TN 1 (01-11)
DI 40105.050 Administrative Res Judicata – Processing Center (PC) Instructions
A. Definition of Res Judicata
Res Judicata is a rule in administrative law. It applies at all levels of the claims process to avoid deciding an issue that we have previously decided based on the same facts, same issues, same parties and same adjudicative period. For more information on Res Judicata, see Field Office (FO) Res Judicata Development and Processing DI 27516.001.
B. Requirements to apply Res Judicata
Administrative res judicata applies when:
A subsequent disability application is filed, and
The last substantive denial or closed period determination occurs
after the earnings requirement was last met (Disability Insurance Benefit (DIB) cases), or
after the prescribed period requirement was later met (Disabled Widows Benefit (DWB) and Childhood Disabled Beneficiary (CDB) reentitlement cases), and
on or after the attainment of age 22 (CDB cases).
C. Administrative Res Judicata does not apply when the administrative decision is subject to administrative revision.
Some examples are:
There is a basis for reopening the prior denial.
In a DIB claim, there has been additional work activity, which could extend the date the earnings requirement was last met.
In a DWB or CDB reentitlement, there is evidence that could extend the date the prescribed period requirement ended.
These claims are usually field office jurisdiction; however, they occasionally come into the Office of Disability Operations, Processing Center-Disability Processing Branch, and Office of International Operations (ODO/PC-DPB/OIO).
D. New determinations
If the above conditions are not met, a new independent determination is needed. Only an Administrative Law Judge (ALJ) or the Appeals Council (AC) may reopen an ALJ’s decision.
If there was a prior denial or closed period at the ALJ level and new and material evidence is submitted, only the ALJ or AC may decide if there is a basis for reopening. See DI 42001.015 D. for instructions on referring these cases to the ALJ.
Prior decisions made at the AC or court level are processed as above, except that wherever the reference “ALJ” is shown, read “AC.”
Also, see Reopenings and Revisions: Pertinent Definitions and Related Policy DI 27501.001.
E. Processing the claim when administrative res judicata applies
When res judicata applies, a Form SSA-831 (Disability Determination and Transmittal) is not necessary. Per DI 27516.005.B.3 the Disability Examiner/Disability Processing Specialist (DE/DPS) annotates the certified electronic folder explaining that res judicata applies and request that the field office (FO) input denial code S1. For instructions on annotating the certified electronic folder (CEF), see Certified Electronic Folder (CEF) Messages DI 81020.090.
F. See also
DI 27516.001 FO Res Judicata Development and Processing
GN 03101.160 Res Judicata
GN 04001.000 Reopening (Title II Only)
DI 11010.075 Title II Technical Denials, and Claims Not Requiring a Disability Determination
DI 11010.080 Subsequent DIB Claim after ALJ, or AC Denial – Insured Status Expired within Period Adjudicated by Prior Decision – Medical Evidence Submitted