PROGRAM OPERATIONS MANUAL SYSTEMPart DI – Disability InsuranceChapter 401 – Processing Center (PC) Processing of Initial ClaimsSubchapter 20 – Processing Subsequent Disability Insurance Benefits (DIB), Disabled Widow(er) Benefits (DWB), and Childhood Disability Benefits (CDB) Claims by Processing Centers (PCs)Transmittal No. 1, 10/08/2020
This is a Quick Action Transmittal. These revisions do not change or introduce new policy or procedures.
Summary of Changes
DI 40120.001 Jurisdiction and Adoption of Subsequent Disability Insurance Benefits (DIB), Disabled Widow(er) Benefits (DWB), and Childhood Disability Benefits (CDB) Claims by Processing Centers (PCs)
We removed references to FO application of collateral estoppel for consistency with the revised collateral estoppel POMS. In addition, we removed POMS titles when context is given and updated POMS titles when no context is given throughout for usability.
When an individual currently entitled to disability benefits files a subsequent application for DIB, DWB, or CDB, collateral estoppel potentially applies. For more information on identifying and flagging claims when collateral estoppel potentially applies, see DI 11011.001.
When the PSC receives a subsequent title II application from a claimant already receiving disability benefits under another title or record, the Disability Examiner/Disability Processing Specialist (DE/DPS) reviews the new claim, and when collateral estoppel applies, adopts the prior favorable determination or decision. The DE/DPS prepares the SSA-831, and forwards the claim to the Claims Authorizer. The PSC processes the subsequent claim to completion, effectuating payment and releasing the notice.
Transfer claims (except Railroad annuitant cases) that require additional development for onset of disability or continuance of disability to the Disability Determination Services (DDS). Request the DDS prepare an initial determination on the subsequent claim, and if there is a raised continuing disability review (CDR) issue, a CDR determination on the current entitlement.
For subsequent claims with work activity after the most recent determination or decision, transfer the claim (including any prior paper folders) to the servicing FO with instructions to document work activity before transferring the claims meeting technical requirements to the DDS.
The DDS also has jurisdiction of DIB, DWB, or CDB claims for an individual who is a Supplemental Security Income (SSI) disability/blindness recipient. For more information on jurisdiction of subsequent claims, see DI 20101.001.
When the claim involves an issue pending under appeal, see DI 12045.010 and DI
The DE/DPS will review the most recent prior favorable determination or decision based on meeting or equaling a listing or medical-vocational rules to determine whether collateral estoppel applies for a fully favorable determination. The DE/DPS must be familiar with the following POMS instructions before determining whether to apply collateral estoppel:
DI 11010.085 Multiple Type Title II Claims
DI 11015.001 Disabled Widow(er)’s Benefits (DWB) General
DI 26510.001 Completing Form SSA-831 (Disability Determination and Transmittal)
DI 27515.001 Collateral Estoppel - Policy
DI 27515.005 Changes to the Listing of Impairments and Collateral Estoppel
DI 27515.010 Changed Vocational Profile and Collateral Estoppel
DI 27515.015 Association of the Prior Paper Folder in Collateral Estoppel Claims
DI 27515.020 Special Situations in Potential Collateral Estoppel Claims
DI 27515.035 Different Determinations or Decisions for the Same Period in Separate Claims
DI 27515.050 Continuing Disability Review (CDR) Issues in Collateral Estoppel Claims
DI 27515.055 Work Incentive Status and Collateral Estoppel Claims