As set forth in 20 CFR 404.988(c), the
Appeals Council (AC) may reopen a determination or decision that
is otherwise final at any time in the following circumstances:
•
The determination
or decision was obtained by fraud or similar fault (see Hearings, Appeals
and Litigation Law (HALLEX) manual HA 01395.007);
•
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 could
not prove that the wage earner died and 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 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 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 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 the deceased 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 the 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 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 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 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 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.