If the above conditions are not met, a new independent determination is needed. Only
an Administrative Law Judge (ALJ) or the Appeals Council (AC) may reopen an ALJ’s
If there was a prior denial or closed period at the ALJ level and new and material
evidence is submitted, only the ALJ or AC may decide if there is a basis for reopening.
See DI 42001.015 D. for instructions on referring these cases to the ALJ.
Prior decisions made at the AC or court level are processed as above, except that
wherever the reference “ALJ” is shown, read “AC.”
Also, see Reopenings and Revisions: Pertinent Definitions and Related Policy DI 27501.001.