If a letter is received from a claimant asking for a form on which to request a hearing,
the DO will send HA-501-U5 (HA-5011-U6) if a Part A, Hospital Insurance claim is involved).
(If such a letter is received by the PSC, INTPSC, Office of Disability Operations
(ODO) or Office of Central Records Operations (OCRO), they will send it to the DO.)
Include an SSA-1696-U4 for completion if the claimant has a representative and an
SSA-1696-U4 has not already been filed.
As in B. above, the date of receipt of the letter or the mailing date is considered
the date of filing.
The transmittal letter to the claimant or his representative should request the information
set forth in GN 03103.010, and remind the claimant of the requirement that the request be filed within a certain
time frame. If the request for hearing is filed, attach the letter requesting the
form to the ALJ's copy of the HA-501-U5. The DO should also contact the claimant and
explain his right to appear at the hearing per GN 03103.010.