TN 3 (01-89)

GN 04001.020 Who Can Reopen

A. Policy Principle

The component(s) (and job position(s)) which has the authority to reopen is either:

  • The component(s) (and job position(s)) which made the determination; or

  • The component(s) (and job position(s)) which has the authority to review and, if necessary, revise the determination.

    • Examples of components within SSA include FO, RO, PSC, DDS, CO, ALJ, and AC.

      Examples of job positions include BA, CR, CA, and RECONR.

      EXCEPTION: If the initial determination was made by the PSC (e.g., by a CA) but under DOFA the DO (e.g., a CR) now has authority to make the initial determination, then the DO (e.g., CR) can reopen and revise the initial determination made by the PSC (e.g., CA).

B. Operating Procedure - How to Process Reopening When There is a Subsequent Application

If a new application is filed and the initial determination on a prior application was appealed and finally decided (denied) at a level higher than the initial level, an initial claims adjudicator should first process the new application.

1. NO NEW EVIDENCE

If the claimant does not submit new evidence, the initial claims adjudicator might deny the new application on the basis of res judicata (GN 03101.160 and GN 04040.010).

2. DIFFERENT FINDINGS OF FACTS

It is possible that in adjudicating the new application, the initial claims adjudicator would make findings of fact different from the findings made in the earlier determination (e.g., existence of marriage).

3. ROUTING ALLOWANCES

After the initial claims adjudicator processes the new application, he/she should refer the case to the reconsideration branch only if the new application is allowed.

4. REOPENING PRIOR DETERMINATION

  1. If the reconsideration branch believes that the prior determination should be reopened, it will either reopen or forward the case to the ALJ or AC, depending on the level at which the earlier determination was finally decided.

  2. Only at this point can an affirmative action by the proper person occur. (See GN 04001.050 B for affirmative action.) Even if the proper person determines there is no basis for reopening the prior determination, the claimant can still be paid on the current application. The month of entitlement would be based on the current application. (See DI 42010.025 for disability claims effectuated in ODO and see DI 27505.020B.3. when reopening is precluded and new application is filed.)


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0204001020