---
kind: "range"
citation: "20 C.F.R. §§ 404.907–404.922"
title: "20"
from: "404.907"
to: "404.922"
count: 14
url: "https://uscodex.org/cfr/20/404.907..404.922"
---

# §404.907. Reconsideration—general.


If you are dissatisfied with the initial determination, reconsideration is the first step in the administrative review process that we provide, except that we provide the opportunity for a hearing before an administrative law judge as the first step for those situations described in §§ [404.930 (a)(6)](/cfr/20/404.930.md?p=a-6) and [(a)(7)](/cfr/20/404.930.md?p=a-7), where you appeal an initial determination denying your request for waiver of adjustment or recovery of an overpayment (see [§ 404.506](/cfr/20/404.506.md)). If you are dissatisfied with our reconsidered determination, you may request a hearing before an administrative law judge.


# §404.908. Parties to a reconsideration.

- (a) **Who may request a reconsideration.** If you are dissatisfied with the initial determination, you may request that we reconsider it. In addition, a person who shows in writing that his or her rights may be adversely affected by the initial determination may request a reconsideration.
- (b) **Who are parties to a reconsideration.** After a request for the reconsideration, you and any person who shows in writing that his or her rights are adversely affected by the initial determination will be parties to the reconsideration.

# §404.909. How to request reconsideration.

- (a) We shall reconsider an initial determination if you or any other party to the reconsideration files a written request—
  - (1) Within 60 days after the date you receive notice of the initial determination (or within the extended time period if we extend the time as provided in [paragraph (b)](#b) of this section);
  - (2) At one of our offices, the Veterans Administration Regional Office in the Philippines, or an office of the Railroad Retirement Board if you have 10 or more years of service in the railroad industry.
- (b) **Extension of time to request a reconsideration.** If you want a reconsideration of the initial determination but do not request one in time, you may ask us for more time to request a reconsideration. Your request for an extension of time must be in writing and must give the reasons why the request for reconsideration was not filed within the stated time period. If you show us that you had good cause for missing the deadline, we will extend the time period. To determine whether good cause exists, we use the standards explained in [§ 404.911](/cfr/20/404.911.md).

# §404.911. Good cause for missing the deadline to request review.

- (a) In determining whether you have shown that you had good cause for missing a deadline to request review we consider—
  - (1) What circumstances kept you from making the request on time;
  - (2) Whether our action misled you;
  - (3) Whether you did not understand the requirements of the Act resulting from amendments to the Act, other legislation, or court decisions; and
  - (4) Whether you had any physical, mental, educational, or linguistic limitations (including any lack of facility with the English language) which prevented you from filing a timely request or from understanding or knowing about the need to file a timely request for review.
- (b) Examples of circumstances where good cause may exist include, but are not limited to, the following situations:
  - (1) You were seriously ill and were prevented from contacting us in person, in writing, or through a friend, relative, or other person.
  - (2) **There was a death or serious illness in your immediate family.**
  - (3) **Important records were destroyed or damaged by fire or other accidental cause.**
  - (4) You were trying very hard to find necessary information to support your claim but did not find the information within the stated time periods.
  - (5) You asked us for additional information explaining our action within the time limit, and within 60 days of receiving the explanation you requested reconsideration or a hearing, or within 30 days of receiving the explanation you requested Appeal Council review or filed a civil suit.
  - (6) We gave you incorrect or incomplete information about when and how to request administrative review or to file a civil suit.
  - (7) **You did not receive notice of the determination or decision.**
  - (8) You sent the request to another Government agency in good faith within the time limit and the request did not reach us until after the time period had expired.
  - (9) Unusual or unavoidable circumstances exist, including the circumstances described in [paragraph (a)(4)](#a-4) of this section, which show that you could not have known of the need to file timely, or which prevented you from filing timely.

# §404.913. Reconsideration procedures.

- (a) **Case review.** With the exception of the type of case described in [paragraph (b)](#b) of this section, the reconsideration process consists of a case review. Under a case review procedure, we will give you and the other parties to the reconsideration an opportunity to present additional evidence to us. The official who reviews your case will then make a reconsidered determination based on all of this evidence.
- (b) **Disability hearing.** If you have been receiving benefits based on disability and you request reconsideration of an initial or revised determination that, based on medical factors, you are not now disabled, we will give you and the other parties to the reconsideration an opportunity for a disability hearing. (See [§§ 404.914 through 404.918](/cfr/20/404.914..404.918.md).)

