Identification Number:
GN 04040 TN 5
Intended Audience:See Transmittal Sheet
Originating Office:OISP
Title:Administrative Finality - Relationship to Other Procedures (Title II only)
Type:POMS Transmittals
Program:All Programs
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part GN – General
Chapter 040 – Administrative Finality
Subchapter 40 – Administrative Finality - Relationship to Other Procedures (Title II only)
Transmittal No. 5, 10/15/2020

Audience

PSC: BA, CA, CS, DE, DS, ICDS, IES, ILPDS, IPDS, ISRA, PETE, RECONR, SCPS, TSA, TST;
OCO-OEIO: BIES, CR, CTE, FCR, FDE, PETL, RECONE, RECONR, RECOVR;
OCO-ODO: BTE, CR, CST, CTE, CTE TE, DE, DEC, DS, PAS, PETE, PETL, RCOVTA, RECONE, RECOVR;
FO/TSC: CS, CS TII, CSR, CTE, DRT, DT, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

OISP

Effective Date

Upon Receipt

Background

This is a Quick Action Transmittal. We are updating this section to conform with changes made to DI are being made to conform with with updates made to DI 27515 chapter of the POMS published on July 30, 2020.

Summary of Changes

GN 04040.020 Collateral Estoppel

Summary of Changes

A.

1. Add the following sentence after sentence one. For collateral estoppel in disability claims, see DI 11011.001 and DI 27515.000

2.. Example: after the word we, delete the word will and add the word may

3. Delete C

GN 04040.020 Collateral Estoppel

A. Policy Principle

Collateral estoppel provides that an issuewhich has already been decidedin a previous determination or decision in a claim involving the same parties but arising under a different title of the Act or under the Federal Coal Mine Health and Safety Act, will not be considered againunless there are reasons to believe that it was wrong. For collateral estoppel in disability claims, see DI 11011.001 and DI 27515.000.

EXAMPLE:If a claimant is found disabled for title II, based on collateral estoppel, we may find him disabled for title XVI.

B. Operating Policy—When We Can Have Different Determinations Under Different Titles

  • If in processing the later claim on one title we discover that the determination on the earlier claim under a different title was incorrect, we do not have to adopt the erroneous determination when we process the new claim.

  • We can only change the incorrect determination on the first claim if it can be reopened and revised under the rules of administrative finality.

C. Example

A claimant filed for RSI benefits. We established 1924 as her date of birth (DOB) and entitled her. She did not appeal the DOB. Two years later, when she filed for SSI aged benefits, she was denied at the initial and reconsideration levels because, based on a 1924 DOB, she was not age 65. However, the ALJ established 1923 as her DOB, which made her age 65. If the ALJ DOB decision was based on new and material evidence or if there was an error on the face of the evidence on the RSI claim, the processing center can reopen and revise the DOB in the RSI claim. However, if the ALJ decision was based on the same evidence which was used to establish the DOB in the RSI claim, the case should be referred to the AC since the ALJ decision violates the doctrine of collateral estoppel. The 1924 DOB in the RSI case would not be changed and would be used in the SSI claim.

D. Reference

See GN 04040.010 for comparison with res judicata.


GN 04040 TN 5 - Administrative Finality - Relationship to Other Procedures (Title II only) - 10/15/2020