20 C.F.R. § 404.988

Conditions for reopening

Read at: eCFRecfr.gov CornellLII GovInfogovinfo.gov CasesGoogle Scholar

A determination, revised determination, decision, or revised decision may be reopened—

(a) Within 12 months of the date of the notice of the initial determination, for any reason;

(b) Within four years of the date of the notice of the initial determination if we find good cause, as defined in § 404.989, to reopen the case; or

(1) It was obtained by fraud or similar fault (see § 416.1488(c) of this chapter for factors which we take into account in determining fraud or similar fault);

(2) Another person files a claim on the same earnings record and allowance of the claim adversely affects your claim;

(3) A person previously determined to be dead, and on whose earnings record your entitlement is based, is later found to be alive;

(4) Your claim was denied because you did not prove that a person died, and the death is later established—

(i) By a presumption of death under § 404.721(b); or

(ii) By location or identification of his or her body;

(5) The Railroad Retirement Board has awarded duplicate benefits on the same earnings record;

(6) It either—

(i) Denies the person on whose earnings record your claim is based gratuitous wage credits for military or naval service because another Federal agency (other than the Veterans Administration) has erroneously certified that it has awarded benefits based on the service; or

(ii) Credits the earnings record of the person on which your claim is based with gratuitous wage credits and another Federal agency (other than the Veterans Administration) certifies that it has awarded a benefit based on the period of service for which the wage credits were granted;

(7) It finds that the claimant did not have insured status, but earnings were later credited to his or her earnings record to correct errors apparent on the face of the earnings record (section 205(c)(5)(C) of the Act), to enter items transferred by the Railroad Retirement Board, which were credited under the Railroad Retirement Act when they should have been credited to the claimant's Social Security earnings record (section 205(c)(5)(D) of the Act), or to correct errors made in the allocation of wages or self-employment income to individuals or periods (section 205(c)(5)(G) of the Act), which would have given him or her insured status at the time of the determination or decision if the earnings had been credited to his or her earnings record at that time, and the evidence of these earnings was in our possession or the possession of the Railroad Retirement Board at the time of the determination or decision;

(8) It is fully or partially unfavorable to a party, but only to correct clerical error or an error that appears on the face of the evidence that was considered when the determination or decision was made;

(9) It finds that you are entitled to monthly benefits or to a lump sum death payment based on the earnings of a deceased person, and it is later established that:

(i) You were convicted of a felony or an act in the nature of a felony for intentionally causing that person's death; or

(ii) If you were subject to the juvenile justice system, you were found by a court of competent jurisdiction to have intentionally caused that person's death by committing an act which, if committed by an adult, would have been considered a felony or an act in the nature of a felony;

(10) It either—

(i) Denies the person on whose earnings record your claim is based deemed wages for internment during World War II because of an erroneous finding that a benefit based upon the internment has been determined by an agency of the United States to be payable under another Federal law or under a system established by that agency; or

(ii) Awards the person on whose earnings record your claim is based deemed wages for internment during World War II and a benefit based upon the internment is determined by an agency of the United States to be payable under another Federal law or under a system established by that agency; or

(11) It is incorrect because—

(i) You were convicted of a crime that affected your right to receive benefits or your entitlement to a period of disability; or

(ii) Your conviction of a crime that affected your right to receive benefits or your entitlement to a period of disability is overturned.

[45 FR 52081, Aug. 5, 1980, as amended at 49 FR 46369, Nov. 26, 1984; 51 FR 18313, May 19, 1986; 59 FR 1635, Jan. 12, 1994; 60 FR 19165, Apr. 17, 1995; 75 FR 33168, June 11, 2010]

Notes of Decisions

Cited in 302 cases (69 in the last 5 years), 1981–2026 · leading case: Luther D. Mullen v. Otis Bowen, Sec'y of Health & Human Servs., Richard G. Shepherd v. Otis Bowen, Sec'y of Health & Human Servs., 800 F.2d 535 (6th Cir. 1986).

Sort: Relevance Newest Treatment

Luther D. Mullen v. Otis Bowen, Sec'y of Health & Human Servs., Richard G. Shepherd v. Otis Bowen, Sec'y of Health & Human Servs., 800 F.2d 535 (6th Cir. 1986). · cites it 4× “See 20 C.F.R. § 404.988 (a) (“A determination .”

Willie Ousley v. Comm'r of Soc. Sec., 909 F.3d 786 (6th Cir. 2018). · cites it 2× “” 20 C.F.R. § 404.988 (c)(1). The Program Operations Manual System (“POMS”) (an internal instruction manual) explains that the SSA will not reopen initial determinations unless there is “a preponderance of evidence to prove the existence of fraud.”

Charles PURTER, Appellant, v. Margaret HECKLER, Sec'y Dept. of Health & Human Servs., 771 F.2d 682 (3rd Cir. 1985). · cites it 4× “” 20 C.F.R. §§ 404.988 (b), 404.-989(a)(1) (1984).”

John E. WOLFE, Plaintiff-Appellant, v. Shirley S. CHATER, Comm'r of Soc. Sec. Admin., Defendant-Appellee, 86 F.3d 1072 (11th Cir. 1996). · cites it 3× “The ALJ, however, must be aUowed some leeway to evaluate how newly presented evidence relates back to the prior application in order to determine whether to reopen the case pursuant to 20 C.F.R. §§ 404.988 , 404.989. Hall, 840 F.”

