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DI 51501.030: DDS Actions on Subsequent Disability Claims

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  • Effective Dates: 03/08/2013 - Present
  • Effective Dates: 02/28/2018 - Present
  • BASIC (03-12)
  • DI 51501.030 DDS Actions on Subsequent Disability Claims
  • If the field office (FO) accepted a disability application filed on or after July 28, 2011, and the disability determination services (DDS) discovers there is a prior claim pending at the Appeals Council (AC) for the same title and benefit type, the DDS must take the following actions.
  • * Verify that the protective filing date or date of application is July 28, 2011 or later.
  • * Review and consider all available evidence (for Case Development Procedures, see DI 22501.001), including electronic file evidence (e.g., the case file pending at the AC), FO observations on the current SSA-3367 (Disability Report – Field Office), the claimant’s allegations and statements on the current SSA-3368 (Disability Report – Adult), or Internet SSA-3368 (i3368).
  • * Evaluate whether there is evidence that may indicate a new critical or disabling condition occurred after the date of the hearing decision on the prior claim.
  • A. New critical or disabling condition
  • A “new” critical or disabling condition means the onset occurred after the date of the hearing decision on the prior claim. A “critical or disabling condition” is a condition that meets a listed impairment or that meets the criteria under Terminal Illness (TERI), Compassionate Allowances (CAL), or Presumptive Disability/Presumptive Blindness (PD/PB).
  • B. DDS review of evidence
  • 1. Evidence indicates a new critical or disabling condition
  • If the DDS finds evidence that may indicate a new critical or disabling condition, the DDS must:
  • * Document a description of the new critical or disabling condition on an SSA-5002 (Report of Contact) on the pending EDCS segment. Also, identify and include contact information for any new medical sources.
  • * Send an email to |||ODAR OAO. In the subject line, type: “Request for Subsequent Disability Application Exception.” In the email, type: “See SSA-5002 on the new EDCS segment.”
  • * Send an email to ^DCARO OAO. In the subject line, type: “Request for Subsequent Disability Application Exception.” In the email, type: “See SSA-5002 on the new EDCS segment.”
  • * Retain the subsequent disability claim until the AC responds (see DI 51501.030B.3. in this section).
  • The AC will expedite the email request and determine if the claimant meets the exception. If the AC does not respond after 2 business days, forward the original email to |||ODAR OAO. In the email subject line, type: “2nd Inquiry – Request for Subsequent Disability Application Exception.” If the AC does not respond to the 2nd inquiry, send another status request 5 workdays after the 2nd inquiry.
  • The AC will expedite the email request and determine if the claimant meets the exception. If the AC does not respond after 2 business days, forward the original email to ^DCARO OAO. In the email subject line, type: “2nd Inquiry – Request for Subsequent Disability Application Exception.” If the AC does not respond to the 2nd inquiry, send another status request 5 workdays after the 2nd inquiry.
  • 2. Evidence does not indicate a new critical or disabling condition
  • If the DDS finds no evidence indicating a new critical or disabling condition after the date of the hearing decision on the prior claim, the DDS must:
  • * Document this information on an SSA-5002;
  • * Process a DDS “No Determination” (ND);
  • * Select ND Reason: Send to Another office; and
  • * Add in remarks: “Subsequent Claim”
  • The DDS ND action closes the case in the legacy system and gives jurisdiction back to the FO.
  • 3. AC decision on DDS request for subsequent disability application exception
  • The AC will respond via email to the DDS and will either instruct the DDS to continue development on the new claim OR instruct the DDS to return the case to the FO.
  • If the AC determines the claimant does not meet the exception, follow the instructions in DI 51501.030B.2. in this section.
  • C. Related references
  • * DI 51501.001 Procedural Change for Subsequent Disability Applications Effective July 28, 2011
  • * DI 51501.010 Field Office Actions on Subsequent Disability Applications
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