AR, any prior finding described in this section at DI 52707.010B.1.a, or DI 52707.010B.1.b, as applicable, must be considered as evidence in light of all relevant facts and
circumstances in determining disability with respect to the subsequent claim. In determining
the probative value of such a prior finding by the ALJ as evidence, the adjudicator
will consider the factors described in this section at DI 52707.010A.2.d, DI 52707.010A.2.e, and DI 52707.020B.4.