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DI 51501.005: Claimant Requests to File a New Disability Application

changes
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  • Effective Dates: 03/05/2014 - Present
  • Effective Dates: 01/11/2018 - Present
  • TN 3 (03-14)
  • DI 51501.005 Claimant Requests to File a New Disability Application
  • In all situations, if a person wants to file a new disability application, the field office (FO) must determine if there is a pending disability claim for the same title and benefit type.
  • NOTE: If a third party visits or calls the FO about filing a disability application on behalf of a claimant, see DI 51501.005D in this section.
  • A. Identify pending disability claims
  • If a person calls or visits the FO and wants to file a new disability application, you must first determine if a prior disability claim for the same title and benefit type is pending administrative review.
  • You can determine this by checking one or more systems or queries, such as:
  • * Master Beneficiary Record (MBR), or Modernized Claims System (MCS);
  • * Supplemental Security Record (SSR), or Modernized Supplemental Security Income Claims System (MSSICS);
  • * Disability Determination Services Query (DDSQ);
  • * Electronic Disability Collect System (EDCS), or eView;
  • * Case Processing and Management System (CPMS); or
  • * Appeals Review Processing System (ARPS).
  • B. Claimant has a disability claim for same title and benefit type pending administrative review
  • If the claimant has a prior disability claim for the same title and benefit type pending at any level of administrative review, do not accept a new disability application. Also, do not establish a lead or protective filing in the 800 number system for a new disability application.
  • EXCEPTION: If the claimant’s prior claim is pending at the Appeals Council (AC) and the claimant has evidence that may indicate a new critical or disabling condition, see DI 51501.015C.
  • 1. Paper application procedures
  • If you receive a paper application in person or by mail, return it to the claimant immediately. In addition, send the claimant the Subsequent Disability Application notice in the Document Processing System (DPS).
  • NOTE: The paper application does not give the claimant a protective filing date.
  • 2. What the claimant needs to know
  • Explain that he or she cannot have two disability claims pending for the same title and benefit type.
  • The claimant must choose one of the following:
  • * Continue the appeal of the prior claim, or
  • * Request in writing to withdraw the appeal and file a new application.
  • Do not tell the claimant which choice to make.
  • 3. Claimant chooses to continue the appeal
  • No further action unless the claimant has additional evidence to submit (see DI 51501.015).
  • 4. Claimant wants to withdraw the appeal
  • Follow the procedures in DI 51501.020.
  • REMINDER: You must wait until his or her request is approved before taking a new application.
  • 5. Written requests for a protective filing date
  • If you receive a written request in person or by mail from the claimant or representative to establish a protective filing date for a new application for disability benefits (and the claimant has an appeal pending for the same title and benefit type), send the claimant and representative, if any, the Protective Filing for Subsequent Disability Application notice in DPS.
  • C. Improper lead established in the 800 number system
  • If we improperly establish a lead for a new application in the 800 number system while the claimant has a pending appeal, make only one attempt to contact the claimant by phone.
  • 1. Contact successful
  • If the contact is successful, explain that he or she must make a choice to either continue the appeal or request to withdraw the appeal and file a new application.
  • * Document the claimant’s choice on an SSA-5002 (Report of Contact) in the pending EDCS claim.
  • * Management must delete the improper lead using the instructions in MSOM APPTS 001.015.
  • 2. Contact unsuccessful
  • If the contact is unsuccessful, explain at the time of the claimant’s appointment that he or she must make a choice to either continue the appeal or request to withdraw the appeal and file a new application.
  • * Document the claimant’s choice on an SSA-5002 in the pending EDCS claim.
  • * Management must delete the improper lead using the instructions in MSOM APPTS 001.015.
  • If the claimant does not keep his or her appointment:
  • * Send an SSA-2708 (Field Office Call Come In Request); and
  • * Management must delete the improper lead using the instructions in MSOM APPTS 001.015.
  • D. Third-party inquiries
  • If a third party visits or calls the FO and inquires about filing a disability application on behalf of a claimant, always verify the third party’s identity first. For detailed instructions about verifying the identity of third parties, see GN 03380.010. Then, without disclosing any information, determine if the claimant has a prior disability claim for the same title and benefit type pending administrative review, and follow the applicable guidance in this subsection.
  • 1. Claimant has a pending claim
  • Verify that the claimant appointed the third party to represent him or her by checking systems or queries, such as MBR/MCS, SSR/MSSICS, CPMS, ARPS, or Claims File Records Management System (CFRMS).
  • Verify that the claimant appointed the third party to represent him or her by checking systems or queries, such as MBR/MCS, SSR/MSSICS, CPMS, ARPS, or Claims File User Interface (CFUI).
  • a. Third party is the appointed representative
  • If the third party is the representative for the claimant, follow the instructions in DI 51501.005B in this section.
  • b. Third party is not the appointed representative
  • If the third party is not the appointed representative for the claimant, you cannot disclose any information, including whether a prior disability claim is pending. Explain to the third party that you cannot release any information about the claimant without the claimant’s written consent.
  • Advise the third party to have the claimant contact the FO as soon as possible.
  • NOTE: Do not establish a lead or schedule an appointment for the claimant.
  • 2. Claimant has no pending claim
  • Refer to the instructions for third parties in GN 00204.003B.3. and GN 00204.013.
  • References:
  • * GN 03305.000 Disclosure With Consent
  • * GN 03340.040 Disclosures to Third Parties and Authorized Representatives
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