TN 4 (12-09)

A. DDS jurisdiction for reopening a prior determination

A reopening is a formal review of a determination or decision where an error is involved, or where a reevaluation of the evidence used in a prior determination or decision has occurred, provided the determination to be reopened has not exceeded the timeframes of administrative finality.

For policy on applying the rules of administrative finality, see Rules for Reopening DI 27500.000.

The DDS considers the reopening question and prepares a new or revised determination, as appropriate; although the following offices may have prepared the prior determination:

• another DDS;

• the Processing Center (PC);

• the Field Office (FO); or

• the Disability Quality Branch (DQB).

If reopening is required on the basis of “new and material evidence,” and a new application has not been filed, the DDS in the State where the claimant currently resides has jurisdiction.

NOTE: The DDS does not reopen or revise Administrative Law Judge (ALJ) or Appeals Council (AC) decisions.

1. Certified Electronic Folder (CEF) process

Process CEFs according to the instructions in Processing Reopenings DI 81020.115 and Processing Medical Reactivations DI 81020.117.

2. Modular Disability Folder (MDF) process

Process MDFs according to the instructions in DI 27500.000

3. Additional medical evidence

If you receive additional medical evidence after releasing the folder:

• For CEFs, see Processing Trailer Material for the Certified Electronic Folder DI 81020.140.

• For MDFs, see Disposition of Trailer Material DI 22520.001.

REFERENCE:

DI 27500.000 – Reopenings, Adoptions, and Refilings.

B. SSA jurisdiction for reopening a prior determination

If the prior determination was prepared by SSA or was a work-issue case only, the jurisdictional guidelines are the same as for initial claims in the following areas:

• Foreign claim – see DI 20101.030B.

• Claimants in U.S. Possessions – see DI 20101.030C.

• Career Railroad or RR annuitant Case – see DI 20101.040A.

• Changed Identity Claims – see DI 20101.040B.

• Emergency Clause – see DI 20101.040C.

• Substantial Gainful Activity Case – see DI 24001.005 – Initial and Subsequent Work Issue Cases.