Background

This transmittal amends various sections in chapter I-2-9 of the Hearings, Appeals and Litigation Law (HALLEX) manual to update instructions on reopening and revising determinations and hearing decisions.

Explanation of Content and Changes

Chapter I-2-9 is amended as follows:

I-2-9-1 – We retitled the section “Reopening and Revising Determinations and Decisions - General” to more accurately reflect the content of the section. We removed information that was unnecessary or duplicative of information in HALLEX I-2-8-5. We moved some of the information to HALLEX I-2-9-7, I-2-9-10, I-2-9-20, and I-2-9-85. We added a subsection A titled “General” and incorporated regulatory information and helpful citations to other HALLEX instructions. We added a subsection B titled “Reopening and Revising by an Administrative Law Judge (ALJ).” We clarified that an ALJ can consider a reopening issue at the request of a claimant, whether express or implied, or, under some circumstances, at the ALJ's own initiative.

I-2-9-5 – We added a new section titled “Administrative Law Judge Jurisdiction to Reopen and Revise a Determination or Decision,” and incorporated information previously in HALLEX I-2-9-10 and I-2-9-70. In subsection A, we changed the title to “When an Administrative Law Judge (ALJ) Has Jurisdiction to Reopen and Revise,” and made minor editorial changes to the language and formatting for clarity. We incorporated a NOTE, previously in HALLEX I-3-9-7, regarding reopening when a prior ALJ unfavorable decision is affirmed by a Federal court. We moved the information previously in subsection B to HALLEX I-2-9-6, and titled the subsection “When an ALJ Lacks Jurisdiction to Reopen and Revise.” We more clearly stated when an ALJ does not have jurisdiction to reopen and revise a prior final determination or decision, and provided instructions that an ALJ may use to request jurisdiction from the Appeals Council if the ALJ is later prepared to issue a fully favorable decision based on new information. We added a reference to HALLEX I-3-9-5 and incorporated information previously in subsection A.

I-2-9-6 – We added a new section titled “Administrative Law Judge Believes Claimant Is Disabled During Time Adjudicated in Appeals Council Decision.” We incorporated information previously in HALLEX I-2-9-10 B, and made minor language and formatting changes to the information.

I-2-9-7 – We added a new section titled “Referring a Request for Reopening When Administrative Law Judge Does Not Have Jurisdiction to Reopen,” and incorporated information previously in HALLEX I-2-9-1.

I-2-9-10 – We moved the information previously in this section to new HALLEX I-2-9-5 and I-2-9-6. We retitled the section “Claimant Requests Reopening (Express and Implied),” and incorporated information previously in HALLEX I-2-9-1 and I-2-9-70. We made minor language and formatting changes to the information.

I-2-9-15 – We removed the section in its entirety as it was duplicative of information in HALLEX I-3-9-5.

I-2-9-20 – In subsection A, we clarified that the time period for reopening is computed between the date of the notice of the initial determination the ALJ is considering reopening and the date of the request for reopening. We also added information showing that the date of the request for reopening will vary from case to case. We retitled subsection B “Reopening Multiple Prior Determinations or Decisions,” made minor language and formatting changes to simplify the instruction, and updated the example. We added a new subsection C titled “Acquiescence Rulings (AR) that Expand the Time to Request Reopening,” and incorporated information previously in HALLEX I-2-9-1.

I-2-9-30 – We made minor editorial corrections to the existing language and clarified that a reason for reopening must exist. We added a NOTE explaining that a claimant need not necessarily submit a reason for reopening within 12 months, but an ALJ may reopen based on a “reason” demonstrated in the record.

I-2-9-60 – We retitled subsection A “Title II Claim” and subsection B “Title XVI Claim.” We made minor formatting and editorial changes.

I-2-9-70 – We removed the section in its entirety as the information was incorporated in HALLEX I-2-9-5 and I-2-9-10.

I-2-9-80 – We moved some of the information to HALLEX I-2-9-85. We retitled the section “Notice of Revised Determination or Decision,” clarified when notice is required before a revised decision is issued, and explained what is required in the notice. We retitled subsection A “When Advance Notice is Required” and subsection B “Content of Advance Notice of Proposed Revision.” We moved the information previously in subsection C to HALLEX I-2-9-85. We made editorial and formatting changes to the information.

I-2-9-85 – We added a new section titled “Decisions - Addressing Reopening Issue or Issuing a Revised Decision.” We incorporated information previously in HALLEX I-2-9-1 and I-2-9-80, and made editorial and formatting changes to the information.

Date: July 27, 2015