2197. Reopening Determinations/Decisions Under the Rules of Administrative Finality

2197.1 Can final decisions/determinations be reopened?

Even though a determination, revised determination, decision, or revised decision has become final, it may be reopened and revised by the Social Security field office, reviewing office, ALJ, or Appeals Council within certain time limitations and under certain conditions. See §2016.

We may decide to reopen a determination or decision on our own or as the result of receiving a written request from a claimant, eligible spouse, or representative payee. The decision to reopen or not to reopen is not an initial determination and is not subject to appeal.

2197.2 How are decisions reopened?

Determinations or decisions may be reopened as follows:

1. Within 12 months from the date of notice of the initial determination for any reason;

2. After such 12-month period but within two years (for Title XVI) from the date of notice of the initial determination if there is "good cause" for reopening it. After such 12-month period, but within four years (for Title II) from the date of notice of the initial determination if there is "good cause" for reopening it. "Good cause" may exist when:

   1. New and material evidence is submitted;

   2. A clerical error was made; or

   3. The evidence that was considered in making the determination clearly shows that an error was made.

      Note: "Good cause" does not exist where the only basis for reopening the determination or decision is a change of legal interpretation or administrative ruling on which the determination or decision was based.

   4. At any time if it was obtained by fraud, or an unintentional act that results in fraud, by the claimant or some other person.

Last Revised: Aug. 7, 2008