# §404.914. Disability hearing—general.

- (a) **Availability.** We will provide you with an opportunity for a disability hearing if:
  - (1) You have been receiving benefits based on a medical impairment that renders you disabled;
  - (2) We have made an initial or revised determination based on medical factors that you are not now disabled because your impairment:
    - (i) Has ceased;
    - (ii) Did not exist; or
    - (iii) Is no longer disabling; and
  - (3) **You make a timely request for reconsideration of the initial or revised determination.**
- (b) **Scope.** The disability hearing will address only the initial or revised determination, based on medical factors, that you are not now disabled. Any other issues which arise in connection with your request for reconsideration will be reviewed in accordance with the reconsideration procedures described in [§ 404.913(a)](/cfr/20/404.913.md?p=a).
- (c) **Time and place—**
  - (1) **General.** Either the State agency or the Associate Commissioner for Disability Determinations or his or her delegate, as appropriate, will set the time and place of your disability hearing. We will send you a notice of the time and place of your disability hearing at least 20 days before the date of the hearing. You may be expected to travel to your disability hearing. (See [§§ 404.999a-404.999d](/cfr/20/404.999a-404.999d.md) regarding reimbursement for travel expenses.)
  - (2) **Change of time or place.** If you are unable to travel or have some other reason why you cannot attend your disability hearing at the scheduled time or place, you should request at the earliest possible date that the time or place of your hearing be changed. We will change the time or place if there is good cause for doing so under the standards in § [404.936 (c)](/cfr/20/404.936.md?p=c) and [(d)](/cfr/20/404.936.md?p=d).
- (d) **Combined issues.** If a disability hearing is available to you under [paragraph (a)](#a) of this section, and you file a new application for benefits while your request for reconsideration is still pending, we may combine the issues on both claims for the purpose of the disability hearing and issue a combined initial/reconsidered determination which is binding with respect to the common issues on both claims.
- (e) **Definition.** For purposes of the provisions regarding disability hearings ([§§ 404.914 through 404.918](/cfr/20/404.914..404.918.md)) we, us or our means the Social Security Administration or the State agency.

# §404.915. Disability hearing—disability hearing officers.

- (a) **General.** Your disability hearing will be conducted by a disability hearing officer who was not involved in making the determination you are appealing. The disability hearing officer will be an experienced disability examiner, regardless of whether he or she is appointed by a State agency or by the Associate Commissioner for Disability Determinations or his or her delegate, as described in paragraphs [(b)](#b) and [(c)](#c) of this section.
- (b) **State agency hearing officers—**
  - (1) **Appointment of State agency hearing officers.** If a State agency made the initial or revised determination that you are appealing, the disability hearing officer who conducts your disability hearing may be appointed by a State agency. If the disability hearing officer is appointed by a State agency, that individual will be employed by an adjudicatory unit of the State agency other than the adjudicatory unit which made the determination you are appealing.
  - (2) **State agency—** defined. For purposes of this subpart, State agency means the adjudicatory component in the State which issues disability determinations.
- (c) **Federal hearing officers.** The disability hearing officer who conducts your disability hearing will be appointed by the Associate Commissioner for Disability Determinations or his or her delegate if:
  - (1) A component of our office other than a State agency made the determination you are appealing; or
  - (2) The State agency does not appoint a disability hearing officer to conduct your disability hearing under [paragraph (b)](#b) of this section.

