TN 49 (09-00)

GN 00204.028 Duplicate Applications

A. Definition

A duplicate application is an unnecessary application filed for the same benefit or same period of disability for which a previous claim has already been filed. See SI 00601.048 for instructions for processing title XVI duplicate applications.

B. Procedure - General

Mark the application or annotate the development worksheet screen “duplicate” and develop any new information or evidence that is material. Retain the duplicate application because it is a permanent part of SSA's record. Process the duplicate application as follows:

STEP    

ACTION

1     

Was the duplicate application filed before adjudication of the original claim (i.e., a notice of initial determination was not sent on the original claim)?

  • If no, go to step 2.

  • If yes, adjudicate the original claim after considering any new information which accompanies the duplicate application, if applicable, and send both applications to the PC.

2    

Send the duplicate claim to the PC.

3     

The PC will take responsibility for the remaining steps:

  • Reexamine the file to verify the correctness of the prior initial determination; and

  • Consider any new information or evidence which may have been submitted.

4    

Did the original application result in an award of benefits?

  • If yes, go to step 5.

  • If no, go to step 6.

5    

Does the new information or evidence affect the award?

  • If yes, go to step 9.

  • If no, notify the claimant that his/her rights to benefits were determined based on the prior application on which the award notice was received. Do not include the blanket closeout or reconsideration paragraphs.

NOTE: If the award or denial notice was sent to the claimant after the receipt of the duplicate application or the award or denial notice and the duplicate application crossed in the mail, no notice is necessary.

6

Was the prior disallowance determination correct?

  • If no, go to step 9.

  • If yes, go to step 7.

7

Are all the issues involving the duplicate application the same?

  • If no, go to step 8.

  • If yes, notify the claimant that the new application presents the same issues as the prior application, that the prior determination was correct and accordingly, a favorable action cannot be taken. Also, include the reconsideration paragraph and state that any subsequent reconsideration will be limited to the question of whether the issue is the same as that previously determined.

8

If it is decided that the issue is not the same:

  • make a full determination of the case; and

  • include the blanket closeout paragraph in the notice, even though the application is technically a duplicate, and all other classes of benefits were previously denied using the blanket closeout paragraph.

9

If the claimant submits new and material evidence or it is discovered that the prior determination is incorrect:

  • reopen the initial determination if permitted following the rules of administrative finality; or

  • adjudicate the duplicate application and notify claimant of new initial determination.

C. Procedure - Duplicate DIB Applications

Substantive instructions concerning the processing of duplicate applications are contained in GN 00204.028B. However, there are special considerations for duplicate DIB applications.

1. Prior Claim Denied - No New Issues

The SSA L-837 (Social Security Notice of Disapproved Claim) is a suitable notice for most duplicate applications. (See GN 04040.010D. for a discussion of Res Judicata.)

2. Filed While Prior Claim Pending at the Appeals Level

  • For same title claims filed while prior claim pending at the reconsideration level follow DI 12045.030

  • For same title claims filed while prior claim pending at the hearing level follow DI 12045.035

3. Filed Prior to Release of Favorable Notice

No acknowledgement of the duplicate application is necessary, unless an issue of reopening or continuing disability is raised.

4. Filed After Release of Favorable Notice -- No New Issue(s)

Take the following actions:

  • Send a letter acknowledging the duplicate application. Inform the claimant that his/her rights to benefits were determined based on the prior application on which the award notice was received. No new closeout is needed, and no reconsideration paragraph will be included (see NL 00603.020).

  • Document the file to show that there is no change in the disability determination.

5. Continuing Disability Issue Raised

Process the case in accordance with the continuing disability procedures in DI 13001.000 ff.

6. Disability Freeze Established for Statutory Blindness or Disability - DIB Denied

Process the claim following the instructions in DI 11055.075.

7. Prior Claim Awarded at the Appeals Council (AC) Level – Subsequent Claim is a Duplicate

When the AC awards continuing DIB based on the prior claim and the subsequent claim has not already been adjudicated, the subsequent claim is a duplicate application to be processed as follows:

  • Send a notice to the claimant to acknowledge the duplicate application. Advise the claimant that his/her right to benefits as stated in the notice of award resulted from the prior application. Do not include appeal rights or closeout language in the notice.

  • Document SSA records that action is not necessary on the duplicate application because the favorable AC decision was rendered first.

D. Procedure - Auxiliary Application Filed - DIB Claim Denied

Use the language in DI 11010.030 as a guide for preparing the notice when an auxiliary applicant files a duplicate application on behalf of a NH and also files an auxiliary application on behalf of self and others, and the original claim has been or is being denied. This letter is a combination of the Guide Letter, Acknowledging Multiple Application Filed by the Secondary Applicant and Form Letter SSA-L823 (Denial Notice to Auxiliary Applicant) and should be substituted for them under the circumstances described above.

E. Reference

For DOTEL procedures on how to obtain information from the prior claim, see GN 01070.200 ff.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0200204028
GN 00204.028 - Duplicate Applications - 07/31/2015
Batch run: 07/31/2015
Rev:07/31/2015