As set forth in 20 CFR 404.988(c), an
administrative law judge (ALJ) has the authority to reopen a determination
or hearing decision which is otherwise final at any time in the following
circumstances:
•
The determination
or hearing decision was obtained by fraud or similar fault (see
Hearings, Appeals and Litigation Law (HALLEX) manual HA 01290.065);
•
Another person files a claim on the same earnings
record and allowance of that claim adversely affects the earlier
claim;
•
A person previously determined to be dead, and on
whose earnings record entitlement is based, is later found to be
alive;
•
The claim was denied because the claimant did not
prove that a person died, and the death is later established by
a presumption of death under 20 CFR 404.721(b) or by location
or identification of his or her body;
•
The Railroad Retirement Board has awarded duplicate
benefits on the same earnings record;
•
The determination or hearing decision denies the
person on whose earnings record the claim is based gratuitous wage
credits for military or naval service because another Federal agency
(other than the Department of Veterans Affairs) has erroneously
certified that it has awarded benefits based on the service;
•
The determination or hearing decision credits the
earnings record of the person on which the claim is based with gratuitous
wage credits and another Federal agency (other than the Department
of Veterans Affairs) certifies that it has awarded benefits based
on the same period of service for which the wage credits were granted;
•
The claimant was denied for lack of insured status,
but earnings for the appropriate period of time were later credited
to the claimant's earnings record under the conditions described
in 20 CFR
404.988(c)(7);
•
The determination or hearing decision is fully or
partially unfavorable to a party, but only to correct a clerical
error or an error that appears on the face of the evidence that
was considered when the determination or decision was made;
•
A claimant is found entitled to monthly benefits
or to a lump-sum death payment based on the earnings of a deceased
person, and it is later established that the claimant was convicted
of a felony or an act in the nature of a felony for intentionally
causing that person's death;
•
A claimant is found entitled to monthly benefits
or to a lump-sum death payment based on the earnings of a deceased
person, and it is later established that, if the claimant was subject
to the juvenile justice system, the claimant was found by a court
of competent jurisdiction to have intentionally caused that person's
death by committing an act which, if committed by an adult, would
have been considered a felony or an act in the nature of a felony;
•
The determination or hearing decision denies the
person on whose earnings record the claim is based deemed wages
for internment during World War II because of an erroneous finding
that a benefit based upon the internment has been determined by
an agency of the United States to be payable under another federal
law or under a system established by that agency;
•
The determination or hearing decision awards the
person on whose earnings record the claim is based deemed wages
for internment during World War II and a benefit based upon the
internment is determined by an agency of the United States to be
payable under another federal law or under a system established
by that agency;
•
The determination or hearing decision is incorrect
because the claimant was convicted of a crime that affected his
or her right to receive benefits or his or her entitlement to a period
of disability; or
•
The determination or hearing decision is incorrect
because the claimant's conviction of a crime that affected his or
her right to receive benefits, or his or her entitlement to a period
of disability is overturned.