Citations:

Regulations 20 CFR 404.950(f) and 416.1450(f)

TN 9 (10-93)

A. Policy

The concept of collateral estoppel is that a factual finding made in the previous determination or decision must be accepted unless there is reason(s) to believe it was wrong. See EM–11034 REV for adjudicating cases with a potential issue of a changed vocational profile.

1. Rules

A prior favorable disability determination/decision by SSA or the court must be adopted for the same period in the new disability claim provided:

• the same rules for determining disability apply, and

• there is no reason(s) to question the correctness of the prior disability determination/decision (see DI 27515.015).

Adjudicators must not substitute judgment or arbitrarily question a prior determination/decision.

2. When Adoption Does Not Apply

1. A prior favorable determination/decision is not adopted if it is clearly incorrect and can be reopened and revised under the rules of administrative finality or the time period for reopening has expired. See DI 27505.001.

2. Adoption does not apply when title XVI disability is due to conversion, unless there has been a subsequent continuance determination or decision under Federal criteria (see DI 27515.020C.). Information on the prior title XVI determination can be obtained from the SSA-831/832/833-U3 or a systems query. In a systems query if the field RB: X is coded “4,” then the case was allowed/continued under Federal criteria.

B. Example(s)

Examples of possible adoption situations are listed below:

• DIB application - SSI EOD was prior to DLI

• CDB application - SSI EOD was between age 18-22

• CDB application - SSI EOD prior to age 18 and favorable age 18 redetermination made using adult standard

• DWB application - SSI EOD was prior to end of the prescribed period.