NOTE: The following instructions apply only to potential collateral estoppel claims. The
FO will continue to develop potential res judicata claims. For FO res judicata development
and processing, see DI 27516.001. For initial title II technical denials and claims not requiring a disability determination,
see DI 11010.075.
When an individual currently entitled to disability benefits files a subsequent title
II or title XVI application for disability benefits, complete the full front-end disability
and non-disability development, including completing SSA-3368 Disability Report –
Adult, SSA-827 Authorization to Disclose Information to the Social Security Administration,
and an SSA-3367 Disability Report – Field Office. This includes development of any
work performed after the established onset date (EOD) of the current entitlement.
For initial claims processing, see DI 11000.000. For guidance on processing new initial Supplemental Security Income (SSI) claims,
see DI 11055.000. For more information on documenting work activity, see DI 10501.025. Inform the claimant that a continuing disability review (CDR) may be required on
his or her existing entitlement. Once FO development is complete, transfer the subsequent
claim to the DDS for a determination.
IMPORTANT: The FO must inform the claimant that the new claim could result in a denial or potentially
raise a CDR on the existing entitlement. During the interview, verbally explain to
the claimant and add a remark to the RMKS screen or SSI application page. For example,
“I understand that SSA will make a determination for this application, which could
be favorable or unfavorable. I also understand that SSA may need to review continuing
eligibility for my current disability benefits. SSA will notify me if they need to
review my current benefits.” When it is not possible to inform the claimant verbally,
the FO will issue a notice with the explanation. The FO will not initiate a CDR on
the existing entitlement until requested by the DDS.
The FO will alert the DDS to consider collateral estoppel on the subsequent claim
by completing the following actions:
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•
Add the “Potential Collateral Estoppel Issues Apply” case flag to the Electronic Disability
Collect System (EDCS). The flag does not indicate an allowance based on collateral
estoppel. The flag must remain in the certified electronic folder (CEF) at all times.
Do not remove the flag unless added erroneously (e.g., claimant is not currently entitled
to disability benefits). When the claim is excluded from electronic processing, add
the paper collateral estoppel flag:
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•
Document all prior filings with a medical determination or decision, or substantial
gainful activity (SGA) denial, on the SSA-3367. This includes the prior favorable
determination or decision for the existing entitlement.
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•
Obtain a current Master Benefit Record (MBR) or Supplemental Security Income Display
(SSID) query to document the existing disability entitlement. Fax a copy of the query
into the CEF using the appropriate barcode cover sheet.
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•
Transfer the subsequent claim to the DDS for adoption or a new determination, depending
on the facts of the case.
When the prior favorable determination or decision is not in the CEF, the FO will
request the paper folder under established procedures. For more information, see DI 11005.085B and DI 27515.015. The FO will not delay transferring the subsequent claim to the DDS while obtaining
the prior file. Complete Item 7 on the SSA-3367 to document the prior paper folder
request. Once received, route the paper folder to the DDS to associate with the pending
claim.