June 8, 2008 by admin

2005. The Reconsideration Process

2005.1 What is the reconsideration process?

The reconsideration process is a thorough and independent reexamination of all evidence on record related to the case. It is based on the evidence submitted for the initial determination, and any further evidence and information that you or your representative submits in connection with the reconsideration.

2005.2 What issues can be raised in the reconsideration process?

The reconsideration is not limited to the issues that you raise.

2005.3 Is the person who makes the reconsidered determination the same one who made the initial one?

No. The person who makes the reconsidered determination must have had no prior involvement with the initial determination.

2005.4 How is the claimant notified of the determination?

You will receive a personalized notice detailing the basis for the determination in your case. (See §111.2.)

2005.5 What are the options for the reconsideration process in Title XVI cases?

In Title XVI cases, the reconsideration process may be a case review, or, under certain circumstances, an informal conference or a formal conference.

1. Case Review. An independent review of the record as described in the first paragraph of this section. This is the only option available in cases involving the medical aspects of an initial determination on an application for benefits.

2. Informal Conference. A review as in (A) above in which you may participate. You may present witnesses and may present the case in person.

3. Formal Conference. In addition to participating in an informal conference, you may request that adverse witnesses be issued a subpoena and cross-examined by you or your representative. This type of reconsideration is available only if you are eligible for SSI payments and are notified that the payments will be reduced, suspended, or terminated.

2005.6 Is the reconsidered determination binding?

The reconsidered determination is binding unless:

1. You or any other party to the reconsideration requests a hearing before an ALJ within the stated time period and a decision is made;

2. The expedited appeals process (see §2000.3 and §2001) is used; or

3. The reconsidered determination is revised.

Last Revised: Nov. 29, 2004