# AR 00-1(4): AR 00-1(4): Albright v. Commissioner of the Social Security Administration , 174 F.3d 473 (4th Cir. 1999) (Interpreting Lively v. Secretary of Health and Human Services )—Effect of Prior Disability Findings on Adjudication of a Subsequent Disability Claim—Titles II and XVI of the Social Security Act

> Federal · Rulings · In force

URL: https://www.frixlaw.com/law-library/statutes/SSA_SSR_AR_AR_00_1_4

## Section

- **Citation:** AR 00-1(4)
- **Heading:** AR 00-1(4): Albright v. Commissioner of the Social Security Administration , 174 F.3d 473 (4th Cir. 1999) (Interpreting Lively v. Secretary of Health and Human Services )—Effect of Prior Disability Findings on Adjudication of a Subsequent Disability Claim—Titles II and XVI of the Social Security Act
- **Jurisdiction:** Federal
- **Kind:** Rulings
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Social Security Rulings / AR / Fourth Circuit Court / AR 00-1(4)

## Text

AR 00-1(4)

EFFECTIVE/PUBLICATION DATE: 1/12/2000

Acquiescence Ruling 00-1(4)

Issue:

Whether, in making a disability determination or decision on a subsequent
disability claim with respect to an unadjudicated period, the Social
Security Administration (SSA) [1] must consider a finding of a claimant's residual functional capacity or
other finding required under the applicable sequential evaluation process
for determining disability, made in a final decision by an Administrative
Law Judge (ALJ) or the Appeals Council on the prior disability claim.

Statute/Regulation/Ruling Citation:

Sections 205(a) and (h) and 702(a)(5) of the Social Security Act (42
U.S.C. 405(a) and (h) and 902(a)(5)), 20 CFR 404.900(a), 404.957(c)(1),
416.1400(a), 416.1457(c)(1), Acquiescence Ruling (AR) 94-2(4) (rescinded).

Circuit:

Fourth (Maryland, North Carolina, South Carolina, Virginia, West
Virginia)

Albright v. Commissioner of the Social Security
Administration , 174 F.3d 473 (4th Cir. 1999) (Interpreting Lively v. Secretary of Health and Human Services , 820 F.2d
1391 (4th Cir. 1987)).

Applicability of Ruling:

This Ruling applies to determinations or decisions at all levels of the
administrative review process (i.e., initial, reconsideration, ALJ hearing
and Appeals Council).

Lively [2]

Description of Case:

In a decision dated October 19, 1981, an ALJ found that the plaintiff, Mr.
Lively, was not disabled under Rule 202.10 of the medical-vocational
guidelines, 20 CFR Part 404, Subpart P, Appendix 2, and denied his
application for disability insurance benefits. In applying Rule 202.10,
the ALJ found that Mr. Lively had the residual functional capacity for
light work. The decision that Mr. Lively was not entitled to disability
insurance benefits became the final decision of SSA and was affirmed by
the district court.
e medical-vocational
guidelines, 20 CFR Part 404, Subpart P, Appendix 2, and denied his
application for disability insurance benefits. In applying Rule 202.10,
the ALJ found that Mr. Lively had the residual functional capacity for
light work. The decision that Mr. Lively was not entitled to disability
insurance benefits became the final decision of SSA and was affirmed by
the district court.

The plaintiff filed a second application for disability insurance benefits
on December 14, 1983. After holding a hearing, an ALJ concluded that the
plaintiff was not entitled to disability insurance benefits. The ALJ
determined that Mr. Lively retained the functional capacity for the
performance of work activity at any exertional level on and prior to
December 31, 1981, the date his insured status expired. The ALJ did not
discuss in his decision the 1981 finding by another ALJ that the plaintiff
had the residual functional capacity to do only light work. This decision
became the final decision of SSA and was appealed to the district court.
The case was referred to a United States Magistrate who found that the
evidence before the ALJ on the plaintiff's 1983 application was sufficient
to sustain SSA's decision that the plaintiff was not disabled as of
December 31, 1981. The district court adopted the Magistrate's Report and
Recommendation. Mr. Lively then appealed to the United States Court of
Appeals for the Fourth Circuit.

