If fewer than 4 years have elapsed since the date of the initial notice for the prior determination or decision in a title II claim, process the prior application to payment according to the instructions in DI 42010.020. Use the date of the prior application in Block 3 of the determination Form SSA-831. Do not refer the case to the Office of Appellate Operations (OAO) as a protest case solely because the ALJ did not provide a basis for reopening.

If more than 4 years have elapsed since the initial notice of the prior determination or decision in a title II claim, and the ALJ reopens and revises a prior determination or decision to a favorable decision without explaining why the rules for unrestricted reopening apply, expedite payment on the current application before the ALJ. Prepare an SSA-567 referring the file to the proper reviewing technician to prepare a protest memorandum to the OAO based on the reopening issue. For protest memorandum guidelines and procedure see DI 42010.080.

The ALJ may establish onset in the period covered by a prior unfavorable determination or decision without reopening, but the ALJ must address the reopening issue in the decision (see HALLEX I-2-9-85 and DI 25501.250A5.). If the ALJ addresses the reopening issue in the decision and declines to reopen the prior determination or decision, process the claim using the current application date and earlier disability onset date. If the ALJ does not address reopening, and the prior determination or decision could potentially be reopened under the provisions of 20 CFR 404.987- 404.989, see DI 42010.065 for an explanation on how to submit a protest to OAO.

If the rules of administrative finality prohibit reopening and the ALJ incorrectly reopened a prior determination or decision, or if the ALJ erroneously reopened a prior court or AC decision, process the current application to payment, if possible. Follow the instructions in DI 42010.020 for preparing the determination form, and enter in item 3 (Filing Date) the date of the later application which was before the ALJ for a hearing. Prepare an SSA-567 referring the case after payment to the appropriate reviewer for preparation of a protest memorandum to OAO based on the reopening issue. For protest memorandum guidelines and procedure, see DI 42010.065 and DI 42010.080.

If the ALJ decision establishes a claimant’s disability onset during a prior period of disability entitlement, the processing center (PC) will be unable to correctly effectuate the case for payment. Do not treat the case as a continuance. Not allowing a claimant a new period of disability can be disadvantageous. When a hearing level decision is impossible to effectuate or contains an error of fact or law, the technician refers the matter to OAO. For protest memorandum guidelines and procedure, see DI 42010.065 and DI 42010.080 for protest memorandum guidelines and procedure.