There are situations where the Disability Determination Services (DDS) makes a favorable determination on an initial or reconsideration title XVI claim based on disability or blindness, but before any benefit payment has been issued the field office (FO) technically denies the claim for non-medical reasons, e.g., excess income.

We do not require a new DDS disability determination when the claimant files a new SSI application if:

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  The new claim is filed within 12 months of the date of the favorable DDS determination; and

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  The claimant meets all non-medical eligibility factors; and

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  No benefit payment has been issued.

See SI 00603.011 for procedures when a nondisability denial is reversed.

See SI 04010.020 for appeals considerations in SSI claims

See SI 04070.015 for information on reopening SSI determinations.

The FO must send the new SSI application for a DDS Disability Determination if:

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  The claimant files a new application after 12 months from the date of the prior favorable DDS disability determination; or

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  The DDS established a medical improvement expected (MIE) diary and it is 6 months or less before the scheduled reexamination date; or

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  Any of the requirements for not making a new disability determination in DI 11055.077C. is not met.

A new DDS disability determination is NOT required if:

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  The criteria in DI 11055.077A. are met.

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  The claimant files the new SSI application within 12 months from the date of the prior favorable DDS disability determination; and

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  There is no intervening work activity; and

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  There is no allegation of medical improvement; and,

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  If there was an MIE diary on the prior claim, it is 6 months or less before the scheduled reexamination date.

If a new DDS disability determination is not required, take the following actions:

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  Use the disability data from the prior favorable DDS disability determination to complete the Disability Clearance Data (CDIB) screen in the Modernized SSI Claims System (MSSICS); and

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  Process the new SSI application under current procedures.

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  In the SSI claim path enter the remarks, "Prior favorable disability determination dated (MM/DD/YYYY) used to establish medical eligibility in the new claim" under 'File Documentation Notes' on the Disability page and input the medical allowance data on the Disability Clearance page.

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  Issue an SSA-L8025 (Notice of Award) notifying the claimant of SSI eligibility. For any intervening period of ineligibility, include the appropriate notice paragraphs listed in NL 00804.000 (e.g., paragraph #1200 when the claimant resided in a public institution).

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  The comparison point decision (CPD) for a continuing disability review (CDR) is the date of the previous favorable medical determination.