TN 1 (03-17)

DI 24503.050 Determining the Filing Date for Evaluating Evidence

A. Background for evaluating evidence

1. Significance of the filing date for evaluating evidence

For some policies we use to evaluate medical and nonmedical evidence, a claim’s filing date will determine which set of policies we use in a disability or blindness claim. To use the correct policies, adjudicators at all adjudicative levels must know whether the filing date of the claim is before March 27, 2017, or whether the filing date of the claim is on or after March 27, 2017. Follow the guidance in this section to determine which set of policies based on the filing date to apply to a disability or blindness claim.

For more information about how the Field Office (FO) determines the filing date of a claim, see Application Filing Date in section GN 00204.007.

2. Specific evidence policies in which the filing date of a claim is relevant

The filing date of a claim is relevant for the following evidence policies:

  • Which medical sources are acceptable medical sources (AMS) only for claims filed on or after March 27, 2017. See DI 22505.003;

  • The definition of these categories of evidence: medical opinions, opinions, and other medical evidence. See DI 24503.005;

  • The rules for considering medical opinions and prior administrative medical findings. See DI 24503.025 and DI 24503.035;

  • The articulation requirements for medical opinions and prior administrative medical findings. See DI 24503.030 and DI 24503.035;

  • The articulation requirements for statements on issues reserved to the Commissioner. See DI 24503.040; and

  • The articulation requirements for decisions from other governmental agencies and nongovernmental entities. See DI 24503.045.

3. eView Medical Evidence indicator

The purposes of the Medical Evidence indicator in the eView header are:

  • to help adjudicators at all adjudicative levels understand which set of policies to use; and

  • to direct systems at the Office of Disability Adjudication and Review (ODAR) to produce correct notice language and display correct decisional screens that correspond to the filing date.

This indicator is set when the FO transfers the claim to the Disability Determination Services (DDS) and will appear in the eView header for all claim types. For claims filed before March 27, 2017, the indicator must say “MedEv: Prior Rules”. For claims filed on or after March 27, 2017, the indicator must say “MedEv: Current Rules”.

B. How to determine the filing date of a claim

1. Electronic claim using eView and eCAT

Generally, the earliest filing date displayed in the eView Medical Evidence indicator and in eCAT is the correct filing date to use to determine which set of policies to use to evaluate evidence in a claim. Therefore, in most claims, the eView indicator will display the correct filing date information to use to determine which policies apply when evaluating evidence.

However, it is possible the indicator will display incorrect filing date information when:

  • the claimant submits an application for a second claim after the FO transfers the first claim to the DDS, or

  • we previously made a determination or decision on a claim filed by the claimant.

Follow the guidance in subsection DI 24503.050D in this section to determine which set of policies to follow.

NOTE: DDS adjudicators should check to see if the FO added a new claim after transfer of the first claim to the DDS. This information may be in the Update-After-Transfer Utility, Certified Electronic Folder Alerts, or a SSA-5002 (Report of Contact). For more information, see “Certified Electronic Folder (CEF) Alerts” in DI 81020.080.

2. Paper claim

Follow the guidance in the filing date scenarios in subsection DI 24503.050D in this section to determine which set of policies to follow.

NOTE: Look at the available SSA-831s to determine if there are prior filings.

C. Adjudicator responsibilities related to the filing date of a claim

1. Policy responsibility

An adjudicator must use the correct set of policies related to the filing date of a claim to evaluate evidence before issuing a determination or decision. Adjudicate claim(s) with a filing date prior to March 27, 2017, using the “prior rules.” Adjudicate claim(s) with a filing date on or after March 27, 2017, using the “current rules.” Follow the guidance in subsection DI 24503.050D in this section to determine which set of policies to follow.

2. Procedural responsibility for electronic claims

An adjudicator must ensure that the eView Medical Evidence indicator shown in the eView header displays the correct value based on the filing date of the claim before issuing the determination or decision. If an adjudicator believes that the indicator’s value may be incorrect, contact the FO to resolve any issues, as appropriate. If the indicator displays an incorrect value, the adjudicator must manually correct the indicator’s value by clicking on the eView “MedEv” indicator hyperlink and correcting the value displayed.

