TN 4 (06-05)

Citations:

Regulations at 20 CFR 416.1487 – 20 CFR 416.1494

A. Introduction

When it has been determined that an individual is eligible for SSI payments, he or she should be able to rely on that determination. Moreover, it is a well established principle in Federal payment programs that, generally, the administrative agency should not be required to establish findings of fact after the lapse of a considerable time from the date of the events involved. The regulations, therefore, prescribe time limits for the reopening of determinations and decisions. An initial, reconsidered, or revised determination, or a decision or revised decision of an ALJ or the AC becomes final and binding on the parties to it after the expiration of the time limit provided for the appropriate appeal:

• if the recipient has not filed a timely request for such appellate review, and,

• unless special circumstances exist which permit its reopening and revision.

  The rules regarding administrative finality are set by regulation, not statute, under the Commissioner’s rulemaking authority under Section 1631(a) (1) of the Social Security Act. The regulatory language parallels administrative finality regulations for Titles II and XVIII.

B. Background

This chapter explains why a determination or decision can be reopened and revised and provides the procedures and time limits for reopening and revising a determination or decision after it has become final.

C. Policy

A determination or decision can be reopened and revised to correct erroneous determinations and decisions. Correct determinations and decisions may not be reopened and revised (see SI 04070.010C.1. through SI 04070.010C.3. for EXCEPTIONS).