If you have previously filed a claim for Social Security disability benefits and your claim was denied at the hearing level by an Administrative Law Judge (ALJ), your second claim for benefits may be denied based on res judicata, which in simplest terms means that there is no new and material evidence in your second claim. If there is no new and material evidence contained in your second claim for disability benefits, the SSA may summarily deny your claim as it has previously denied it based on the very same evidence or similar evidence demonstrating your conditions have an equal level of severity and impact on your occupational and social functioning.
Keep in mind, new and material evidence is not just new evidence, i.e. new medical records that continue to demonstrate you experience the same symptoms of the same disorders with the same level of severity and continue to receive the same or similar medical treatment. This type of evidence, though helpful in that it demonstrates you are continuing to seek care for your disabilities, does not constitute new and material evidence because it does not demonstrate that one of your conditions has worsened in some way or that you now experience symptoms of an altogether new condition, one that had not been diagnosed or treated at the time of your previous denial. If your claim includes evidence of this type, the SSA has no valid basis to deny summarily your Social Security disability claim via res judicata.
Even if you have been unable to continue receiving prescribed medical treatment or your condition and its treatment remains generally the same as it was at the time your first claim for benefits was denied, there may be other circumstances which allows your claim to escape a res judicata denial. For instance, between the time of your first claim and the adjudication of your second claim, there may have been a change to the SSA’s rules and regulations, including the listing of impairments, that now dictates that your claim can be approved. Similarly, if your age has changed between your first and second claims such that you now fall into a new Social Security age category, your claim may be approved in spite of a lack of new and material medical evidence demonstrating more severe symptomatology or the presence of a new condition. For instance, if your first claim received an unfavorable final determination when you were 49 years of age, meaning that the SSA considered you to be part of its “younger individual age 45-49” category, because the SSA found you were still able to perform sedentary work. However, if you are 55 or older at the time of your second claim, it may be approved even if the medical and other evidence of record continues to demonstrate that your impairments still do not preclude your ability to perform sedentary work (for more information, please see https://www.ssa.gov/OP_Home/cfr20/404/404-app-p02.htm).
If your claim for Social Security disability benefits has been previously denied by an ALJ, you will need to submit new and material evidence or demonstrate a change in circumstances to avoid having your claim denied based on res judicata. Viner Disability Law can assess your claim for benefits and help you develop a strategy to avoid a summary denial based on res judicata.