TN 2 (01-21)

DI 27515.020 Special Situations in Collateral Estoppel Claims

A. New title II claim - title XVI disability previously established

  • Prepare a title II determination adopting the prior title XVI determination or decision under Federal criteria when none of the exceptions in DI 27515.001E applies.

  • Adopt the prior title XVI determination or decision even when in suspense for technical issues. Collateral estoppel does not apply when the prior favorable determination or decision is in terminated status. For using queries to determine current title XVI eligibility, see DI 28030.010.

  • Review the prior favorable determination or decision when needed to determine the established onset date (EOD) in accordance with guidelines in the table below. For requesting a prior paper folder, see DI 20505.015.

When the EOD in the prior favorable title XVI determination or decision is…

Then...
The date of filing and evidence supports an earlier EOD

Establish the earlier EOD in the title II determination as warranted by the evidence.

A conversion case which has been continued under Federal criteria

Establish the title II EOD as the continuance under Federal criteria unless the evidence warrants an earlier EOD.

NOTE: When collateral estoppel applies, the Disability Determination Services (DDS) may establish a title II EOD later than the date set by a prior title XVI determination or decision because of the performance of substantial gainful activity (SGA) after the title XVI EOD or because the date first insured is later than the title XVI EOD.

B. New title XVI claim – title XVI claim previously denied for technical reasons

The DDS may have made a favorable determination on an initial title XVI claim for Supplemental Security Income (SSI) based on disability or blindness, but the FO technically denied the claim (e.g., excess income) before issuing any benefit payment.

When the claimant files a new application, collateral estoppel does not apply and a new determination is required.

NOTE: Even when collateral estoppel does not apply, the DDS may make a favorable determination based on the evidence in the new claim.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0427515020
DI 27515.020 - Special Situations in Collateral Estoppel Claims - 01/12/2021
Batch run: 01/13/2021
Rev:01/12/2021