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DI 28501.025: Reopening and Revision of a Prior Continuing Disability Review (CDR) Reconsideration Determination

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  • Effective Dates: 01/23/1990 - Present
  • Effective Dates: 12/12/2017 - Present
  • BASIC (03-86)
  • TN 1 (12-17)
  • DI 28501.025 Reopening and Revision of a Prior CDR Reconsideration Determination
  • DI 28501.025 Reopening and Revision of a Prior Continuing Disability Review (CDR) Reconsideration Determination
  • A. Reconsideration Determination Issued by DDS or Proper Developing Component
  • A. Reconsideration determination issued by the Disability Determination Services (DDS) or proper developing component
  • If the DDS or proper developing component finds that its reconsideration determination should be reopened under the rules of administrative finality, it will prepare a Summary of Evidence (SSA-887), realign the folder and transmit the case to the DHU. When transmitting such a case, annotate the SSA-408 to show: “Folder Forwarded for Review and Possible Reopening.” Upon receipt of the folder, a DHO will review the case. If a reopening is indicated, the DHU will afford due process and offer the claimant a disability hearing before taking any action to reopen.
  • 1. The DDS or proper developing component needs to reopen a reconsideration
  • If a processing center requests the DDS to reopen its reconsideration determination and the DDS feels the determination should not be reopened, it will prepare an SSA-408 returning the case to the PC. Annotate the SSA-408 to show why the folder is being forwarded and document the folder to show why the reconsideration determination should not be reopened. When such a case is being forwarded to the DHU, it will not be necessary for the DDS to prepare a Summary of Evidence or to realign the folder.
  • The DDS will only reopen CDR reconsiderations if the determination is fully favorable. A disability hearing officer (DHO) makes all other types of CDR determinations. For more information about component responsibilities, see DI 29001.010.
  • B. Reconsideration Determination Issued by DHO
  • If the rules of administrative finality allow a reopening when a determination is not fully favorable, the DDS or proper developing component will complete the following:
  • A reconsideration determination issued by a DHO may only be reopened (under the rules of administrative finality) by a DHO, the ODH, an ALJ or a member of the AC. Thus, any reopening issues on DHO's determinations should be referred to the DHU. If ODH issued the reconsideration determination, refer the reopening issue to ODH.
  • If a certified electronic folder (CEF):
  • * Prepare and add an SSA-887 (Summary of Evidence) to Section E – Disability Related Development (Blue),
  • * Add, “Folder forwarded for review and possible reopening” under the “Alerts & Messages” tab, and
  • * Forward CEF to Disability Hearings Unit (DHU).
  • If a Modular Disability Folder (MDF):
  • * Prepare an SSA-887 (Summary of Evidence) to return the case to the PC,
  • * Annotate the SSA-408 (Route Slip) with “Folder Forwarded for Review and Possible Reopening.”, and
  • * Transmit the paper case to the DHU.
  • Upon receipt of the folder, a DHO or supervisory hearing officer (SHO) will review the case. If a reopening is appropriate, the DHU will afford due process and offer the individual a disability hearing before taking any action to reopen.
  • 2. Processing center (PC) requests the DDS reopen its reconsideration determination
  • a. If the DDS disagrees with reopening the determination
  • If a PC requests the DDS reopen its reconsideration determination and the DDS disagrees, the DDS will take the following actions:
  • If CEF:
  • * Add, “Folder forwarded for review and possible reopening” under the “Alerts & Messages” tab,
  • * Prepare a SSA-5002 (Report of Contact) to explain why the DDS will not reopen the reconsideration determination. Add SSA-5002 to Blue section, and
  • * Forward CEF to DHU.
  • If MDF:
  • * Prepare a SSA-408 returning the case to the PC. Annotate the SSA-408 to show why the DDS is forwarding the folder, and
  • * Prepare a SSA-5002 to document why the DDS will not reopen the reconsideration determination.
  • b. If the DDS agrees with reopening the determination
  • If the DDS agrees to reopen a reconsideration determination under the rules of administrative finality, the DDS will take the following actions:
  • If CEF:
  • * Prepare a Form SSA-5002 (Report of Contact) to explain why the DDS will reopen the reconsideration determination. Add SSA-5002 to Blue section,
  • * Add the remark, “Folder forwarded for review and possible reopening.” under the “Alerts & Messages” tab, and
  • * Forward the CEF to the DHU.
  • If MDF:
  • * Realign the folder,
  • * Prepare a SSA-5002 (Report of Contact) (to explain why the DDS will reopen the reconsideration determination,
  • * Annotate the SSA-408 to show why the DDS is forwarding the folder, and
  • * Transmit the folder to the DHU.
  • When the DDS forwards the case to the DHU, the DDS does not need to prepare a Summary of Evidence (SSA-887).
  • B. Reconsideration decision issued by a disability hearing officer (DHO)
  • Only a DHO, an administrative law judge (ALJ), or a member of the Appeals Council (AC) can reopen a reconsideration decision issued by a DHO.
  • Therefore, refer any reopening issues on a DHO's decision to the DHU. If the Office of Hearing Operations (OHO) issued the reconsideration decision, refer the reopening issue to OHO.
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