[Federal Register Volume 76, Number 145 (Thursday, July 28, 2011)]
[Notices]
[Pages 45309-45311]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-19103]


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SOCIAL SECURITY ADMINISTRATION

[Docket No. SSA-2011-0057]


Social Security Ruling 11-1p; Titles II and XVI: Procedures for 
Handling Requests To File Subsequent Applications for Disability 
Benefits

AGENCY: Social Security Administration.

ACTION: Notice of Social Security Ruling (SSR)

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SUMMARY: We are giving notice of SSR 11-1p, in which we explain our new

[[Page 45310]]

procedures for handling your request to file a disability claim when 
you have a pending claim of the same title and benefit type in our 
administrative review process. This change will allow us to more 
efficiently use our limited resources to handle the increase in the 
number of initial disability claims that we have seen in light of the 
economic downturn.

DATES: Effective Date: July 28, 2011.

FOR FURTHER INFORMATION CONTACT: Mary Beth Rochowiak, Social Security 
Administration, 6401 Security Boulevard, Baltimore, MD 21235-6401 (410) 
594-2302, or TTY 1-800-325-0778.

SUPPLEMENTARY INFORMATION: We are publishing this SSR in accordance 
with 20 CFR 402.35(b)(1).
    Through SSRs, we make available to the public precedential 
decisions relating to the Federal old-age, survivors, disability, 
Supplemental Security Income, and special veteran's benefits programs. 
We may base SSRs on determinations or decisions made at all levels of 
administrative adjudication, Federal court decisions, Commissioner's 
decisions, opinions of the Office of the General Counsel, or other 
interpretations of the law and regulations.
    Although SSRs do not have the same force and effect as statutes or 
regulations, they are binding on all of our components. 20 CFR 
402.35(b)(1).
    This SSR will be in effect until we publish a notice in the Federal 
Register that rescinds it or publish a new SSR that replaces or 
modifies it.

(Catalog of Federal Domestic Assistance Program Nos. 96.001 Social 
Security--Disability Insurance; 96.006--Supplemental Security 
Income.)

    Dated: July 22, 2011.
Michael J. Astrue,
Commissioner of Social Security.

Policy Interpretation Ruling

Titles II and XVI: Procedures for Handling Requests To File Subsequent 
Applications for Disability Benefits

    Purpose: To explain our revised procedure under which we will no 
longer process a subsequent disability claim if you already have a 
claim under the same title and of the same type pending in our 
administrative review process.
    Citations: Sections 202(j), 216(i), 223(a), and 1631(e) of the 
Social Security Act, as amended; Regulations No. 4, subpart G, sections 
404.601, 404.603; subpart J, sections 404.900(b), 404.970(b), 
404.976(b); and Regulations No. 16, subpart C, section 416.305; subpart 
N, sections 416.1400(b), 416.1470(b), 416.1476(b).

Introduction

    In 1999, we adopted a procedure that allowed us to process a 
subsequent disability claim while your prior disability claim was 
pending at the Appeals Council level of our administrative review 
process.
    Under that procedure, if you filed a subsequent application for 
disability benefits while you had a disability claim pending at the 
Appeals Council, we sent your subsequent claim to the disability 
determination services (DDS) or similar case-processing center for 
development and adjudication. If we denied your subsequent application 
at the earlier stages, and you requested a hearing before an 
administrative law judge (ALJ), the hearing office took no action until 
the Appeals Council completed its action on your prior claim.
    We have seen an increase in the number of subsequent disability 
claims in recent years. When two disability claims under the same title 
and type are pending at the same time, there can be conflicting 
decisions that we must then reconcile. Subsequent claims may result in 
improper payments, increased administrative costs, and unnecessary 
workloads stemming from duplication. Because of these problems and the 
significant increase in the number of initial disability claims that we 
have experienced in recent years, we are changing our procedures for 
handling subsequent applications for disability claims of the same 
title and type.

Policy Interpretation

    Under the new procedures we are adopting in this Ruling, generally 
you will no longer be allowed to have two claims for the same type of 
benefits pending at the same time. If you want to file a new disability 
claim under the same title and of the same type as a disability claim 
pending at any level of administrative review, you will have to choose 
between pursuing your administrative review rights on the pending 
disability claim or declining to pursue further administrative review 
and filing a new application. This Ruling explains our new procedures.

If You Choose To Pursue Your Pending Disability Claim Instead of Filing 
a New Claim Under the Same Title and of the Same Type

    If you decide to pursue your administrative review rights on the 
pending disability claim, we will not accept your subsequent 
application for benefits under the same title and for the same type of 
benefit as the pending claim. Although we will not accept your 
subsequent application while your prior disability claim is pending 
administrative review, you can still provide us with evidence that is 
relevant to your pending claim, in accordance with our existing 
regulations and procedures. Our technological improvements, such as 
Electronic Records Express and electronic alerts and messages, enable 
our offices to communicate with one another faster and more efficiently 
and act on additional evidence promptly. If the additional evidence 
indicates a critical or dire need situation, we will act expeditiously.

