If a claimant was previously entitled to DIB benefits and files a new claim, determine
if the prior period of disability ended more or less than five years ago (seven years
for DWB or CDB) before the current potential onset date (POD).
If the prior period ended more than (or close to) five years before the current POD,
document the SSA-3367 Disability Report - Field Office with the prior diagnosis code.
(See DI 11010.261D.1.). This will alert the DDS to determine if the current impairment is the same as,
or directly related to, the prior impairment.
EXAMPLE 1: Claimant’s entitlement terminated 10/2005 due to work. He re-filed 02/2011 because
substantial gainful activity (SGA) ended 01/2011. Since there is no possibility of
earlier entitlement, we need the DDS to determine if the impairment is the same as,
or related to, the prior impairment because it has been more than five years since
we terminated benefits.
EXAMPLE 2: Claimant’s entitlement terminated 10/2005 for medical recovery. There is no SGA work
since termination. He files again in 02/2009 for a new impairment. If DDS allows his
claim, we can count his prior months of entitlement because he became disabled again
before five years passed since termination.
EXAMPLE 3: Claimant entitlement terminated 10/2005 due to work. He worked through 10/2009 and
had no SGA work after that time. He re-filed in 02/2011 with an alleged onset date
(AOD) of 02/2010. Since it is possible that DDS will not find the claimant disabled
within five years of the prior termination, we need DDS to document if the impairment
is the same, or related to, the prior impairment.
Additional examples are in HI 00801.152C.