When collateral estoppel applies, the DDS may, with some exceptions, make the determination without medical consultant (MC) or psychological consultant (PC) review. For additional information, see DI 24501.001B.2 and DI 24501.002A.
When the potential onset date (POD) in the new claim is earlier than the EOD in the prior favorable determination or decision, the DDS must complete development for the period not previously adjudicated to determine the established onset date (EOD). This will require adjudication in the usual manner for the earlier period, including MC or PC review and signature. For information on medical evaluation, see DI 24501.002.
When a diary was never scheduled on the prior favorable determination or decision, the diary is due, or the diary is past due, or will be due within 3 months, set a MIE diary on the new claim to mature in 1 year unless the diary was MIP or MINE. When the diary on the prior determination or decision was MIP or MINE, and no CDR issue is raised, set a MIP or a MINE diary based on the individual case facts. For more information on diaries, see DI 26525.000.
Enter the regulation basis code “CE” for title II claims and “ACE” for title XVI claims in Item 22 of the SSA-831.
NOTE: Because eCAT functionality requires an MC/PC signature, the DDS may process collateral estoppel determinations that do not require an MC/PC signature outside of eCAT.