TN 25 (02-95)

NL 00804.224 Appeal Language

1701. Situation Where Used:

OBSOLETE

Use on Notice of Award (SSA-L8025), Notice of Disapproved Claim (SSA-L8030) and Notice of Change in Payment (SSA-L8151).

 

DO YOU THINK WE'RE WRONG?

If you think we're wrong, you have the right to appeal. We'll correct mistakes. We'll look at any new facts you have.

 

  • You have 60 days to ask for an appeal.

     

  • The 60 days start the day after you get this letter.

     

  • You'll have to have a good reason for waiting more than 60 days.

     

  • To appeal, you must fill out a form called “Request for Reconsideration.” The form number is SSA-561. To get this form, contact one of our offices. We'll help you fill out the form.

     

HOW TO APPEAL

There are two ways to appeal. You can pick the one you want. If you meet with us in person, it may help us decide your case.

 

  • Case Review.You have a right to review the facts in your file. You can give us more facts to add to your file. Then we'll decide your case again. You won't meet with the person who decides your case. This is the only kind of appeal you can have to appeal a medical decision.

     

  • Informal Conference.You'll meet with the person who decides your case. You can tell that person why you think you're right. You can give us more facts to help prove you're right. You can bring other people to help explain your case.

     

IF YOU WANT HELP WITH YOUR APPEAL

You may want help from a friend, lawyer or someone else. There are groups that can find you a lawyer. Some can give you a free lawyer. We can give you the names of these groups.

 

2550. Situation Where Used:

Use on Notice of Change in Payment (SSA-L8100).

 

DO YOU THINK WE'RE WRONG?

If you think we're wrong, you have the right to appeal. A person who hasn't seen your case will look at it. That person will be an Administrative Law Judge. In the rest of our letter we'll call this person an ALJ. The ALJ will correct mistakes and look at any new facts you have before deciding your case. We call this a hearing.

 

You have 60 days to ask for a hearing.

 

The 60 days start the day after you get this letter.

 

You'll have to have a good reason for waiting more than 60 days to ask for a hearing.

 

You have to ask for an appeal in writing. We'll ask you to sign an SSA form HA-501, called “Request for Hearing.” Contact one of our offices if you want help.

 

HOW A HEARING WORKS

A hearing works like this.

 

The ALJ will tell you the time and place for the hearing.

 

The ALJ will explain the law in your case. The ALJ will state the known facts and tell you what has to be decided.

 

You can tell the ALJ why you think we're wrong. You can give the ALJ more facts. And you can bring people to say why you're right.

 

The ALJ can make people come to your hearing and bring important papers. You can question these people at your hearing.

 

We'll ask if you want to go to the hearing in person. If you say you want to go, you should attend if at all possible. If you change your mind or if you can't get to the hearing, you should tell us. You should know that your being there may help the ALJ decide your case.

 

IF YOU WANT HELP WITH YOUR HEARING

You may want help from a friend, lawyer or someone else. There are groups that can find you a lawyer. Some can give you a free lawyer. We can give you the names of these groups.

 

2551. Situation Where Used:

Use on Notice of Planned Action (SSA-L8155).

 

DO YOU THINK WE'RE WRONG?

If you think we're wrong, you have the right to appeal. We'll correct mistakes. We'll look at any new facts you have.

 

You have 60 days to ask for an appeal.

 

The 60 days start the day after you get this letter.

 

You'll have to have a good reason for waiting more than 60 days.

 

To appeal, you must fill out a form called “Request for Reconsideration.” The form number is SSA-561. To get this form, contact one of our offices. We can help you fill out the form.

 

APPEAL IN 10 DAYS TO KEEP GETTING YOUR SAME CHECKS

 

We won't change your check if you appeal within 10 days.

 

The 10 days start the day after you get this letter.

 

If you lose your appeal, you might have to pay back some or all of this money.

 

HOW TO APPEAL

There are three ways to appeal. You can pick the one you want. If you meet with us in person, it may help us decide your case