We will not again decide the issue of disability if, in a prior final determination or decision (and any subsequent continuance determination or decision), we have already decided that the individual is disabled for the time period covered by the new application and all of the following conditions are met:

1. 1. 

   Both the prior determination or decision and new claim require application of the same statutory definition of disability.

2. 2. 

   We have not made an intervening medical determination or decision finding that the individual’s disability ceased.

3. 3. 

   The claimant has not engaged in substantial gainful activity (SGA) since the prior established onset date (EOD).

4. 4. 

   The EOD in the prior claim is on or before the date when the nonmedical requirements for entitlement are last met in the new claim.

5. 5. 

   The record with the prior favorable disability determination or decision is not in terminated status.

6. 6. 

   We do not have reason to believe that the prior disability determination or decision was wrong.

NOTE: The Title II claims processing procedures described in this section are generally for the field office (FO) and Disability Determination Services (DDS) but may also apply to the Program Service Center (PSC) Disability Processing Branch (DPB) and Disability Processing Unit (DPU), as applicable.

When the POD in a subsequent Title II disability claim precedes the EOD from the prior favorable determination or decision under a different title or for a different benefit under the same title, the FO cannot apply collateral estoppel to issue a fully favorable determination based on the prior disability determination or decision.

In these situations, the FO is responsible for reviewing the applicable case information to determine that the criteria in DI 27515.001A in this section are met and collateral estoppel would apply from the prior EOD. The FO then:

1. 1. 

   Obtains the necessary forms, e.g., SSA-3368 (Disability Report–Adult) and SSA-827 (Authorization to Disclose Information to the Social Security Administration).

2. 2. 

   Identifies the case by entering remarks “The FO finds that collateral estoppel would apply from the prior EOD of [mm/dd/yyyy] - a determination is needed on a possible earlier onset date before the benefits may be issued on the new claim.” with the applicable POD on the SSA-3367 (Disability Report–Field Office).

3. 3. 

   Adds the case flag for “Potential Collateral Estoppel Issues Apply.”  

4. 4. 

   Sends the claim to the DDS for a determination on whether the evidence supports the earlier onset applying the sequential evaluation or the prior EOD must be adopted.

The DDS will only process collateral estoppel cases that require consideration of the period before the prior EOD.

When a new initial claim is concurrently pending with a medical CDR reconsideration under a different title or claim type and, upon reconsideration, the DDS decides to reverse the cessation to a continuance:

• •

  If the concurrent determination would be fully favorable in the new initial claim, issue the determination for both the CDR reconsideration and the new claim.

• •

  If the concurrent determination would be less than fully favorable in the new initial claim, issue the reconsidered CDR determination and return the new claim to the FO with ND reason “FO determination requested.”

When returning the new claim with ND, 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 per instructions in DI 11011.001.”