TN 3 (01-89)
GN 04001.090 Reopenings - Appeal Rights — Operating Procedure
A. Policy Principle — Level of Appeal
When an initial determination is revised, the next level of appeal is an ALJ hearing with the exception of revised determination on medical issues and AERO recalculations. In revised determinations concerning medical factors and AERO recalculations, the next level of appeal is a reconsideration.
B. Operating Procedure — Notice of Revision
When an initial or reconsidered determination is reopened and revised, mail a notice of the revision to the claimant at his/her last known address. The notice should inform the claimant:
The prior determination has been reopened and revised, the basis for the revision and the months affected by the revision; and
He/she has a right to a reconsideration or hearing (as appropriate).
C. Related Procedure
When an overpayment is involved, follow the overpayment procedures in GN 02201.003 to recover the overpayment.
D. Policy Principle — Refusal to Reopen Is Not an Initial Determination
A denial of a request to reopen a determination or decision under the rules of administrative finality is not an initial determination and does not give the claimant the right to appeal. The appeal rights paragraph should not be included in the notice to the claimant.