I-2-9-5.Administrative Law Judge Jurisdiction to Reopen and Revise a Determination or Decision

Last Update: 7/27/15 (Transmittal I-2-145)

A. When an Administrative Law Judge (ALJ) Has Jurisdiction to Reopen and Revise a Determination or Decision

An ALJ has jurisdiction to consider reopening and revising a prior final determination or decision in the following circumstances:

  • The claimant did not request Appeals Council (AC) review on the prior final decision;

  • The AC has not initiated own motion review;

  • The AC did not issue the prior final decision;

  • The AC or another component referred the case to the ALJ to consider reopening and revising a prior final ALJ decision (and another component does not have jurisdiction);

  • The claimant filed a request for review on a prior final decision, the AC denied the request for review, and the 60-day period for filing a civil action on the final decision has expired;

  • The claimant filed a request for review on the prior final decision but the AC dismissed the case for a reason other than the death of the claimant; or

  • The AC did not affirm an allowance on a subsequent application or otherwise find that a determination is final and binding.

NOTE 1:

An ALJ does not have jurisdiction to reopen when the AC dismisses a request for review based on the death of the claimant because the AC has already determined that there is no person who qualifies as a substitute party for that claim. However, the AC will vacate its order of dismissal if any qualified substitute party requests that it do so within 60 days of the dismissal. For more information about qualified substitute parties, see Hearings, Appeals and Litigation Law (HALLEX) manual I-3-4-4.

NOTE 2:

Subject to the limitations noted above, a court's affirmation of a prior unfavorable ALJ decision does not affect a current ALJ's jurisdiction to reopen and revise the prior otherwise final decision.

NOTE 3:

If the ALJ who initially issued the decision is no longer available or will be absent for an extended period of time, see HALLEX I-2-9-1 B NOTE 2.

B. When an ALJ Lacks Jurisdiction to Reopen and Revise a Determination or Decision

Generally, there are two circumstances when an ALJ lacks jurisdiction to reopen and revise a final determination or decision:

  • The matter is pending before the AC or a Federal court; or

  • The issue was already finally decided by the AC.

For a detailed description of when reopening and revision is within the AC's jurisdiction, see HALLEX I-3-9-5.

NOTE:

If an ALJ lacks jurisdiction but believes the claimant was disabled during an already adjudicated time period, see HALLEX I-2-9-6.

1. Matter Is Pending Before AC or Federal Court

An ALJ does not have jurisdiction to reopen and revise a final decision if the matter is currently pending before the AC, whether on request from the claimant or on the AC's own motion. Additionally, an ALJ does not have jurisdiction to reopen and revise a final decision if the matter is currently pending before a Federal court.

However, if the case is pending before the AC and the ALJ who issued an unfavorable or partially favorable decision would now issue a more favorable decision based on new information, the ALJ or designated hearing office (HO) staff may request that the AC return jurisdiction by sending an email to ¦¦¦ODAR OAO with the subject line “Request to Remand Case.” In the email, the ALJ or designated HO staff will include the claimant's name, Social Security number, and a brief explanation that the ALJ received new evidence and that under HALLEX I-2-9-5, the ALJ is requesting remand in order to issue a more favorable decision. The AC will review the request and determine whether remanding the case is appropriate. For AC processing instructions, see generally HALLEX I-3-7-25.

2. Issue Already Decided by the AC

An ALJ does not have jurisdiction to reopen issues already finally decided by the AC. For example, an ALJ cannot reopen an AC decision.

NOTE:

The AC is not issuing a decision when it denies review of an ALJ decision. When the AC denies review, the ALJ's decision becomes the final decision of the Commissioner. For general information on AC actions, see HALLEX I-3-0-10.