I-2-2-22.Escalated Claim(s) – Common Issue
Last Update: 1/13/16 (Transmittal I-2-159)
In some cases, a claimant may have a claim pending before an administrative law judge (ALJ) and a different claim pending at the initial or reconsideration level. In these instances, the field office (FO) will evaluate whether the claims share a common issue that should be considered together. A common issue is present when two or more claims, in any combination, share any overlapping period of time, and all have the same medical or substantial gainful activity issue. See Program Operations Manual System DI 12045.010.
If the FO determines a common issue is present, it will ask the claimant and the ALJ to consider joining the claims. See Program Operations Manual System DI 12045.015B.1. If both the claimant and the ALJ agree, a new initial disability claim, initial CDR, or age-18 redetermination can be escalated and joined with a pending initial disability claim or CDR at the hearing level.
For the purposes of escalation and consolidation, an ALJ will generally accept the FO's request when a common issue exists. However, the ALJ will not accept an escalated claim if:
The ALJ does not agree that there is a common issue;
For other reasons, the ALJ does not find it appropriate to join the claims; or
The claimant objects to joining the claims.
If the ALJ or the claimant objects to joining the subsequent claim, CDR, or age-18 redetermination with the pending hearing level appeal, the FO will follow the standard initial claim, CDR, or age-18 redetermination process and route the new claim, CDR, or age-18 redetermination to the disability determination services (DDS).
B. Providing Notice
In most cases, the ALJ will notify the claimant of an escalated claim in the notice of hearing. If an escalated claim issue arises after the notice of hearing is mailed, the ALJ will send an amended notice of hearing. The ALJ will also include the information as part of the recitation of the procedural history and issues in the case during the opening statement at hearing. Adhering to these procedures is necessary to ensure the claimant has the opportunity to submit any objection to joining the claims prior to or at the hearing. An ALJ will handle any objection as set forth in Hearings, Appeals and Litigation Law manual I-2-2-20.
It may be appropriate in some cases for the ALJ to notify the claimant of the proposed joining of claims prior to issuing the notice of hearing. The ALJ will notify the claimant in writing that the ALJ is considering joining claims prior to sending a notice of hearing if:
The ALJ would otherwise join the claims; and
The record indicates the claimant previously objected to joining the claims, or certain facts present suggest the claimant might object to joining the claims.