I-2-9-20.Computing the Time Periods for Reopening

Last Update: 9/28/05 (Transmittal I-2-65)

A. Compute from the Date of the Initial Determination

Generally, in determining whether the conditions for reopening and revising a final determination or ALJ decision are met, the ALJ must compute the time elapsed between the date of the notice of the initial determination on the application on which the determination or decision was based, and the filing date of the current application or other communication in which the claimant requested reopening. The ALJ must determine, based on the elapsed time, which reopening criteria, if any, apply. (See I-2-9-30, Reopening for Any Reason Within 12 Months; I-2-9-40, Reopening for Good Cause; and I-2-9-60, Reopening at Any Time.)

B. Limit on Reopening Prior Applications

When a current application is before the ALJ and the conditions for reopening a determination or ALJ decision on a prior application exist, the ALJ must reopen the determination or ALJ decision made on the prior application. However, once the determination or decision on that prior application has been reopened, the ALJ may not use the filing date of such prior application to compute the time period under which a preceding, final determination or decision on an even earlier application may be reopened.

The time period for reopening the final determination or ALJ decision on the “even earlier application” is determined by the length of time elapsed from the date of the initial determination on the “even earlier application” to the date of filing of the current application or other communication in which the claimant requested reopening, not to the date of filing of the prior application that was adjudicated in the determination or decision which is being reopened.

Example:

The claimant filed an application for disability insurance benefits (DIB) on December 13, 1997, alleging that he became disabled on November 4, 1996. The application was denied initially on February 12, 1998, and again upon reconsideration on April 12, 1998. The claimant did not appeal the reconsideration determination; therefore, the reconsideration determination dated April 12, 1998 became final and binding.

The claimant filed a second application for DIB on February 10, 2001, alleging that he had been disabled since November 4, 1996. This application was denied initially on April 15, 2001, and was denied upon reconsideration on June 13, 2001. The claimant did not appeal the reconsideration determination; therefore, the reconsideration determination dated June 13, 2001 became final and binding.

The claimant filed a third (current) application for DIB on September 23, 2004, again alleging that he had been disabled since November 4, 1996. In connection with the current application, he submits evidence, including evidence which was new and material with respect to the prior applications, which establishes that he has in fact been disabled since November 4, 1996. None of the “reopening at any time” criteria are met.

Because the current application of September 23, 2004 was filed within 4 years of April 15, 2001, the date of the notice of the initial determination on the second application, the ALJ (based on the new and material evidence) must reopen the final determination on the second application. However, the ALJ cannot reopen the final determination on the first application filed on December 13, 1997, because the current application filed on September 23, 2004 was not filed within four years of February 12, 1998, the date of the notice of the initial determination on the first application.

Although the ALJ finds an onset of November 4, 1996, the ALJ cannot reopen the determination on the first application even though the claimant's second application of February 10, 2001 (which resulted in the final determination of June 13, 2001 which the ALJ is reopening) was filed within 4 years of February 12, 1998, the date of the notice of the initial determination on the first application.

Therefore, the claimant is under a disability which began on November 4, 1996, and he is entitled to DIB based on his application filed on February 10, 2001. This means he is entitled to DIB commencing February 2000, twelve months immediately before the month in which the application was filed.