BASIC (03-12)

DI 51501.015 Claimant Submits Additional Evidence

If the claimant submits additional evidence to the field office (FO), the FO must forward the evidence to the office handling the prior claim.

A. Additional evidence

Additional evidence includes, but is not limited to, medical evidence, statements by the claimant about his or her impairment and restrictions, and disability reports; e.g., SSA-3368 (Disability Report – Adult), Internet SSA-3368 (i3368), SSA-3367 (Disability Report – Field Office).

1. Prior claim pending at the initial, reconsideration, or hearing level

  • Fax the evidence into the electronic folder (EF).

  • For paper folders, mail the evidence to the Disability Determination Services (DDS) or hearing office (HO).

2. Prior claim pending at the Appeals Council (AC) level

  • Fax the evidence into the EF.

  • Use the UAT function to alert the AC that there is additional evidence in file.

  • For paper folders, mail the evidence to the AC and attach an SSA-5002 (Report of Contact) to notify the AC of the additional evidence in file. If the evidence indicates a new critical or disabling condition (defined in DI 51501.001B), follow the instructions in DI 51501.015C in this section.

B. AC review of additional evidence

1. Evidence relates to the period on or before the date of the hearing decision

If the AC determines the evidence relates to the period on or before the date of the hearing decision, and the evidence is new and material, the AC will consider the evidence together with the entire record.

NOTE: The AC may expedite its review based on the new evidence.

2. Evidence does not relate to the period on or before the date of the hearing decision

If the AC determines the evidence does not relate to the period on or before the date of the hearing decision, the AC will return the evidence to the claimant. The notice returning the additional evidence will:

  • explain why the AC did not accept the evidence, and

  • include protective filing language.

The AC will decide what the protective filing date will be. The protective filing date for the new claim will usually be the date the claimant requested AC review of the prior claim.

Reference:

GN 03104.350A.3. How AC Treats New and Material Evidence

C. AC review of evidence that indicates a new critical or disabling condition

If a prior claim is pending at the AC, and the claimant provides evidence that may indicate a new critical or disabling condition after the date of the hearing decision on the prior claim, explain to the claimant that he or she may be able to file a new application. If the claimant wants to file a new application, explain that we will forward the evidence to the AC, and the AC will determine if he or she can file a new disability application based on this evidence.

The FO must:

  1. Fax the evidence into the EF; and

  2. Document the following information on an SSA-5002 on the AC appeals segment in the Electronic Disability Collect System (EDCS):

    • Description of the new critical or disabling condition; and

    • Identify and include contact information for any new medical sources.

  3. Send an email to |||ODAR OAO. In the subject line, type: “Request for Subsequent Disability Application Exception.” In the email, include the claimant’s name, SSN, and add the remark: “See SSA-5002 on the AC appeals segment.”

  4. If there is a new EDCS segment, leave it open until the AC responds.

  5. Hold the claim until the AC responds.

The AC will expedite the email request and determine if the claimant meets the exception to file a new disability application. If the AC does not respond after 2 business days, forward the original email to |||ODAR OAO. In the subject line, type: “2nd Inquiry – Request for Subsequent Disability Application Exception.” If the AC does not respond to the 2nd inquiry, send another status request 5 workdays after the 2nd inquiry.

D. AC decision on FO request for subsequent disability application exception

The AC will respond via email to the FO with its decision. The AC decision is also noted in the Message section in eView.

1. Claimant permitted to file a new application

The FO can accept and process a new application. If the claimant already has a new application pending in the FO, the FO can continue to process that application.

The filing date for the new application will be the date the claimant requested AC review of the prior claim.

2. Claimant not permitted to file a new application

If the AC determines the claimant does not meet the exception, the FO cannot accept a new application from the claimant, unless the claimant asks to withdraw the appeal for the pending claim and the AC approves the claimant’s request. If the new application is pending at the FO, the FO will dispose of the new application. See Disposition of Subsequent Disability Applications, DI 51501.025B.

E. Related references

  • DI 51501.001 Procedural Change for Subsequent Disability Applications Effective July 28, 2011

  • DI 51501.005 Claimant Requests to File a New Disability Application

  • DI 51501.010 Field Office Actions on Subsequent Disability Applications

  • DI 51501.020 Claimant Requests to Withdraw Pending Appeal

  • DI 51501.025 Disposition of Subsequent Disability Applications

  • DI 51501.030 DDS Actions on Subsequent Disability Claims


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0451501015
DI 51501.015 - Claimant Submits Additional Evidence - 09/17/2012
Batch run: 09/17/2012
Rev:09/17/2012