D. Filing date scenarios

Use the earliest possible filing date for the claim(s) to determine which set of policies to follow. In each scenario, ensure that the eView Medical Evidence indicator displays the correct value. The following instructions present the possible filing date scenarios with the corresponding policy that adjudicators must follow.

NOTE: We refer to the rules in place before March 27, 2017, as the “prior rules.” We refer to the rules in place on or after March 27, 2017, as the “current rules.”

1. Single claim

If the filing date of the claim is:

  • before March 27, 2017, use the prior rules; or

  • on, or after March 27, 2017, use the current rules.

2. Multiple claims

a. General rule

Except as stated in DI 24503.050D.2.b. in this section, use the earliest possible filing date of the claims to determine which set of rules to follow.

If the earliest filing date of the claim is:

  • before March 27, 2017, use the prior rules; or

  • on, or after March 27, 2017, use the current rules.

NOTE: If the first claim has been appealed when the second claim is filed, consolidate and escalate the second claim to the same level of appeal.

b. When a Title II claim is closed before a Title XVI claim is filed

Do not relate the filing dates of multiple claims if a Title XVI claim’s earliest filing date is 61 days or more after a Title II claim is decided and there is no appeal filed on the Title II claim.

NOTE: Evidence from the second claim might constitute new and material evidence to justify reopening the first claim. See the instructions for reopening claims in DI 24503.050D.3. in this section.

c. Prior closed claim(s) under one SSN and new claim(s) filed under a different SSN

The new claim(s) involving a different SSN filed by the same individual does not relate to the earlier claim(s) because the earlier claim(s) is closed. For example, this scenario can occur if an individual who is receiving childhood disability benefits (CDB) or disabled widow benefits (DWB) then files for disability or blindness benefits on his or her earnings record. Decide the new claim(s) using the rules that apply to its filing date, not that of the claims in pay status. Ensure that the Medical Evidence indicator shows the correct filing date value for the new claim(s).

NOTE: Evidence from the second claim might constitute new and material evidence to justify reopening the first claim. See the instructions for reopening claims in DI 24503.050D.3. in this section.

3. Reopenings

If you reopen an earlier claim(s), ensure that the eView Medical Evidence indicator displays the correct value corresponding to the filing date of the earlier claim(s). For more information about reopenings, see:

  • DI 27501.005 Reopening and Revising a Determination or Decision

  • DI 27505.001 Conditions for Reopening a Final Determination or Decision

4. Collateral estoppel

If a person files a claim that is a collateral estoppel claim, use the filing date rules in effect for the earlier determination or decision. To determine the filing date for the earlier claim, see the Form SSA-831-U3, Items 3 and 34, (Disability Determination and Transmittal).

See:

5. Res judicata

If a person submits a Title II claim on or after March 27, 2017, for the same period as a previous Title II claim filed prior to March 27, 2017, and there is no other reason to reopen the claim, res judicata applies. For more information, see Disability Determination Services (DDS) Medical Evaluation Criteria to Determine Applicability of Res Judicata in DI 27516.010.

6. Claims under the Office of Quality Review (OQR) jurisdiction

If a claim(s) is under OQR’s jurisdiction when an individual files a subsequent claim with a protective filing date that changes the set of evidence rules that the adjudicative component should use for the claim(s), OQR will return the claim(s) to the adjudicative component with any cited deficiencies and corrective actions so that the adjudicative component can adjudicate the earlier claim(s) under the appropriate rules. For more information, see Adjudicating Component Actions on Deficient Cases in subchapter DI 30005.000.

7. Continuing disability review

Use the rules in effect for the filing date of the first favorable determination or decision in the claim (not the most recent comparison point decision (CPD)). For more information, see The CDR Evaluation Process in subchapter DI 28005.000.

E. References