# §404.916. Disability hearing—procedures.

- (a) **General.** The disability hearing will enable you to introduce evidence and present your views to a disability hearing officer if you are dissatisfied with an initial or revised initial determination, based on medical factors, that you are not now disabled as described in [§ 404.914(a)(2)](/cfr/20/404.914.md?p=a-2).
- (b) **Your procedural rights.** We will advise you that you have the following procedural rights in connection with the disability hearing process:
  - (1) You may request that we assist you in obtaining pertinent evidence for your disability hearing and, if necessary, that we issue a subpoena to compel the production of certain evidence or testimony. We will follow subpoena procedures similar to those described in [§ 404.950(d)](/cfr/20/404.950.md?p=d) for the administrative law judge hearing process;
  - (2) You may have a representative at the hearing appointed under subpart R of this part, or you may represent yourself;
  - (3) You or your representative may review the evidence in your case file, either on the date of your hearing or at an earlier time at your request, and present additional evidence;
  - (4) You may present witnesses and question any witnesses at the hearing;
  - (5) You may waive your right to appear at the hearing. If you do not appear at the hearing, the disability hearing officer will prepare and issue a written reconsidered determination based on the information in your case file.
- (c) **Case preparation.** After you request reconsideration, your case file will be reviewed and prepared for the hearing. This review will be conducted in the component of our office (including a State agency) that made the initial or revised determination, by personnel who were not involved in making the initial or revised determination. Any new evidence you submit in connection with your request for reconsideration will be included in this review. If necessary, further development of the evidence, including arrangements for medical examinations, will be undertaken by this component. After the case file is prepared for the hearing, it will be forwarded by this component to the disability hearing officer for a hearing. If necessary, the case file may be sent back to this component at any time prior to the issuance of the reconsidered determination for additional development. Under [paragraph (d)](#d) of this section, this component has the authority to issue a favorable reconsidered determination at any time in its development process.
- (d) **Favorable reconsideration determination without a hearing.** If all the evidence in your case file supports a finding that you are now disabled, either the component that prepares your case for hearing under [paragraph (c)](#c) or the disability hearing officer will issue a written favorable reconsideration determination, even if a disability hearing has not yet been held.
- (e) **Opportunity to submit additional evidence after the hearing.** At your request, the disability hearing officer may allow up to 15 days after your disability hearing for receipt of evidence which is not available at the hearing, if:
  - (1) The disability hearing officer determines that the evidence has a direct bearing on the outcome of the hearing; and
  - (2) **The evidence could not have been obtained before the hearing.**
- (f) **Opportunity to review and comment on evidence obtained or developed by us after the hearing.** If, for any reason, additional evidence is obtained or developed by us after your disability hearing, and all evidence taken together can be used to support a reconsidered determination that is unfavorable to you with regard to the medical factors of eligibility, we will notify you, in writing, and give you an opportunity to review and comment on the additional evidence. You will be given 10 days from the date you receive our notice to submit your comments (in writing or, in appropriate cases, by telephone), unless there is good cause for granting you additional time, as illustrated by the examples in [§ 404.911(b)](/cfr/20/404.911.md?p=b). Your comments will be considered before a reconsidered determination is issued. If you believe that it is necessary to have further opportunity for a hearing with respect to the additional evidence, a supplementary hearing may be scheduled at your request. Otherwise, we will ask for your written comments on the additional evidence, or, in appropriate cases, for your telephone comments.

# §404.917. Disability hearing—disability hearing officer's reconsidered determination.

- (a) **General.** The disability hearing officer who conducts your disability hearing will prepare and will also issue a written reconsidered determination, unless:
  - (1) The disability hearing officer sends the case back for additional development by the component that prepared the case for the hearing, and that component issues a favorable determination, as permitted by [§ 404.916(c)](/cfr/20/404.916.md?p=c);
  - (2) It is determined that you are engaging in substantial gainful activity and that you are therefore not disabled; or
  - (3) The reconsidered determination prepared by the disability hearing officer is reviewed under [§ 404.918](/cfr/20/404.918.md).
- (b) **Content.** The disability hearing officer's reconsidered determination will give the findings of fact and the reasons for the reconsidered determination. The disability hearing officer must base the reconsidered determination on the preponderance of the evidence offered at the disability hearing or otherwise included in your case file.
- (c) **Notice.** We will mail you and the other parties a notice of reconsidered determination in accordance with [§ 404.922](/cfr/20/404.922.md).
- (d) **Effect.** The disability hearing officer's reconsidered determination, or, if it is changed under [§ 404.918](/cfr/20/404.918.md), the reconsidered determination that is issued by the Associate Commissioner for Disability Determinations or his or her delegate, is binding in accordance with [§ 404.921](/cfr/20/404.921.md), subject to the exceptions specified in that section.

