Effective Dates: 8/28/2024 - Present

Identification Number:
DI 33015 TN 23
Intended Audience:See Transmittal Sheet
Originating Office:ORDP ODP
Title:Procedures for Disability Hearing and Related Policy Issues
Type:POMS Full Transmittals
Program:All Programs
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM

Part DI – Disability Insurance

Chapter 330 – Disability Hearing Unit Procedures

Subchapter 15 – Procedures for Disability Hearing and Related Policy Issues

Transmittal No. 23, 08/28/2024

Audience

PSC: DEC, RECONR;
OCO-OEIO: CTE, FCR, FDE, RECONE;
OCO-ODO: DE, RECONE;
ODD-DDS: DHU;

Originating Component

ODP

Effective Date

Upon Receipt

Background

The agency recently revised the collateral estoppel policy and procedures. This revision aligns the disability hearing policy with the policy updates in DI 27515.001.

Summary of Changes

DI 33015.060 New Application Filed and Request for Reconsideration of Disability Cessation Pending

We updated POMS instructions to cover procedures for when the disability hearing officer returns the new claim to the Field Office for a determination on collateral estoppel.

DI 33015.060 New Application Filed and Request for Reconsideration of Disability Cessation Pending

Citations: 20 CFR 404.914(d), 20 CFR 416.1414(d)

A. Policy on common issue

An individual may file a new application or request reconsideration of an initial denial at the same time they request reconsideration of a disability cessation, or while such a request is pending. When common issue exists, the field office (FO) escalates the new claim to the disability determination services (DDS) or disability hearing unit (DHU), depending on when the FO receives the new claim. The disability hearing officer (DHO) will issue a combined initial and reconsideration determination through the date of the decision with respect to the common issues on both claims. A reconsideration of an initial denial is handled in the same manner as a new application.

B. Preparing the determination

1. Duplicate claim - DHO's determination is favorable and cases are same title and same benefit type

The new claim is considered a duplicate claim when the reconsideration is favorable, and the new claim is the same title and same benefit type.

  1. a. 

    Annotate “Since the claimant is still disabled, we will not process the application filed on (insert date of application)” in the "Other Conclusion" section of the DHO's Determination.

  2. b. 

    Prepare an SSA-833 Cessation or Continuance of Disability or Blindness Determination and Transmittal (Title II) or SSA-832 Cessation or Continuance of Disability or Blindness Determination and Transmittal (Title XVI).

  3. c. 

    Prepare a No Determination (ND) for the new claim with the remark "Not processed- duplicate claim."

NOTE: Based on SSR 11-1p we no longer accept a new disability application while a prior claim is pending for the same title and benefit type at any level of administrative review. However, SSR 11-1p does not apply when the pending claim is a CDR, see DI 51501.001B.

2. Determination does not involve a duplicate claim

Follow the appropriate instruction below based on the outcome of the reconsideration determination and new claim when the new claim is not a duplicate.

  1. a. 

    The reconsideration is unfavorable, or the reconsideration is favorable with a favorable new claim that is a different title or different benefit type.

    • •

      Prepare an SSA-833 Cessation or Continuance of Disability or Blindness Determination and Transmittal (Title II), SSA-832 Cessation or Continuance of Disability or Blindness Determination and Transmittal (Title XVI), or SSA-831 (Disability Determination and Transmittal).

    • •

      Prepare the SSA-831 for the new claim and include the remark "Escalated to DH."

    • •

      Advise the beneficiary (or recipient), in the DHO's determination, that the two determinations have been combined.

    • •

      For notice instructions, see DI 33015.025.

  2. b. 

    The reconsideration is favorable and the new claim is unfavorable.

    • •

      For the reconsideration determination, prepare an SSA-833 Cessation or Continuance of Disability or Blindness Determination and Transmittal (Title II), SSA-832 Cessation or Continuance of Disability or Blindness Determination and Transmittal (Title XVI), or SSA-831 (Disability Determination and Transmittal).

    • •

      For notice instructions, see DI 33015.025.

    • •

      For the new claim, complete a ND with the remark " FO determination requested." Add a message or SSA-5002 (Report of Contact) to the folder stating "Initial claim processing stopped because the new application became a potential collateral estoppel case when the prior cessation was reversed. The FO must determine whether collateral estoppel will now apply as per DI 11011.001." See DI 27515.001 for more information on collateral estoppel.

C. References

DI 29005.022 New Application and Request for Reconsideration

DI 27515.001 Collateral Estoppel Issues and Title II Claims Involving Possible Earlier Onset

DI 11011.001 Applying Collateral Estoppel in Disability Claims


DI 33015 TN 23 - Procedures for Disability Hearing and Related Policy Issues - 8/28/2024