In general, a prior determination or decision that is made is final and binding if a timely request for review or appeal is not filed. These prior determinations or decisions include initial, reconsideration, and hearing decisions. This means if you received a denial on reconsideration (dated November 1, 2022) and you did not appeal that determination within the time frame given, saying you disagree with that decision, then that reconsideration decision would be final and binding. This generally means you cannot refile and allege disability prior to November 1, 2022 (the date of the determination decision). However, there are some circumstances that allow for reopening and revising prior determinations and decisions.
These rules for reopening Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) claims are governed by the Social Security Code of Federal Regulations. Specifically, 20 C.F.R 404.988 sets forth the guidelines for reopening SSDI claims. This regulation states a SSDI determination or decision may be reopened several specific situations (see reference link). The situations in which a SSDI determination may be reopened are: 1) within 12 months of the date of the notice of the initial determination, for any reason; 2) within four years of the date of notice of the initial determination if we find good cause as defined in § 404.989, to reopen the case; and 3) at any time – (regulation sets out 11 specific situations). 20 C.F.R 416.1488 sets forth the guidelines for reopening SSI claims which allows for reopening in more limited situations which include: 1) within 12 months of the date of notice of the initial determination, for any reason; 2) within two years of the date of the notice of the initial determination if we find good cause, as defined in § 416.1489, to reopen the case; or 3) at any time if obtained by fraud or similar fault. Overall, issues of reopening can be confusing and complex. Therefore, it is important to talk with your attorney to better understand if reopening is possible and what needs to be shown.
Reference Links:
https://www.ssa.gov/OP_Home/cfr20/404/404-0988.htm (SSDI guidelines)
https://www.ssa.gov/OP_Home/cfr20/416/416-1488.htm (SSI guidelines)
