POMS Reference

GN 04010: Reopening Within 4 Years (Title II and Entitlement Under Title XVIII)

TN 4 (09-92)

A. DEFINITION

SSA considers a “clerical error” to mean a mistake that was made by SSA, not one that was made by another agency.

EXAMPLE:  If the Bureau of Vital Statistics made a clerical error in information it furnished to us, SSA is not bound by that clerical error since it was made by someone outside of its control.

B. POLICY — TYPES OF CLERICAL ERRORS

There are two types of clerical errors. Those:

  • Subject to the rules of administrative finality (see 1. below);

  • Not subject to the rules of administrative finality, called “administrative” errors (see 2. below).

For both types of clerical errors, an error made by a computer is treated the same as an error made by a human being.

IMPORTANT:  If folder documentation is not clear as to whether the clerical error was part of the initial determination, as in 1. below, or was the type of error referred to in 2. below, consider the action an initial determination and, therefore, subject to the rules of administrative finality.

1. Clerical Errors Subject to the Rules of Administrative Finality

A determination or decision may be reopened within 4 years of the date of notice of initial determination if the determination or decision contained an error in the computation of the benefit or LSDP (e.g., mathematical error, misapplication of benefit tables, etc.) which resulted in an incorrect payment favorable to the claimant.

If the incorrect payment was unfavorable to the claimant, then the determination or decision may be reopened at any time (see
GN 04020.080).

EXAMPLE:  The CA makes an addition error in computing the PIA, so the benefit amount he puts on the award form is incorrect. The BA pays the amount which is shown on the award form.

In this situation, within 4 years of the date of the notice of the initial determination of the PIA and benefit amount, both can be recomputed to correct the error whether favorable or unfavorable to the claimant.

After 4 years, the PIA and benefit amount can be recomputed to correct the error only if it was unfavorable to the claimant; i.e., the error caused the claimant to receive less money.

2. Administra tive Errors Not Subject to the Rules of Administrative Finality

Any clerical error which occurs in the processing of the determination or decision after the person with authority has adjudicated it is considered an administrative error and can be corrected at any time.

EXAMPLE 1:  The CA correctly computes the PIA and benefit amount and puts the correct amounts on the award form. However, the BA “clerically” pays the wrong amount; e.g., inadvertently substitutes a 1 for a 2. This type of error can be corrected at any time, whether it was favorable or unfavorable to the claimant, since the initial determination (made by the CA) was correct.

EXAMPLE 2:  The CA made an incorrect initial determination and awarded a RIB of $106.50; the correct rate should have been $98.50. In processing the award, the BA incorrectly paid a monthly rate of $102.50. Since the action taken by the CA was an initial determination, it can only be reopened and the $106.50 changed to $98.50 if the rules of administrative finality permit. However, since the action taken by the BA is not an initial determination, the $102.50 benefit amount can be changed whenever we discover it. If both errors are discovered after 4 years, there is no basis under the rules of administrative finality for reopening the CA's initial determination. Therefore, $106.50 is the benefit amount we are legally required to pay. We can increase the $102.50 paid by the BA to $106.50 effective with the first month of entitlement. This principle applies regardless of whether the notice showed a correct or incorrect amount payable.