TN 55 (08-96)
DI 12586.035 The Stieberger Development Period
In most cases, the Stieberger DEVELOPMENT PERIOD will begin with the 48th month immediately preceding the date of SSA's receipt of the request for review and end at the point of readjudication. In some cases, however, the DEVELOPMENT PERIOD may start earlier or later than the 48th month. (See C.1, below.)
Application of the DEVELOPMENT PERIOD in cessation cases is discussed in DI 12586.015D.
Finally, there are some instances in which the DDS may have to develop for the entire retroactive period. (See D. below.)
B. Policy -- Documentation
The FO is responsible for computing the DEVELOPMENT PERIOD prior to releasing the Stieberger case to the DDS. This will be done by using the DEVELOPMENT/PAYMENT PERIOD Worksheet in DI 12586.095, Exhibit 10, or, if available, the PC program.
The DEVELOPMENT/PAYMENT PERIOD worksheet must be prong filed on the right side of the DIB jacket, just beneath the SSA-831.
Follow the directions on the DEVELOPMENT/PAYMENT PERIOD worksheet (Exhibit 10, DI 12586.095) or, if available, the PC program, to compute the DEVELOPMENT PERIOD:
1. Computing the DEVELOPMENT PERIOD
Find the date SSA received the request for review in the RESPONSE DATE field on the Stieberger Court Case Alert (Exhibit 9, DI 12586.095). The 48 month chart which appears in DI 12586.095, Exhibit 12 may also be helpful.
If the class member is deceased, see 2., below.
In counting back 48 months from the date SSA received the request for review, DO NOT include:
periods the class member was already entitled (even if in suspense) to title II unreduced `A', `HA', `DWB' or CDB;
periods of eligibility (even if in suspense) for title XVI;
periods of potential entitlement to any benefit above, based on a claim pending at any administrative level or in court, regardless of whether or not consolidation is possible or has occurred;
periods covered by a medical denial/cessation decision issued while the class member was not a New York State resident; or,
years that the computer earnings query shows annual earnings levels which exceeded the SGA guidelines. (See DI 12586.040 for a complete discussion as to how work activity may affect the DEVELOPMENT PERIOD.)
2. Stieberger Class Member Deceased
Where the Stieberger class member died before the Response Date, substitute the date of death for the Response Date and compute the DEVELOPMENT PERIOD in accordance with the rules in 1., above.
D. Policy -- Developing the Entire Period
The DDS will develop all the way back to the alleged onset (or the cessation date) in the earliest title II Stieberger claim, or the date claim filed in the earliest title XVI Stieberger claim (or the cessation date), if the following (see 2., below) Section 10(e)(5) exception (taken from the Settlement Agreement) applies. Also, if it is necessary to develop back to the earliest retroactive date, it will be necessary to obtain the prior file(s). If an exception cannot be made under Section 10(e)(5) criteria, a determination is prepared based on the period developed.
2. Section 10(e)(5) Exception
The DDS must develop all the way back to the earliest retroactive date (see 1., above, and DI 32586.095, Exhibit 4) if it is determined at any step of the sequential evaluation process that the individual was not disabled during all or part of the DEVELOPMENT PERIOD, i.e., the 48-month period, plus the period from the date of receipt of the request for review to the present, and one of the following conditions is corroborated:
The individual had a chronic impairment during the DEVELOPMENT PERIOD; AND, she/he alleged it was more severe in the past, AND, more information is needed about any earlier acute phase (e.g., rheumatoid arthritis in major joints that was not active during the DEVELOPMENT PERIOD, previously uncontrolled epilepsy or diabetes that was under control during the DEVELOPMENT PERIOD); OR,
His/her treating source(s) during the DEVELOPMENT PERIOD differed from his/her treating source(s) prior to the DEVELOPMENT PERIOD, or s/he had no treating source during the DEVELOPMENT PERIOD; AND, it is learned that other evidence may be available, e.g. from an earlier treating source, that may attest to more serious impairment in the past.
NOTE: Before developing the additional period of disability, the DDS must determine whether one of the conditions in the bullets, above, has been corroborated by the combination of a statement from the claimant, a medical report submitted by the claimant and/or information in SSA's records. Exception: If the reopened case was a cessation, 10(e)(5) is deemed to be met.
The DDS will use the CORROBORATION OF STIEBERGER 10(e) (5) (i) (ii) CONDITIONS checklist to determine whether the 10(e)(5) exception applies.
E. Procedure -- DDS Requests Folders and DLI
If the 10 (e) (5) conditions are met, the DDS will return the green jacket and request that the FO obtain any prior folders and verify the DLI. The FO will:
Request any prior folders using the Folder Request Memo (Exhibit 11, DI 12586.095) with copies of the alert and any queries attached. If the folder is UTL, reconstruct it with the disability report information covering the period from AOD through the beginning of the basic development period.
Obtain SSA-821s, as necessary.
Verify the DLI.
Return the green jacket, etc., to the DDS.
F. Procedure -- Disabled Widows and Disabled Children
CDB and DWB readjudications require special handling because the Stieberger development (and payment) limitations conflict with the standard CDB and DWB development provisions.
Therefore, in establishing the DEVELOPMENT PERIOD for DWBs and CDBs, it will be necessary to ignore the Stieberger development limitations and develop far enough back to determine whether the:
CDB claimant had a disability that began before age 22 (or the close of the 84 month period following the month in which the child's most recent entitlement to benefits as a CDB terminated because his/her disability ceased) -- see DI 11020.001ff; or,
DWB claimant had a disability that began within the prescribed 7-year period (see DI 25501.350).
The PAYMENT PERIOD will still be limited to the appropriate 48-month (or less) period.