You asked us to take another look at your claim for Social Security (1) benefits. Someone who did not make the first decision reviewed you case, including
any new facts you gave us. After this review, we found that our first decision was
correct.
(Optional)
3474A You are not entitled to benefits because (1) (2) .
On the enclosed form, we discuss the reasons for our decision in more detail.
3474B
Do You Disagree With The Decision?
If you disagree with the decision, you have the right to request a hearing. At the
hearing, a person who has not seen your case before will look at it. That person is
an Administrative Law Judge. The judge will review those parts of the decision which you
disagree with and consider any new facts you have. The judge may also review those
parts which you agree with and may make them unfavorable or less favorable to you.
-
•
You have 60 days to ask for a hearing.
-
•
The 60 days start the day after you receive this letter. We assume you got this letter
5 days after the date on it,
unless you show us that you did not get it within the 5-day period.
-
•
You must have a good reason if you wait more than 60 days to ask for a hearing.
-
•
You have to ask for a hearing in writing. If you want to make a request, please contact
one of our offices. We can help you complete the required form.
Or
3474BF
If you disagree with the decision, you have the right to request a hearing. At the
hearing, a person who has not seen your case before will look at it. That person is
an Administrative Law Judge. The judge will review those parts of the decision you
disagree with and consider any new facts you have. The judge may also review those
parts which you agree with and may make them unfavorable or less favorable to you.
-
•
You have 60 days to ask for a hearing.
-
•
The 60 days start the day after you receive this letter.
-
•
You must have a good reason if you wait more than 60 days to ask for a hearing.
-
•
You can only have a hearing in the United States. You would have to pay any costs
for traveling to the United States for the hearing. If you cannot come to the hearing,
the judge will review your case plus any new information you send us. We will send
you a letter about the judge's decision.
You have to ask for a hearing in writing. Contact us if you want help.
Or
3474C
If you disagree with the decision, you have the right to request a hearing. At the
hearing, a person who has not seen your case before will look at it. That person is
an Administrative Law Judge. The judge will review your case again and consider any
new facts you have.
-
•
You have 60 days to ask for a hearing.
-
•
The 60 days start the day you receive this letter. We assume you got this letter 5
days after the date on it, unless you show us that you did not get it within the
5-day period.
-
•
You must have a good reason if you wait more than 60 days to ask for a hearing.
-
•
You have to ask for a hearing in writing. If you want to make a request, please contact
one of our offices. We can help you complete the required form.
Or
3474D
If you disagree with the decision, you have the right to request a hearing. At the
hearing, a person who has not seen your case before will look at it. That person is
an Administrative Law Judge. The judge will review those parts of the decision you
disagree with and consider any new facts you have. The judge may also review those
parts which you agree with and may make them unfavorable or less favorable to you.
-
•
You have 60 days to ask for a hearing.
-
•
The 60 days start the day after you receive this letter. We assume you got this letter
5 days after the date on it, unless you show us that you did not get it within the
5-day period.
-
•
You must have a good reason if you wait more than 60 days to ask for a hearing.
-
•
You have to ask for a hearing in writing. We will ask you to fill out a Form HA-501,
called “Request for Hearing.” If you want to make a request, please contact one of
our offices. We can help you fill out the form.
Please read the enclosed pamphlet, “You Right to an Administrative Law Judge Hearing
and Appeals Council Review of Your Social Security Case.” It contains more information
about the hearing.
Or
3474E
If you disagree with the decision, you have the right to request a hearing. At the
hearing, a person who has not seen your case before will look at it. That person is
an Administrative Law Judge. The judge will review your case again and consider any
new facts you have.
-
•
You have 60 days to ask for a hearing.
-
•
The 60 days start the day after you receive this letter. We assume you got this letter
5 days after the date on it, unless you show us that you did not get it within the
5-day period.
-
•
You must have a good reason if you wait more than 60 days to ask for hearing.
-
•
You have to ask for a hearing in writing. We will ask you to fill out a Form HA-501,
called “Request for Hearing.” If you want to make a request, please contact one of
our offices. We can help you fill out the form.
Please read the enclosed pamphlet, “Your Right to an Administrative Law Judge Hearing
and Appeals Council Review of Your Social Security Case.” It contains more information
about the hearing.
Or
3474CF
If you disagree with the decision, you have the right to request a hearing. At the
hearing, a person who has not seen your case before will look at it. That person is
an Administrative Law Judge. The judge will review your case again and consider any
new facts you have.
-
•
You have 60 days to ask for a hearing.
-
•
The 60 days start the day after you get this letter.
-
•
You must have a good reason if you wait more than 60 days to ask for a hearing.
-
•
You can only have a hearing in the United States. You would have to pay any costs
for traveling to the United States for the hearing. If you cannot come to the hearing,
the judge will review your case plus any new information you send us. We will send
you a letter about the judge's decision.
-
•
You have to ask for a hearing in writing. Contact us if want help.
(Optional)
If You Want Help With Your Appeal
REPC01 and REP002
(Optional)
New Application
3900A
If You Have Any Questions
3901C - Domestic
3901D - Foreign
Enclosure:
SSA Pub. No 70-102811
Form SSA-662 or Form SSA-1227
1 Omit this enclosure in foreign case.