The following sections discuss the time limitations on the reopening of final determinations and final decisions, except those dealing with a Social Security earnings record. (Earnings records are corrected in accordance with the statute of limitations (see §1423)).
2016.1 Can a determination or decision be reopened and revised?
Even though a determination or decision has become final, it may be reopened and revised (by the SSA field office, DDS, reviewing office, ALJ, or Appeals Council) as described below.
2016.2 When may a determination or decision be reopened?
A determination or decision which has become final (see §2001) may be reopened and revised:
Within 12 months from the date of the notice of the initial determination for any reason;
Within four years (two years in the SSI program) from the date of the notice of the initial determination, if there is good cause for reopening it. “Good cause” can be found to exist if:
New and material evidence is submitted;
A clerical error was made; or
The evidence that was considered in making the determination or decision 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.
Action reopening the determination or decision under either (A) or (B) above must be started within the time limit specified.
At any time if the determination or decision was based on fraud or similar fault. For Title II cases only, several other provisions listed in our regulations permit reopening a determination at any time. In Title XVI cases, the “at any time” rule applies only if fraud or similar fault is involved.
We may decide to reopen a determination or decision on our own initiative or as the result of receiving a written request from you, an eligible spouse, or representative payee. The decision to not reopen is not an initial determination, as defined by our regulations, and is not subject to appeal. It is an administrative action that we will usually take if the above criteria are met.
Last Revised: Sep. 3, 2009