Holding:

The Fourth Circuit reversed and remanded the decision of the district
court. The court stated that:

Congress has clearly provided by statute that res judicata prevents
reappraisal of both [SSA]'s findings and ... decision in Social Security
cases that have become final, 42 U.S.C. § 405(h), and the courts have
readily applied res judicata to prevent ... [SSA] from reaching an
inconsistent result in a second proceeding based on evidence that has
already been weighed in a claimant's favor in an earlier proceeding.
provided by statute that res judicata prevents
reappraisal of both [SSA]'s findings and ... decision in Social Security
cases that have become final, 42 U.S.C. § 405(h), and the courts have
readily applied res judicata to prevent ... [SSA] from reaching an
inconsistent result in a second proceeding based on evidence that has
already been weighed in a claimant's favor in an earlier proceeding.

The court noted that the plaintiff became 55 years of age two weeks after
the ALJ, in connection with the first application for benefits, found that
Mr. Lively was limited to light work. The court further noted that a
person with the plaintiff's education and vocational background who is 55
years of age or older and limited to light work would be considered
disabled under Rule 202.02 of the medical-vocational guidelines, 20 CFR
Part 404, Subpart P, Appendix 2. The court found it inconceivable that Mr.
Lively's condition had improved so much in two weeks as to enable him to
perform medium work. Accordingly the court held:

Principles of finality and fundamental fairness ... indicate that ...
[SSA] must shoulder the burden of demonstrating that the claimant's
condition had improved sufficiently to indicate that the claimant was
capable of performing medium work. ... [E]vidence, not considered in the
earlier proceeding, would be needed as an independent basis to sustain a
finding contrary to the final earlier finding.

Albright

Description of Case:
l fairness ... indicate that ...
[SSA] must shoulder the burden of demonstrating that the claimant's
condition had improved sufficiently to indicate that the claimant was
capable of performing medium work. ... [E]vidence, not considered in the
earlier proceeding, would be needed as an independent basis to sustain a
finding contrary to the final earlier finding.

Albright

Description of Case:

In November and December 1992, Mr. Albright filed subsequent applications
for disability insurance benefits and Supplemental Security Income. These
claims were denied initially and again upon reconsideration. On October
26, 1994, an ALJ found that Mr. Albright's prior claims had been denied at
the second step of the sequential evaluation process and that there was an
absence of new and material evidence regarding the severity of his
impairment. Accordingly, the ALJ applied AR
94-2(4) which was published on July 7, 1994, and found that Mr.
Albright was not disabled. [4]

After the Appeals Council denied the claimant's request for review, he
sought judicial review. The district court referred the case to a
magistrate judge who found that SSA had interpreted the holding in Lively too broadly in promulgating AR 94-2(4) . The district court adopted
the magistrate judge's findings and conclusions, and remanded Mr.
Albright's claims for de novo consideration by SSA. After the district
court's denial of SSA's motion to alter or amend the judgment, SSA
appealed to the United States Court of Appeals for the Fourth Circuit.

Holding:
t SSA had interpreted the holding in Lively too broadly in promulgating AR 94-2(4) . The district court adopted
the magistrate judge's findings and conclusions, and remanded Mr.
Albright's claims for de novo consideration by SSA. After the district
court's denial of SSA's motion to alter or amend the judgment, SSA
appealed to the United States Court of Appeals for the Fourth Circuit.

Holding:

The Fourth Circuit affirmed the district court's decision and held that AR 94-2(4) was not an accurate statement
of the holding in Lively . The court further stated that Lively was a "rare case" involving "a finding that initially
disqualified the claimant from an award of benefits [which later]
convincingly demonstrated his entitlement thereto as of two weeks hence."
The court then stated that "[u]nlike the [Acquiescence] Ruling at issue in
... [Albright's] case, however, the prior adjudication in Lively — though highly probative — was not
conclusive." The court further held that:

We therefore disagree with the Commissioner that Lively abrogated the
established law of preclusion.... At its essence, Lively really has very
little to do with preclusion. Although we discussed the doctrine of res
judicata generally, and more particularly its incorporation into the
Social Security Act through 42 U.S.C. § 405(h) , Lively
is not directly predicated on the statute, but on "[ p ]rinciples of
finality and fundamental fairness drawn from § 405(h)."
[ Lively , 820 F.2d at 1392] (emphasis added). The distinction
is subtle, but important.
h preclusion. Although we discussed the doctrine of res
judicata generally, and more particularly its incorporation into the
Social Security Act through 42 U.S.C. § 405(h) , Lively
is not directly predicated on the statute, but on "[ p ]rinciples of
finality and fundamental fairness drawn from § 405(h)."
[ Lively , 820 F.2d at 1392] (emphasis added). The distinction
is subtle, but important.

