Acquiescence Rulings
The new musculoskeletal listings affect the way SSA adjudicates a subsequent disability claim of an individual with a musculoskeletal impairment(s) under the Chavez, Albright or Drummond Acquiescence Rulings (AR).
The Chavez AR applies to claimants residing in Alaska, Arizona, California, Guam, Hawaii, Idaho, Montana, Nevada, Northern Mariana Islands, Oregon or Washington at the time of the adjudication of a subsequent claim. It applies when:
· The claimant had a prior disability claim on which there was a final ALJ or AC decision which found the claimant not disabled; and
· The adjudicator is deciding a subsequent disability claim under the same title of the Act involving a period that was not adjudicated in the final ALJ or AC decision on the prior claim.
When adjudicating the subsequent claim involving an unadjudicated period, adjudicators will apply a presumption of continuing nondisability and determine that the claimant is not disabled with respect to that period, unless the claimant rebuts the presumption. A claimant may rebut the presumption by showing a changed circumstance affecting the issue of disability with respect to the unadjudicated period (see DI 32720.010 A.3 ).
For purposes of the Chavez AR, the presumption of continuing nondisability is rebutted if the final ALJ or AC decision on the prior claim of an individual with a musculoskeletal impairment(s) was made before February 19, 2002, the effective date of the final rules for the new musculoskeletal listings.
If the presumption is rebutted for any reason, an adjudicator then must adopt prior findings required at a step in the sequential evaluation process for determining disability (see DI 32720.010 B.1.a. or B.1.b ., as appropriate) from the final ALJ or AC decision on the prior claim in determining whether the claimant is disabled with respect to the unadjudicated period unless:
· there is new and material evidence relating to the prior finding; or
· there has been a change in the law, regulations or rulings affecting the finding or the method for arriving at the finding.
For purposes of the Chavez AR, an adjudicator should not adopt an ALJ or AC finding made at step three of the sequential evaluation process for an individual whose impairment(s) was evaluated under the musculoskeletal listings if the prior finding was made before February 19, 2002.
The Albright AR applies to claimants residing in Maryland, North Carolina, South Carolina, Virginia or West Virginia at the time of the adjudication of a subsequent claim. It applies when:
· The adjudicator is deciding a subsequent disability claim with an unadjudicated period; and
· The subsequent claim arises under the same or a different title of the Act as a prior disability claim on which there has been a final decision by an ALJ or the AC.
In applying the Albright AR when adjudicating a subsequent disability claim, an adjudicator will consider the prior ALJ or AC findings required at a step in the sequential evaluation process for determining disability (see DI 52715.010 B.1.a. or B.1.b. , as appropriate) as evidence and give such findings appropriate weight in light of all relevant facts and circumstances in determining whether the claimant is disabled with respect to the unadjudicated period involved in the subsequent claim.
The weight to be given to a prior finding depends on the extent to which the prior finding has probative value in determining disability with respect to the period being adjudicated in the subsequent claim. In determining the weight to be given to a prior finding, an adjudicator will consider such factors as:
· whether the fact on which the prior finding was based is subject to change with the passage of time,
· the likelihood of such a change, considering the length of time that has elapsed between the period previously adjudicated and the period being adjudicated in the subsequent claim, and
· the extent that evidence not considered in the final decision on the prior claim provides a basis for making a different finding with respect to the period being adjudicated in the subsequent claim.
Under the Albright AR, an adjudicator should not give any weight to an ALJ or AC finding made at step three of the sequential evaluation process for an individual whose impairment(s) was evaluated under the musculoskeletal listings if the prior finding was made before February 19, 2002.
The Drummond AR applies to claimants residing in Kentucky, Michigan, Ohio or Tennessee at the time of the adjudication of a subsequent claim. It applies when:
· The adjudicator is deciding a subsequent disability claim with an unadjudicated period; and
· The subsequent claim arises under the same title of the Act as a prior disability claim on which there has been a final decision by an ALJ or the AC.
Drummond AR [See DI 52705.001 ff ., AR 98-4(6) ].
In applying the Drummond AR when adjudicating a subsequent disability claim, an adjudicator must adopt prior findings required at a step in the sequential evaluation process for determining disability (see DI 52705.010 B.1.a. or B.1.b. , as appropriate) from the final ALJ or AC decision on the prior claim in determining whether the claimant is disabled with respect to the unadjudicated period unless:
· There is new and material evidence relating to such a finding; or
· There has been a change in the law, regulations or rulings affecting the finding or the method for arriving at the finding.
For purposes of the Drummond AR, an adjudicator should not adopt an ALJ or AC finding made at step three of the sequential evaluation process for an individual whose impairment(s) was evaluated under the musculoskeletal listings if the prior finding was made before February 19, 2002 .