DI 27540.040 Reopening and Revision at the Reconsideration Level

A. Policy for affording disability hearings

The opportunity for a disability hearing is afforded at the reconsideration level of appeal in cases involving:

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favorable initial determinations that were adversely reopened and revised based on medical factors, e.g., adverse reopenings that revised an allowance to a denial, established a later onset date, or changed an open period allowance to a closed period;
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reopenings that change only the basis for the cessation; or
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favorable reconsidered determinations that have been reopened and that we propose to adversely revise based on medical factors.

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When an initial determination is reopened and adversely revised based on medical factors, the Disability Determination Services (DDS) sends the claimant a notice containing reconsideration appeal rights that include the right to a disability hearing.
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Before a reconsideration determination is reopened and adversely revised based on medical factors, the disability hearing unit sends a notice to the claimant advising him or her of the proposed revision and his or her right to request a disability hearing before a revised determination is issued.