Rather than signaling a sea change in the law of preclusion, the result in Lively is instead best understood as a practical illustration
of the substantial evidence rule. In other words, we determined that the
finding of a qualified and disinterested tribunal that Lively was capable
of performing only light work as of a certain date was such an important
and probative fact as to render the subsequent finding to the contrary
[relating to a period that began two weeks later] unsupported by
substantial evidence. To have held otherwise would have thwarted the
legitimate expectations of claimants...that final agency adjudications
should carry considerable weight. [Footnotes omitted.]

The court observed that the prior residual functional capacity finding in Lively was "highly probative" of the claimant's residual
functional capacity for the period that began two weeks after the
previously adjudicated period because, absent evidence to the contrary, "a
claimant's condition very likely remains unchanged within a discrete
two-week period." The court indicated that the probative value of a prior
finding relating to a claimant's medical condition will likely diminish
"as the timeframe expands," and that "[t]he logic so evident in Lively . .
.applies with nowhere near the force in Albright's situation" where "the
relevant period exceeds three years."

The court also stated that SSA's "treatment of later-filed applications as
separate claims is eminently logical and sensible, reflecting the reality
that the mere passage of time often has a deleterious effect on a
claimant's physical or mental condition."
c so evident in Lively . .
.applies with nowhere near the force in Albright's situation" where "the
relevant period exceeds three years."

The court also stated that SSA's "treatment of later-filed applications as
separate claims is eminently logical and sensible, reflecting the reality
that the mere passage of time often has a deleterious effect on a
claimant's physical or mental condition."

Statement as to How Albright Differs From SSA's
Interpretation of the Regulations

In a subsequent disability claim, SSA considers the issue of disability
with respect to a period of time that was not adjudicated in the final
determination or decision on the prior claim to be a new issue that
requires an independent evaluation from that made in the prior
adjudication. Thus, when adjudicating a subsequent disability claim
involving an unadjudicated period, SSA considers the facts and issues de
novo in determining disability with respect to the unadjudicated period.
SSA does not consider prior findings made in the final determination or
decision on the prior claim as evidence in determining disability with
respect to the unadjudicated period involved in the subsequent claim.

SSA interprets the decision by the United States Court of Appeals for the
Fourth Circuit in Albright to hold that where a final
decision of SSA after a hearing on a prior disability claim contains a
finding required at a step in the sequential evaluation process for
determining disability, SSA must consider such finding as evidence and
give it appropriate weight in light of all relevant facts and
circumstances when adjudicating a subsequent disability claim involving an
unadjudicated period.

Explanation of How SSA Will Apply The Albright Decision
Within The Circuit
ity claim contains a
finding required at a step in the sequential evaluation process for
determining disability, SSA must consider such finding as evidence and
give it appropriate weight in light of all relevant facts and
circumstances when adjudicating a subsequent disability claim involving an
unadjudicated period.

Explanation of How SSA Will Apply The Albright Decision
Within The Circuit

This Ruling applies only to disability findings in cases involving
claimants who reside in Maryland, North Carolina, South Carolina, Virginia
or West Virginia at the time of the determination or decision on the
subsequent claim at the initial, reconsideration, ALJ hearing or Appeals
Council level. It applies only to a finding of a claimant's residual
functional capacity or other finding required at a step in the sequential
evaluation process for determining disability provided under 20 CFR
404.1520, 416.920 or 416.924, as appropriate, which was made in a final
decision by an ALJ or the Appeals Council on a prior disability
claim. [5]

When adjudicating a subsequent disability claim arising under the same or
a different title of the Act as the prior claim, an adjudicator
determining whether a claimant is disabled during a previously
unadjudicated period must consider such a prior finding as evidence and
give it appropriate weight in light of all relevant facts and
circumstances. In determining the weight to be given such a prior finding,
an adjudicator will consider such factors as: (1) whether the fact on
which the prior finding was based is subject to change with the passage of
time, such as a fact relating to the severity of a claimant's medical
condition; (2) 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 (3) 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 per
o the severity of a claimant's medical
condition; (2) 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 (3) 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.

Where the prior finding was about a fact which is subject to change with
the passage of time, such as a claimant's residual functional capacity, or
that a claimant does or does not have an impairment(s) which is severe,
the likelihood that such fact has changed generally increases as the
interval of time between the previously adjudicated period and the period
being adjudicated increases. An adjudicator should give greater weight to
such a prior finding when the previously adjudicated period is close in
time to the period being adjudicated in the subsequent claim, e.g., a few
weeks as in Lively . An adjudicator generally should give less
weight to such a prior finding as the proximity of the period previously
adjudicated to the period being adjudicated in the subsequent claim
becomes more remote, e.g., where the relevant time period exceeds three
years as in Albright . In determining the weight to be given
such a prior finding, an adjudicator must consider all relevant facts and
circumstances on a case-by-case basis.

