TN 2 (01-21)

DI 27515.010 Changed Vocational Profile and Collateral Estoppel

A. Policy

When the basis of the prior favorable determination or decision was medical-vocational rules and the claimant has performed substantial gainful activity (SGA) since the date of the prior favorable determination or decision, he or she may have a changed vocational profile. When the claimant has a changed vocational profile, collateral estoppel does not apply and a new determination is required.

B. Procedure

When the claimant has performed SGA since the date of the prior favorable determination or decision, the Disability Determination Services (DDS) must determine whether the claimant’s work activity is vocationally relevant.

1. Determine whether work activity is vocationally relevant

When the claimant’s work activity since the prior determination or decision meets all relevancy requirements in DI 25005.015, the work is vocationally relevant and the DDS must consider the work at steps 4 and 5 of the sequential evaluation process.

The following work factors apply:

  • The work activity may meet the requirements of an unsuccessful work attempt (UWA), or

  • Subsidy or impairment related work expenses (IRWE) may reduce the earnings below the SGA level, or

  • Averaging of the wages may apply and reduce the earnings to below the SGA level.

For more information, see:

NOTE: The FO completes work activity development prior to transferring the new claim to the DDS for a determination. For information on FO and DDS responsibilities for work development, see DI 11010.140.

2. Work activity is vocationally relevant

When the claimant’s work activity since the prior favorable determination or decision is vocationally relevant, the DDS must consider the basis for the prior favorable determination or decision as follows:

  1. a. 

    Meets or equals a listing

When the basis of the prior favorable determination or decision was meeting or equaling a listing, the claimant does not have a changed vocational profile regardless of work activity. Collateral estoppel applies when the listing has not substantially changed or become more restrictive in accordance with DI 27515.005B. However, evidence of work activity may indicate medical improvement (MI). When a CDR is required, see DI 27515.050B.1.

b. Medical-vocational rules

When the basis of the prior favorable determination or decision was medical-vocational rules and the work activity since the prior determination or decision meets all relevancy requirements in DI 25005.015, the claimant has a changed vocational profile. Collateral estoppel does not apply and a new determination is required. In addition, evidence of work activity may indicate MI. When a CDR is required, see DI 27515.050B.2.

c. CDR continuance

When the most recent favorable determination or decision was a CDR and the work activity since that determination or decision meets all relevancy requirements in DI 25005.015, the DDS must determine the basis for the CDR continuance:

  • When the basis for the CDR continuance was meeting or equaling a listing, see DI 27515.010B2a.

  • When the basis for the CDR continuance was medical-vocational rules, see DI 27515.010B2b.

  • When the basis for the CDR continuance was no MI, the DDS must continue to review earlier determinations or decisions to find the most recent favorable determination or decision based on meeting or equaling a listing or medical-vocational rules and follow the procedures described above in DI 27515.010B2a or DI 27515.010B2b.

d. Basis unknown

When it is not possible to determine the basis of the prior favorable determination or decision, collateral estoppel does not apply and a new determination is required.

C. Changed vocational profile precludes collateral estoppel

When collateral estoppel does not apply due to a changed vocational profile, the DDS must complete development and make a new determination.

When the determination on the new claim is a denial, the DDS must enter list code 581 (Adoption does not apply - changed vocational profile) in Item 26 of the SSA-831. For disability related list codes, see DI 33530.005.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0427515010
DI 27515.010 - Changed Vocational Profile and Collateral Estoppel - 01/12/2021
Batch run: 01/13/2021
Rev:01/12/2021