Olivia Kneeland v. Nancy Berryhill, Acting Cmsnr, 850 F.3d 749 (5th Cir. 2017). “20 C.F.R. § 404.988 states in relevant part: “A determination, revised determination, decision, or revised decision may be reopened .”

William F. Gosnell v. Sec'y of Health & Human Servs., 703 F.2d 216 (6th Cir. 1983). · cites it 9× “957 has been subsequently recodified and now appears, without substantive change, as 20 C.F.R. 404.988 (1982). This opinion cites the Regulations in their revised form 2 Apparently having abandoned his equal protection claim on appeal, Gosnell now only alleges violation of his…”

Alvarado v. Colvin, 836 F.3d 744 (7th Cir. 2016). “See 20 C.F.R. § 404.988 . That would be the case, for example, if the ALJ found Alvarado's earlier eligibility decisions had been procured by fraud.”

Whittaker v. Comm'r of Soc. Sec., 307 F. Supp. 2d 430 (N.D.N.Y. 2004). · cites it 2× “20 C.F.R. § 404.988 (b). The Commissioner’s regulations provide that such a determination may be reopened more than four years later only if, among other grounds, fraud or similar fault exists, or to correct an error on the face of the evidence that was considered when the…”

Schmidt v. Astrue, 496 F.3d 833 (7th Cir. 2007). “See 20 C.F.R. § 404.988 . Earlier evidence, such as previous physicians’ opinions, can be considered relevant when adjudicating subsequent applications for benefits, see Groves v.”

Ronald L. BOOCK, Plaintiff-Appellant, v. Donna E. SHALALA, Sec'y of Health & Human Servs., Defendant-Appellee, 48 F.3d 348 (8th Cir. 1995). · cites it 4× “The first, 20 C.F.R. § 404.988 (1994), provides that the SSA may reopen an otherwise final decision: (a) for any reason, within 12 months of the notice of the initial determination; (b) for “good cause”, within four years of the notice of the initial determination; and (c) at…”

Fidencio CHAVEZ, Plaintiff-Appellant, v. Otis R. BOWEN, Sec'y of the Dep't of Health & Human Servs., Defendant-Appellee, 844 F.2d 691 (9th Cir. 1988). · cites it 2× “See 20 C.F.R. §§ 404.988 (b), 404.989(a)(1) (1986) (allowing the Secretary to reopen a decision if there is “good cause” to do so, as where “[n]ew and material evidence is furnished”).”

Cynthia Carrillo-Yeras v. Michael Astrue, 671 F.3d 731 (9th Cir. 2011). · cites it 3× “20 C. F.R. § 404.988. Similarly, a determination regarding eligibility for supplemental security income may be reopened (a) “[w]ithin 12 months of the date of the notice of the initial determination, for any reason;” (b) “[wjithin two years of the date of the notice of the…”

Show all 302 citing cases →

— 20 C.F.R. § 404.988(a) — 2 cases

Lloyd A. Gentry v. Donna E. Shalala, Sec'y of Health & Human Servs., 52 F.3d 337 (10th Cir. 1995).

Simmons (D. Or. 2026).

— 20 C.F.R. § 404.988(a)(3) — 1 case

Doris Cole, on Behalf of James E. Cole, Deceased v. Jo Anne B. Barnhart, Comm'r of Soc. Sec., 288 F.3d 149 (5th Cir. 2002).

— 20 C.F.R. § 404.988(b) — 6 cases

William F. Gosnell v. Sec'y of Health & Human Servs., 703 F.2d 216 (6th Cir. 1983). “957 has been subsequently recodified and now appears, without substantive change, as 20 C.F.R. 404.988 (1982). This opinion cites the Regulations in their revised form 2 Apparently having abandoned his equal protection claim on appeal, Gosnell now only alleges violation of his…”

John H. ROBINSON, Appellant, v. Margaret M. HECKLER, Sec'y of the Dep't of Health & Human Servs., Appellee, 783 F.2d 1144 (4th Cir. 1986).

Florence J. Gilbert v. Shirley S. Chater, Comm'r of Soc. Sec., 110 F.3d 73 (10th Cir. 1997).

Moore v. Sullivan, 731 F. Supp. 1009 (D. Kan. 1989).

Gilbert v. Chater (10th Cir. 1997).

— 20 C.F.R. § 404.988(c) — 2 cases

Poisson v. Soc. Sec. (1st Cir. 2000).

— 20 C.F.R. § 404.988(c)(1) — 1 case

H.D. Hulett v. Shirley S. Chater, Comm'r of Soc. Sec., 1, 74 F.3d 1249 (10th Cir. 1996).

— 20 C.F.R. § 404.988(c)(8) — 3 cases

Glazer v. Comm'r of Soc. Sec., 92 F. App'x 312 (6th Cir. 2004).

Graf v. Comm'r of Soc. Sec. (W.D. Wash. 2020).

— 20 C.F.R. § 404.988(e) — 1 case

Joseph D. BUTTERWORTH, Plaintiff-Appellee, v. Otis R. BOWEN, Sec'y of Health & Human Servs., Defendant-Appellant, 796 F.2d 1379 (11th Cir. 1986).

Annotations are extracted automatically from the opinions in the Syfert caselaw corpus and ranked by authority, recency, and treatment. Dots show Syfertize treatment of the citing case itself.