GN 03101.160: Res Judicata
Effective Dates: 06/17/2011 - Present
- TN 13 (06-11)
- GN 03101.160 Res Judicata
- A. Definition of res judicata
- * Administrative res judicata is a rule in civil law and an administrative policy. We apply it at all levels of the claims process to avoid deciding an issue that we have previously decided based on the same facts, same issues, same parties, and same adjudicative period.
- * The purpose of administrative res judicata is to protect SSA from having to consider the same claim (on which it has already issued a determination) repeatedly.
- * In all cases where a claimant files a subsequent application and we deny the subsequent application based on res judicata, the adjudicator will first consider whether reopening and revising applies.
- * Res judicata can apply to post adjudicative issues as well as issues involved with the filing of subsequent applications.
- B. Applying res judicata
- * If a new application is filed with the same issue by the same party and no new facts or evidence, the application may be denied on the basis of res judicata.
* If anything has changed (including law and regulations), we cannot apply res judicata, but must make a determination or decision based on the merits of the application.
- EXAMPLE: Res Judicata Applies
- A claimant denied on the first application and does not appeal (or appeals unsuccessfully). The claimant files a second application, alleges the same onset date, submits no new evidence, and the earnings requirement (date last insured) was last met before or as of the date of the last determination. Since the issue is the same and the claimant submits no new evidence, we would deny the claim based on res judicata.
- EXAMPLE: Res Judicata Does Not Apply
- Using the example above, if the claimant did submit new evidence; we would not apply res judicata but would adjudicate the second application and give the claimant the right to appeal any aspect of our determination.
IMPORTANT: If the claimant's disability insured status continues after the date of the last determination, we cannot apply res judicata to the unadjudicated period (i.e., the period after the date of the last determination). This is true regardless of whether the claimant alleges the same onset date, impairment and there appears to be no change in the claimant's condition.
- C. Postadjudicative issues
- Res judicata can apply to post adjudicative issues as well as issues involved with the filing of subsequent applications.
- EXAMPLE: We denied the claimant’s waiver of recovery of an overpayment based on “not without fault.” Six months later the claimant files another waiver request. When the adjudicator reviews it, there is no new evidence. A second waiver determination is not required. The adjudicator dismisses the request based on res judicata.
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