TN 4 (11-88)

GN 04040.040 Relationship Between Equitable Relief and Administrative Finality

A. Policy Principle—Equitable Relief

Equitable reliefcan only be given with respect to entitlement to Premium Hospital Insurance (Section 1818 of the act) and Supplementary Medical Insurance.

SSA can provide equitable relief when an individual's enrollment or coverage rights are prejudiced because of the error, misrepresentation, or inaction of an employee or agent of the government.

SSA may take whatever action is necessary to prevent or correct inequity to the individual, including (but not limited to) the designation of special enrollment and coverage periods. (See HI 00805.130).

B. Policy Principle—Relationship to Administrative Finality

The requirements for reopeningunder the rules of administrative finality need not be met in order to grant equitable relief, as the statute which rules on equitable relief takes precedence over the rules of administrative finality, which are in the regulations. Therefore, equitable relief can be granted regardless of when the error was made or how far back the claimant should have been or was first entitled to SMI or premium HI.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0204040040
GN 04040.040 - Relationship Between Equitable Relief and Administrative Finality - 12/22/1989
Batch run: 01/27/2009
Rev:12/22/1989