BASIC (03-86)

A. Medical or other evidence of disability

Where new evidence is received (with or without a new application) which could provide a basis for the ALJ to reopen his prior decision, an examiner will send the claims file to the ALJ by memorandum. Provide copies of the memorandum for (1) OHO, (2) claims file. Route the memorandum and claims file to a Manager for approval and release.

B. Additional earnings extend insured status

Where additional earnings extend the date disability insured status is last met, Recon Staff will send the claims file to the ALJ for reopening consideration and a revised decision.

NOTE 1: Any referral to the ALJ should be made after processing to payment any determination favorable to the claimant on the basis of a current application with onset limited to the period after the date of the ALJ's decision.

NOTE 2: If an initial or reconsideration determination is being deferred pending completion of the ALJ's action (see DI 42001.015D), advise the ALJ of this fact.

C. ALJ reopens and revises

If the ALJ reopens and revises his prior decision to an allowance, and there is an outstanding application or request for reconsideration and the ALJ in his revised decision has not disposed of the current application or reconsideration request, Recon Staff must provide language for inclusion with the award notice explaining that since an allowance has been made no action is necessary on the new claim or the request for reconsideration (see DI 42010.020 and DI 42010.025 for effectuation).

D. ALJ declines to reopen

1. Unadjudicated application in file

If the examiner believes that reopening is still indicated, the case should be referred to the AC per the procedures in DI 42010.065. If the examiner believes that the reopening issue is closed, the new application should be processed in the usual manner.

2. Outstanding request for reconsideration in file

Handle the case in accordance with the examiner instruction in DI 42010.045D.1.