POMS Reference

GN 03102: Reconsideration (Title II and Entitlement Under Title XVIII)

TN 4 (12-06)

A. Introduction

This section explains the actions to take when a claimant after reconsideration files a new application, submits additional evidence or writes to the FO or PC instead of requesting a hearing.

B. Policy

PC will review the case in light of the new application, new evidence, and/ or the correspondence and determine the action to take.

C. Procedure

1. New Application filed - no new and material evidence and no change in law or regulations

Apply the doctrine of res judicata (see GN 03101.160 and GN 04040.010).

Advise claimant that new application involves the same issue and is based on the same facts and law as the previous application; therefore, the prior determination is binding on that issue.

Inform claimant of right to reconsideration on whether the issue is the same as that previously determined.

If the reconsideration determination is that the issue is the one previously determined, advise the claimant of the right to a hearing on whether the issue is the same as that previously determined.

2. Additional evidence received - reconsideration affirmed

Time Limit for Requesting a Hearing Has Not Expired.

Send the claimant a letter explaining reasons for the reconsideration determination that affirmed the initial determination and advise of the right to appeal and the time limit for filing an appeal. When additional evidence indicates that the claimant disagrees with the reconsideration determination, refer to GN 03103.010B.4.

Time Limit for Requesting a Hearing Has Expired.

Refer to GN 03101.020 for the rules on extending time limit for good cause.

3. Reconsideration determination - reopening and revising

If the reconsideration determination should be reopened and revised under the rules of administrative finality, take the appropriate action and include the appropriate hearing paragraph.

See GN 04001.000 for administrative finality rules.