Claim Pending at Initial, Reconsideration, or Hearing Level

    The procedures in this Ruling do not preclude you from reporting 
new medical conditions or a worsening in your existing medical 
conditions, and you can submit additional evidence on these matters. We 
will forward any additional evidence you submit to the office that is 
handling the pending claim so that it can be associated with that 
claim.
    You can submit any information or evidence that you feel is helpful 
to your pending disability claim. See 20 CFR 404.900(b) and 
416.1400(b). In adjudicating the pending disability claim, we will 
consider the information and evidence you submit, together with all the 
other information in the claim folder. Id.

Claim Pending With the Appeals Council

    If you choose to pursue your disability claim that is pending at 
the Appeals Council, and you submit additional evidence, the Appeals 
Council will first determine whether the additional evidence relates to 
the period on or before the date of the hearing decision. When the 
additional evidence is new and material and relates to the period on or 
before the date of the hearing decision, the Appeals Council will 
consider it, together with the entire record. 20 CFR 404.970(b), 
416.1470(b), and 405.373.\1\ The Appeals Council will

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review your case if it finds that the ALJ's action, findings, or 
conclusion is contrary to the weight of the evidence currently of 
record. Id.
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    \1\ In the six states that comprise our Boston Region (Maine, 
New Hampshire, Vermont, Rhode Island, Massachusetts, and 
Connecticut), the Appeals Council must consider whether the evidence 
relates to the period on or before the hearing decision, whether 
there is a reasonable probability that the evidence would change the 
outcome of the decision, and one of the following: 1) our action 
misled you; 2) you had a physical, mental, educational, or 
linguistic limitation(s) preventing you from submitting the evidence 
earlier; or 3) some other unusual, unexpected, or unavoidable 
circumstance beyond your control that prevented you from submitting 
the evidence earlier. 20 CFR 405.373.
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    If the new and material evidence that relates to the period on or 
before the date of the hearing decision shows a critical or disabling 
condition, the Appeals Council will expedite its review of your pending 
claim.
    When the additional evidence does not relate to the period on or 
before the date of your hearing decision, the Appeals Council will 
return the additional evidence to you. 20 CFR 404.976(b), 416.1476(b). 
The notice returning the additional evidence will explain why the 
Appeals Council did not accept the evidence and inform you that, under 
certain circumstances, we will consider the date you filed the request 
for Appeals Council review as the filing date for your new claim. If 
you originally filed for disability benefits under title II, and you 
file a new application for title II disability benefits within six 
months of the date of this notice, we will use the date of your request 
for Appeals Council review as the filing date. If both applications are 
for Supplemental Security Income payments based on disability under 
title XVI, and you file the new application within 60 days from the 
date of the notice, we will use the date you requested Appeals Council 
review as the filing date for the new claim. We will permit the filing 
of a new disability claim after the Appeals Council completes its 
action on the request for review of the pending claim.
    If the additional evidence that does not relate to the period on or 
before your hearing decision shows a new critical or disabling 
condition, and you tell us that you want to file a new claim based on 
this evidence, the Appeals Council may permit you to file a new 
disability claim before it completes its action on your request for 
review of the pending claim.

If You Choose To Decline Further Review of Your Pending Disability 
Claim and Instead File a New Claim Under the Same Title and of the Same 
Type

    If, on the other hand, you decide to decline to pursue further 
administrative review on the pending disability claim and file a new 
application, we will assess your eligibility for any other benefits and 
take applications for these benefits. When you received an unfavorable 
or partially favorable decision from us on your pending claim, we 
explained the effect that not pursuing an appeal might have on your 
possible entitlement to benefits.

If Your Subsequent Claim Does Not Involve the Same Title or Type of 
Benefit

    This Ruling does not change the procedure we currently follow when 
you file a subsequent claim under a different title or for a different 
benefit type than a pending claim. When a subsequent claim under a 
different title or for a different benefit type shares a common issue 
with the pending claim, we will usually consolidate it with the pending 
claim through the hearing level. When you file a subsequent claim that 
is under a different title or is for a different benefit type and your 
prior claim is pending review at the Appeals Council, we will process 
the subsequent claim in accordance with our current procedures.
    Cross-References: Program Operations Manual System, DI 12045.027 
and DI 20101.025, DI 23015.005, DI 81010.155, DI 81020.120, GN 
00201.005, GN 00204.028, GN 00206.001, GN 00206.015, GN 01010.030, GN 
03104.370. GN 03104.380, GN 03104.385, GN 03104.390, GN 03104.400, GN 
03104.400, SI 00601.030, SI 00601.048, SI 00601.050, SI 04040.025, SI 
04040.027, Hearings, Appeals and Litigation Law Manual, I-3-1-7, I-3-5-
20, I-3-5-90, I-4-2-30, I-4-2-1, I-5-1-13, and I-5-3-17.

[FR Doc. 2011-19103 Filed 7-27-11; 8:45 am]
BILLING CODE 4191-02-P