Res judicata, a rule in civil law and an administrative policy, provides that once an issue is decided it does not need to be decided again. We apply res judicata at all levels of the claims adjudication process to avoid deciding an issue that we have previously decided based on the same facts, same issues, same parties, and same adjudicative period.

References: GN 03101.160 Res Judicata, GN 04040.010 Res Judicata

A subsequent Title II claim should be denied using the legal principle of res judicata when a previous determination or decision denying a prior Title II claim:

• •

  becomes final (i.e., there was no timely appeal);

• •

  adjudicated the prior claim through the date the non-disability requirements for entitlement were last met (i.e., the date last insured (DLI) for disability insurance benefits (DIB); the end of the prescribed period for disabled widow's or widower's benefits (DWB); or attainment of age 22 for childhood disability benefits (CDB)); and

• •

  considered the same facts, issues, and period.

Ensure that all of the following conditions are met before using res judicata as the basis for denial of the subsequent Title II claim:

• •

  The law or regulations pertaining to the alleged disabling condition have not changed, see DI 27516.010;

• •

  The subsequent claim presents no new facts or issues that were not considered in making the prior determination or decision (such as an unadjudicated period);

• •

  There is no allegation of a new impairment with an onset during the previously adjudicated period;

• •

  The claimant does not allege that they failed to timely appeal an adverse initial or reconsideration Title II determination because of good faith reliance on incorrect, incomplete, or misleading information given by the Social Security Administration (SSA) or the Disability Determination Service (DDS). For additional information, see Social Security Ruling (SSR) 95-1p;

• •

  The claimant does not allege and the evidence does not support a failure by the claimant to timely appeal the previous adverse determination, decision, or dismissal because of the claimant’s mental incapacity. For additional information, see SSR 91-5p;

If all of the conditions in subsection B are met, the claim is the field office's (FO) jurisdiction. When res judicata applies to the subsequent Title II claim in the FO or DDS:

1. 1. 

   Enter the “S1” denial code on the Benefit Continuity Factors (BECF) screen in the Modernized Claim System (MCS);

2. 2. 

   Enter the decision status of “03” and the listing code of “243” on the Decision Input (DECI) screen; and

3. 3. 

   Process via Earnings Computation (EC). Process via the Manual Adjustment Credit and Award Data Entry system

   (MACADE) if the S1 denial will not process through EC, see SM 00380.000.

If the DDS made the initial res judicata determination and the claimant appeals the determination, the DDS has jurisdiction to make the reconsideration determination.

If the FO made the initial res judicata determination and the claimant appeals the determination, the FO has jurisdiction to make the reconsideration determination. For more information on jurisdiction, see GN 03102.175.

The DDS has jurisdiction over subsequent Title II claims in which res judicata does not apply, and over cases in which a medical review is needed to determine whether res judicata applies (e.g., whether there is new and material evidence).

The FO has jurisdiction over claims meeting all of the conditions in subsection B.

The FO will transfer electronic claims which the DDS has jurisdiction to the DDS for a determination, see DI 81010.085.

To ensure that the subsequent claim is readily identifiable by the DDS:

• •

  Annotate the prior filing information section of the SSA-3367 Disability Report – Field Office, with the pertinent facts regarding the prior filing.

• •

  Add a message (without an expiration date) to the certified electronic folder (CEF) stating: “DDS jurisdiction: potential denial on basis of res judicata. DDS review necessary.” For instruction on posting messages to the CEF, see DI 81020.090.

• •

  Obtain the prior claim folder(s) if the prior filing is an official paper folder housed in a Modular Disability Folder (MDF).

• •

  Document the claims folder to show any Supplemental Security Income (SSI) involvement, including the location of the SSI folder.

  For additional information on documenting prior claims activity, see DI 11005.085. If the prior title II folder cannot be located, do not reconstruct the folder. Obtain a new application, SSA-3368, and SSA-827(s).

  For information on the electronic process when unable-to-locate (UTL) folders, see DI 81010.242. If the search is unsuccessful, complete the UTL Report of Contact and include a copy in the current folder.