[1] Under the Social Security
Independence and Program Improvements Act of 1994, Pub. L. No. 103-296,
effective March 31, 1995, SSA became an independent Agency in the
Executive Branch of the United States Government and was provided ultimate
responsibility for administering the Social Security and Supplemental
Security Income programs under titles II and XVI of the Social Security
Act. Prior to March 31, 1995, the Secretary of Health and Human Services
had such responsibility.
No. 103-296,
effective March 31, 1995, SSA became an independent Agency in the
Executive Branch of the United States Government and was provided ultimate
responsibility for administering the Social Security and Supplemental
Security Income programs under titles II and XVI of the Social Security
Act. Prior to March 31, 1995, the Secretary of Health and Human Services
had such responsibility.

[2] The decision of the Fourth
Circuit in Albright (the subject of this AR) was based, in
part, upon the panel's interpretation of the Fourth Circuit's prior
decision in Lively . Accordingly, the following discussion of
that earlier case is provided as background material.

[3] 20 CFR 404.1520 and 416.920
provide a sequential evaluation process for evaluating disability. These
regulations provide at step two that if an individual does not have any
impairment or combination of impairments that is "severe," the individual
is not disabled.

[4] In an action that was
uncontested on appeal and later termed "entirely proper" by the Fourth
Circuit in Albright , the ALJ dismissed Mr. Albright's claims
insofar as they related to the period up to and including May 28, 1992,
the date of the prior ALJ's decision on Mr. Albright's earlier claims.

[5] In making a finding of a
claimant's residual functional capacity or other finding required to be
made at a step in the applicable sequential evaluation process for
determining disability provided under the specific sections of the
regulations described above, an ALJ or the Appeals Council may have made
certain subsidiary findings, such as a finding concerning the credibility
of a claimant's testimony or statements. A subsidiary finding does not
constitute a finding that is required at a step in the sequential
evaluation process for determining disability provided under 20 CFR
404.1520, 416.920 or 416.924.

## Nearby sections

- [AR 00-1(4) AR 00-1(4): Albright v. Commissioner of the Social Security Administration , 174 F.3d 473 (4th Cir. 1999) (Interpreting Lively v. Secretary of Health and Human Services )—Effect of Prior Disability Findings on Adjudication of a Subsequent Disability Claim—Titles II and XVI of the Social Security Act.](https://www.frixlaw.com/law-library/statutes/SSA_SSR_AR_AR_00_1_4.md)
- [AR 15-1(4) AR 15-1(4): Rescinded](https://www.frixlaw.com/law-library/statutes/SSA_SSR_AR_AR_15_1_4.md)
- [AR 86-14 AR 86-14(4): Jones v. Secretary of Health, Education and Welfare , 629 F.2d 334 (4th Cir. 1980) -- Child's Benefits -- Contributions for Support -- Title II of the Social Security Act](https://www.frixlaw.com/law-library/statutes/SSA_SSR_AR_AR_86_14.md)
- [AR 86-22 AR 86-22(4): Parsons v. Health and Human Services , 762 F.2d 1188 (4th Cir. 1985) -- Contributions to Support re: Posthumous Illegitimate Child -- Title II of the Social Security Act](https://www.frixlaw.com/law-library/statutes/SSA_SSR_AR_AR_86_22.md)
- [AR 90-3(3) AR 90-3(3): Rescinded](https://www.frixlaw.com/law-library/statutes/SSA_SSR_AR_AR_90_3_3.md)
- [AR 90-4(4) AR 90-4(4): Culbertson v. Secretary of Health and Human Services , 859 F.2d 319 (4th Cir. 1988); Young v. Bowen , 858 F.2d 951 (4th Cir. 1988) -- Waiver of Administrative Finality in Proceedings Involving Unrepresented Claimants Who Lack the Mental Competence to Request Administrative Review -- Titles II and XVI of the Social Security Act.](https://www.frixlaw.com/law-library/statutes/SSA_SSR_AR_AR_90_4_4.md)
- [AR 93-1(4) AR 93-1(4): Rescinded](https://www.frixlaw.com/law-library/statutes/SSA_SSR_AR_AR_93_1_4.md)
- [AR 94-2(4) AR 94-2(4): Rescinded](https://www.frixlaw.com/law-library/statutes/SSA_SSR_AR_AR_94_2_4.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/SSA_SSR_AR_AR_00_1_4. Check the current official text before relying on it. Not legal advice.