Identification Number:
GN 00204 TN 102
Intended Audience:See Transmittal Sheet
Originating Office:ORDP OISP
Title:Applications
Type:POMS Transmittals
Program:All Programs
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part GN – General
Chapter 002 – Applications and Interviews
Subchapter 04 – Applications
Transmittal No. 102, 04/14/2022

Audience

PSC: CA, CS, ICDS, IES, ISRA, RECONR, SCPS, TSA, TST;
OCO-OEIO: BET, CAQCR, CC, CR, CTE, CTE TE, ERE, FCR, FDE, FDEC, RECONE, RECONR;
OCO-ODO: BET, CR, CST, CTE, CTE TE, DE, DEC, DES, DS, DSE, RECONE;
FO/TSC: CS, CS TII, CS TXVI, CSR, CTE, DRT, DT, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

OISP

Effective Date

Upon Receipt

Background

In 2010, the Office of Disability Policy (ODP) obsoleted the NL 00701.372 section and the SSA L-837 (Social Security Notice of Disapproved Claim) form in Aurora. We now add the SSA L-237 (DIB Denial — Miscellaneous (Fill-In Letter, NL 00701.066) as an alternate ODP notice to use when a prior claim was denied and no new issues apply. In addition, we clarify the processing and documenting instructions for duplicate applications.

 

Summary of Changes

GN 00204.028 Duplicate Applications

Subsection B

Step 1: Bullet 2: We added paperless processing instructions for duplicate applications and the reference MS 03520.003.

Step 2: We added paperless processing instructions for duplicate applications and the reference MS 03520.003

Subsection C.1

We replaced the SSA L-837 with the SSA L-237.

Subsection C.4

Bullet 2: We added the SSA-5002 as the form to use for documenting the file.

Subsection C.6

We replaced the obsoleted reference DI 11055.075 with reference DI 11011.001.

Subsection E

We added reference MS 03520.003 Claim Movement/WMS Clearance(CMWM).

GN 00204.028 Duplicate Applications

A. Definition

A duplicate application is an unnecessary application filed for the same benefit or same period of disability for which a previous claim has already been filed. See instructions for processing title XVI duplicate applications, in SI 00601.048.

B. Procedure for processing the duplicate application

Mark the application or annotate the development worksheet screen “duplicate” and develop any new information or evidence that is material. Retain the duplicate application because it is a permanent part of SSA's record. Process the duplicate application as follows:

Processing the Duplicate Application

STEP    

ACTION

1     

Was the duplicate application filed before adjudication of the original claim (i.e., a notice of initial determination was not sent on the original claim)?

  • If no, go to step 2.

  • If yes, adjudicate the original claim after considering any new information which accompanies the duplicate application and send both applications to the PC via paperless, see MS 03520.003.

2    

Send the duplicate application to the PC via paperless, see MS 03520.003.

3     

The PC will take responsibility for the remaining steps:

  • Reexamine the file to verify the correctness of the prior initial determination; and

  • Consider any new information or evidence which may have been submitted.

4    

Did the original claim result in an award of benefits?

  • If yes, go to step 5.

  • If no, go to step 6.

5    

Does the new information or evidence affect the award?

  • If yes, go to step 9.

  • If no, notify the claimant that their rights to benefits were determined based on the prior claim on which the award notice was received. Do not include the blanket closeout or reconsideration paragraphs.

NOTE: If the award or denial notice was sent to the claimant after the receipt of the duplicate application or the award or denial notice and the duplicate application crossed in the mail, no notice is necessary.

6

Was the prior disallowance determination correct?

  • If no, go to step 9.

  • If yes, go to step 7.

7

Are all the issues involving the duplicate application the same?

  • If no, go to step 8.

  • If yes, notify the claimant that the new application presents the same issues as the prior claim, that the prior determination was correct and accordingly, a favorable action cannot be taken. Also, include the reconsideration paragraph and state that any subsequent reconsideration will be limited to the question of whether the issue is the same as that previously determined.

8

If it is decided that the issue is not the same:

  • Make a full determination of the case; and

  • Include the blanket closeout paragraph in the notice, even though the application is technically a duplicate, and all other classes of benefits were previously denied using the blanket closeout paragraph.

9

If the claimant submits new and material evidence or it is discovered that the prior determination is incorrect:

  • Reopen the initial determination if permitted following the rules of administrative finality; or

  • Adjudicate the duplicate application and notify claimant of new initial determination.

C. Procedure - Duplicate DIB Applications

Substantive instructions concerning the processing of duplicate applications are contained in GN 00204.028B. However, there are special considerations for duplicate DIB applications.

1. Prior Claim Denied - No New Issues

The SSA L-237 (DIB Denial — Miscellaneous (Fill-In Letter)) is a suitable notice for most duplicate applications. ( For a discussion of Res Judicata, see GN 04040.010D.)

2. Filed While Prior Claim Pending at the Appeals Level

  • For same title claims filed while prior claim pending at the reconsideration level follow DI 12045.030

  • For same title claims filed while prior claim pending at the hearing level follow DI 12045.035

3. Filed Prior to Release of Favorable Notice

No acknowledgement of the duplicate application is necessary unless an issue of reopening or continuing disability is raised.

4. Filed After Release of Favorable Notice -- No New Issue(s)

Take the following actions:

  • Send a letter acknowledging the duplicate application. Inform the claimant that their rights to benefits were determined based on the prior application on which the award notice was received. No new closeout is needed, and no reconsideration paragraph will be included, see NL 00603.020.

  • Document the file (i.e., SSA-5002) to show that there is no change in the disability determination.

5. Continuing Disability Issue Raised

Process the case following the continuing disability procedures in DI 13001.000.

6. Disability Freeze Established for Statutory Blindness or Disability - DIB Denied

Process the claim following the instructions in DI 11011.001.

7. Prior Claim Awarded at the Appeals Council (AC) Level – Subsequent Claim is a Duplicate

When the AC awards continuing DIB based on the prior claim and the subsequent claim has not already been adjudicated, the subsequent claim is a duplicate application to be processed as follows:

  • Send a notice to the claimant to acknowledge the duplicate application. Advise the claimant that their right to benefits as stated in the notice of award resulted from the prior claim. Do not include appeal rights or closeout language in the notice.

  • Document SSA records that action is not necessary on the duplicate application because the favorable AC decision was rendered first.

D. Procedure - Auxiliary Application Filed - DIB Claim Denied

Use the language in DI 11010.030 as a guide for preparing the notice when an auxiliary applicant files a duplicate application on behalf of a NH and also files an auxiliary application on behalf of self and others, and the original claim has been or is being denied. This letter is a combination of the Guide Letter, Acknowledging Multiple Applications Filed by the Secondary Applicant and Form Letter SSA-L823 (Denial Notice to Auxiliary Applicant) and should be substituted for them under the circumstances described above.

E. References

GN 01070.200 DOTEL procedures on how to obtain information from the prior claim

MS 03520.003 Claim Movement/WMS Clearance (CMWM)

 


GN 00204 TN 102 - Applications - 4/14/2022