# §404.918. Disability hearing—review of the disability hearing officer's reconsidered determination before it is issued.

- (a) **General.** The Associate Commissioner for Disability Determinations or his or her delegate may select a sample of disability hearing officers' reconsidered determinations, before they are issued, and review any such case to determine its correctness on any grounds he or she deems appropriate. The Associate Commissioner or his or her delegate shall review any case within the sample if:
  - (1) There appears to be an abuse of discretion by the hearing officer;
  - (2) There is an error of law; or
  - (3) The action, findings or conclusions of the disability hearing officer are not supported by substantial evidence.
- (b) **Methods of correcting deficiencies in the disability hearing officer's reconsidered determination.** If the reconsidered determination prepared by the disability hearing officer is found by the Associate Commissioner for Disability Determinations or his or her delegate to be deficient, the Associate Commissioner or his or her delegate will take appropriate action to assure that the deficiency is corrected before a reconsidered determination is issued. The action taken by the Associate Commissioner or his or her delegate will take one of two forms:
  - (1) The Associate Commissioner or his or her delegate may return the case file either to the component responsible for preparing the case for hearing or to the disability hearing officer, for appropriate further action; or
  - (2) The Associate Commissioner or his or her delegate may issue a written reconsidered determination which corrects the deficiency.
- (c) **Further action on your case if it is sent back by the Associate Commissioner for Disability Determinations or his or her delegate either to the component that prepared your case for hearing or to the disability hearing officer.** If the Associate Commissioner for Disability Determinations or his or her delegate sends your case back either to the component responsible for preparing the case for hearing or to the disability hearing officer for appropriate further action, as provided in [paragraph (b)(1)](#b-1) of this section, any additional proceedings in your case will be governed by the disability hearing procedures described in [§ 404.916(f)](/cfr/20/404.916.md?p=f) or if your case is returned to the disability hearing officer and an unfavorable determination is indicated, a supplementary hearing may be scheduled for you before a reconsidered determination is reached in your case.
- (d) **Opportunity to comment before the Associate Commissioner for Disability Determinations or his or her delegate issues a reconsidered determination that is unfavorable to you.** If the Associate Commissioner for Disability Determinations or his or her delegate proposes to issue a reconsidered determination as described in [paragraph (b)(2)](#b-2) of this section, and that reconsidered determination is unfavorable to you, he or she will send you a copy of the proposed reconsidered determination with an explanation of the reasons for it, and will give you an opportunity to submit written comments before it is issued. At your request, you will also be given an opportunity to inspect the pertinent materials in your case file, including the reconsidered determination prepared by the disability hearing officer, before submitting your comments. You will be given 10 days from the date you receive the Associate Commissioner's notice of proposed action to submit your written comments, unless additional time is necessary to provide access to the pertinent file materials or there is good cause for providing more time, as illustrated by the examples in [§ 404.911(b)](/cfr/20/404.911.md?p=b). The Associate Commissioner or his or her delegate will consider your comments before taking any further action on your case.

# §404.919. Notice of another person's request for reconsideration.


If any other person files a request for reconsideration of the initial determination in your case, we shall notify you at your last known address before we reconsider the initial determination. We shall also give you an opportunity to present any evidence you think helpful to the reconsidered determination.


# §404.920. Reconsidered determination.


After you or another person requests a reconsideration, we will review the evidence we considered in making the initial determination and any other evidence we receive. We will make our determination based on the preponderance of the evidence.


# §404.921. Effect of a reconsidered determination.


The reconsidered determination is binding unless—

- (a) You or any other party to the reconsideration requests a hearing before an administrative law judge within the stated time period and a decision is made;
- (b) The expedited appeals process is used; or
- (c) **The reconsidered determination is revised.**

# §404.922. Notice of a reconsidered determination.


We shall mail a written notice of the reconsidered determination to the parties at their last known address. We shall state the specific reasons for the determination and tell you and any other parties of the right to a hearing. If it is appropriate, we will also tell you and any other parties how to use the expedited appeals process.