A claimant applied for a period of social security disability insurance benefits on July 7, 1957. He alleged that he became disabled on August 15, 1954.
He had disability “insured” status through June 30, 1955. This date was known as his “date last insured” (DLI). Thus, in order to be awarded benefits, he needed to prove that he was under a disability on or before his DLI and that the disability lasted continuously through his application date.
The claimant lost his case through all the administrative levels of adjudication, including a hearing before a hearing examiner (these days hearings are conducted by Administrative Law Judges, or ALJs). He appealed to federal court, where the administrative decision was upheld.
On August 1, 1961 claimant again applied for a period of disability insurance benefits. As in his prior application, he claimed that his disability began on August 15, 1954. In support of his application, the only evidence he provided was a one-page letter from his doctor. His claim was again denied.
There had been a change in the law since the time of his previous application. This change had liberalized the rules for determining a person’s date last insured. Claimant’ new DLI was June 30th, 1956.
After claimant’s claim was denied initially and upon reconsideration, he requested a hearing. A hearing examiner had the authority that deny a request for hearing if a prior decision was “res judicata” (previously decided).
In order for the doctrine of res judicata to apply certain elements needed to be satisfied: 1) there was a prior decision 2) with respect to the rights of the same party 3) on the same facts 4) pertaining to the same issues which had previously been judicially determined.
In the claimant’s case, because of the change in the law with respect to a person’s date last insured, the claimant needed to prove that he became disabled on or before June 30th, 1956 and that the disability continued without interruption through the time of his application on August 1, 1961.
This issue differed from his previous application with respect to the period for which he needed to prove his disability. Because of this difference, the principle of res judicata did not apply and claimant was entitled to a hearing.
See Social Security Ruling (SSR) 63-41.
This material should not be construed as legal advice for any particular fact situation, but is intended for general informational purposes only. For advice specific to any individual situation, an experienced attorney should be contacted.
