Have you ever heard of the term “collateral estoppel?” It’s a legal rule that basically says, “once a question has been decided, it’s settled.” Whether you’re involved in a lawsuit, a criminal case, or an administrative hearing, understanding collateral estoppel can be crucial, as it can impact the scope of the proceedings and the potential outcomes. For instance, in the context of Social Security Disability Insurance (SSDI) administrative hearings, this principle can significantly impact the outcome of a claim.
In this post, we’ll break down the concept of collateral estoppel and its impact on your Social Security disability benefits application.
What Is Collateral Estoppel?
Collateral estoppel is a legal principle that prevents parties from determining identical issues in a subsequent case. The issue that was already litigated is final in a subsequent case because the issue or fact was actually litigated and decided in the previous case. The principle of collateral estoppel is used to promote efficiency in the legal system and prevent inconsistent decisions.
The Social Security Administration (SSA) recognizes the principle of collateral estoppel when determining disability. This principle can help claimants who are on disability benefits under one title of the Social Security Act and file a claim for benefits under a different title.
For example, if you are on Supplement Security Income (SSI) benefits and became disabled prior to your 22nd birthday, you can file a claim for Disabled Adult Child benefits and use collateral estoppel to expedite your claim. If you are on SSDI benefits based on your own Social Security number and your spouse dies, you can file a new claim for Disabled Widow(er)’s Benefits (DWB).
In 2024, the SSA issued a new policy regarding how it will apply collateral estoppel. According to the new rule, local SSA field offices can issue a favorable decision in a new claim when collateral estoppel applies. This change will reduce the number of cases that are sent to the Disability Determination Service (DDS) offices, which review the medical evidence in your claim to determine if you are disabled. This will reduce wait times and avoid unnecessary denials.
Applying Collateral Estoppel in Disability Claims
If the SSA makes determines that you are disabled, collateral estoppel will be applied, and the SSA will not again decide the issue of disability. Collateral estoppel will be applied to your claim if the following conditions are met:
1. Both the prior decision and the new claim require the application of the same definition of disability
Claims for SSI and SSDI have different nonmedical requirements. To be eligible for SSI, you must have little or no income and limited resources, meaning that the value of your possessions must be less than $2,000 if you are single or less than $3,000 if you are married. To be eligible for SSDI, you must be insured. SSDI is an insurance program for individuals who have worked and paid Social Security income taxes during employment. Generally, you must have worked 5 of the past 10 years to be eligible for SSDI.
Although the claims for SSI and SSDI have different nonmedical requirements, their medical requirements are the same. Claims for SSI and SSDI have the same definition of disability for adults. If you were previously found disabled under the SSA’s definition of disability for adults, then collateral estoppel may apply. If you were previously found disabled under the SSA’s definition of child disability and are now pursuing disability benefits as an adult, collateral estoppel will not apply.
2. The SSA has not made an intervening medical decision that your disability ended
If you are on disability benefits, the SSA will periodically review your claim to determine if you are still disabled. If they determine that you still suffer from a disability that’s keeping you from working, your benefits will continue. If they review your claim and determine you are not disabled, your disability benefits will end. Collateral estoppel will only apply if the SSA has not decided that your disability ended.
3. You have not engaged in substantial gainful activity (SGA) since the onset date of your disability
Substantial gainful activity is a term used to describe a level of work or earnings that involves significant and productive duties. The SSA considers work to be substantial if it involves significant physical or mental work activities. Work is gainful if done for pay or profit. The main factor in determining SGA is the amount of money you make from the work you perform. In 2024, if you are working and earning more than $1,550 gross per month, you will have engaged in SGA. In 2025, the amount is set at $1,620 per month. If you are working at these levels, collateral estoppel will not be applied.
4. The onset date of disability in your prior claim is before the date when the nonmedical requirements for entitlement are met in your new claim
Collateral estoppel will apply if the old and new claims cover the same period of time. When the SSA determines that you are disabled, they will determine what date you became disabled. This is called the disability onset date. This is especially important in Disabled Adult Child benefits claims, where disability onset must be before age 22. For example, when a person on SSI with an onset date of age 25 applies for Disabled Adult Child benefits, collateral estoppel will not apply because disability was not established before age 22
5. The record with the prior favorable decision is not in terminated status
If you were previously awarded disability benefits and you are no longer eligible to receive benefits, your claim will be in terminated status. If you were no longer eligible for benefits in a prior disability claim, collateral estoppel will not apply in a new disability claim.
6. The SSA does not have reason to believe that the prior disability determination was wrong
The SSA will apply collateral estoppel if there is no reason to believe the prior disability determination was made in error.
If you have more questions about collateral estoppel or need help submitting or appealing a Social Security disability claim, contact LaPorte Law Firm. Our experienced and compassionate lawyers will guide you through the process and be your advocate. Reach out to us today.
FAQs
When a new claim for disability benefits is filed, the local Social Security field office will make a determination if collateral estoppel applies to a case. If collateral estoppel applies, the case will not be sent to the Disability Determination Service for processing. This will speed up the process and avoid unnecessary delays.
The SSA will apply collateral estoppel if the prior disability determination aligns with the definition of disability required for the new claim, no intervening determination has found that you are no longer disabled, you have not engaged in substantial gainful activity, and the onset date of your disability in the previous determination is on or before the date required for the new claim.
Disabled Adult Child (DAC) benefits provide monthly payments to eligible adults who became disabled before age 22. Eligibility requires that the claimant’s parent is deceased or receiving retirement or disability benefits and that the claimant is unmarried or married to another Social Security beneficiary. You can use collateral estoppel to apply for DAC benefits if you were previously on SSI benefits and had been found disabled prior to your 22nd birthday. This often applies when a young adult is on SSI before their parent retires.
For example, suppose you became entitled to SSI benefits when you turned 18 years old, and your parent does not receive Social Security retirement benefits until you are 35 years old. In that case, you can file a claim for DAC benefits and use collateral estoppel to expedite the claim.
If you were previously on SSI benefits or SSDI benefits on your own earning history, you can use collateral estoppel to file a claim for Disabled Widow(er)’s Benefits (DWB) if you were previously found disabled within seven years of your spouse’s death. For example, suppose you became entitled to SSDI benefits and your spouse later passes away. If you are aged 50 to 59, you can apply for DWB and use collateral estoppel to expedite the claim.
