20 CFR 404.957 and 404.958
In August 1963, R, an insured worker domiciled in Pennsylvania, filed application on his earnings record for child's insurance benefits on behalf of his minor child, C. This application was denied because the child was illegitimate under applicable Pennsylvania law and did not have status as R's child as required by section 216(h)(2)(A) of the Social Security Act. Notice of the Administration's initial determination of disallowance was mailed to R on November 1, 1963.
Under the provisions of § 404.908 of the Social Security Administration Regulations No. 4 (20 CFR 404.908), an initial determination becomes binding upon the parties to the determination unless it is reconsidered in accordance with §§ 404.910-404.916 of the Regulations (20 CFR 404.910-404.916), or unless it is revised. A request for reconsideration must be filed within 6 months from the date of mailing notice of the initial determination, unless good cause for an extension of time is shown. R failed to request reconsideration.
On February 10, 1965, R filed a second application for child's insurance benefits on C's behalf. R submitted new evidence showing that he and C's mother contracted a marriage ceremony in Pennsylvania, their State of domicile, on the preceding day. By virtue of this marriage, C under applicable Pennsylvania law was legitimated retroactively as of the date of his birth.
The question presented is whether the determination of disallowance (an initial determination) which had become final may be reopened and revised.
Section 404.957 of the Social Security Administration Regulations No. 4 (20 CFR 404.957) provides in substance that a determination or decision of the Administration may be reopened within 4 years after the date of the written notice of the initial determination to the party to such determination for "good cause."
Under § 404.958 of the Regulations (20 CFR 404.958), there is "good cause" for reopening a decision where the Administration receives "new and material evidence" after notice to the party to the initial determination. The evidence of R's intermarriage with C's mother and the resulting legitimation of C retroactively to the date of his birth constituted new and material evidence since it materially affected the status of the child at the time the first application was filed. Since this evidence was submitted by R within 4 years after notice of the initial determination of disallowance, "good cause" for reopening and revising the determination exists. The initial determination thus reopened may be revised to accord with the new evidence. Accordingly, it is held that the initial determination may be reopened and revised to find that C has the status of R's "child." It is further held that C's entitlement may begin as of the first month within the retroactive period of his application filed in August 1963 in which all other requirements for entitlement were met.