I-3-9-80.Analyst Recommendation to the Appeals Council Regarding Reopening of a Prior Determination or Decision (For Revision or Remand)

Last Update: 7/27/15 (Transmittal I-3-121)

When the issue of reopening is before the Appeals Council (AC), as part of the substantive review of the case pending before the AC, the analyst will also review whether reopening and revising a prior determination or decision is appropriate. In doing so, the analyst will keep in mind the following:

  • If a prior paper claim(s) file is part of the reopening question, the analyst will obtain the claim(s) file before evaluating the issue, whenever possible. See Hearings, Appeals and Litigation Law (HALLEX) manual I-3-1-23.

  • If there are time restraints on the reopening issue present in the case, such as a date by which reopening must be initiated, the analyst must clearly note this in his or her analysis and immediately notify his or her branch chief.

  • Unless the AC has already taken action (see HALLEX I-3-5-50), the AC treats a request for reopening as a request for review. See HALLEX I-3-9-10 A.

  • If the reopening issue was before the prior adjudicator but was not addressed in the case pending before the AC, the AC will evaluate whether a basis for granting review is present (see HALLEX I-3-3-1). In some cases, the analyst may recommend further development to determine whether reopening and revision in the case is warranted. For example, if the administrative law judge (ALJ) had jurisdiction to reopen and revise the prior decision but did not consider the issue, and there is a question as to whether good cause exists that requires further development or proceedings, the analyst may recommend the AC remand the case to the ALJ for consideration of the issue.