If a basis for reopening and revising the final determination on the prior claim exists
(new and material evidence, error on the face, etc.), see DI 27505.001 – Conditions for Reopening a Final Determination or Decision.
NOTE: Only if it is within 12 months from the date of notice of the initial determination
on a claim can a final determination or decision be reopened and revised for any reason
(including a change in the criteria).
After reopening the prior determination or decision, forward the case to the appropriate
If the ALJ, AC, or court issued a prior decision and the rules for reopening apply,
forward the prior and subsequent claims to the Office of Disability Operations (ODO)
per DI 27505.010B.2.
If a Disability Hearing Officer made the determination on the prior claim and the
determination can be reopened under the rules for reopening, forward both the prior
and subsequent claims to the Disability Hearing Unit (DHU).
When a change in disability criteria warrants establishment of disability on the current application,
i.e., claimant now meets disability criteria before nondisability requirement last
met, prepare a substantive determination on the new claim before referring to ODO
or the DHU.
NOTE: This means going into the period previously adjudicated even though the time periods
for reopening have not expired. This action is permissible because the determination
on the new claim is based on a change in the disability criteria, and does not reopen the decision on the prior claim.