Basic (07-08)
When the disabled individual files a new claim after a previous medical denial or cessation, request the prior disability file per DI 11005.085 “Prior Claims Activity”. Because many prior files are now viewable through eView, which contains identifiers to indicate when a file is a Certified Electronic Folder (CEF), DDS should check the eView folder indicators to determine if the prior folder is a CEF. See DI 81020.030 “Prior Folder Material”.
DDS has jurisdiction in the following situations:
A subsequent CDB claim filed after a prior determination or decision that the child was not disabled before age 18 (pre-1972 amendments) requires a disability determination under the 1972 amendments. CDB claims that were adjudicated prior to the 1972 amendments only received a determination as to whether disability existed before age 18.
A subsequent CDB claim filed after a prior determination or decision that the child was not disabled through the date of adjudication, which was prior to attainment of age 22, requires a DDS determination of whether the child is disabled before age 22 or through the date of the current adjudication, whichever is earlier.
A subsequent CDB claim filed where the alleged onset date is within 7 years after the month the last prior CDB terminated.
A subsequent CDB claim filed after a prior determination or decision (made on or before January 5, l986) that the claimant was not disabled prior to the attainment of age 22. A DDS determination is required because of changes in the law due to the l984 disability amendments. This is true regardless of the level at which the prior denial was issued. If the prior claim was denied on or after January 6, l986, see the next bullet in this section.
A subsequent CDB claim filed after a prior determination (made on or after January 6, l986) that the claimant was not disabled prior to the attainment of age 22, and new and material evidence is submitted. If there are any doubts as to whether the evidence is new and material, send the claim to the DDS. (See DI 11010.080 “Subsequent Disability Insurance Benefits (DIB) Claim after Prior Administrative Law Judge (ALJ), or Appeals Council (AC) Denial - Insured Status Expired within Period Adjudicated by Prior Decision - Medical Evidence Submitted”). If a court's decision affirms a decision by an Administrative Law Judge or the Appeals Council that was made before January 6, l986, but the court's decision was made after January 6, l986, send the case to DDS in accordance with DI 11010.260 “Sending Subsequent Disability Insurance Benefits (DIB) or Freeze Claims to the Disability Determination Services (DDS)”.
See Also
DI 11020.050 Field (FO) Authorization of Childhood Disability Benefits (CDB) Involving Substantial Gainful Activity (SGA), and Technical Denials
DI 11020.085 Childhood Disability Benefit (CDB) Claims Excluded from Field Office (FO) Authorization.
NOTE: Effective October 1, 2004, P.L. 108-203 allows reentitlement to childhood disability benefits after the 84-month period if the beneficiary's previous entitlement to disability terminated because of SGA.