A beneficiary or the beneficiary’s representative can file a request for reconsideration
within 60 days of receipt of an IRMAA determination notice. “Date Received” means
5 days after the date on the notice unless the individual shows that they did not
receive it within the 5-day period. For information on when to request a reconsideration,
see GN 03102.100C.
For requests received outside of the allowable timeframe, SSA or the Department of
Health and Human Services (DHHS) (for appeals beyond the reconsideration) determines
whether to establish good cause for late filing. For instructions on developing good
cause, see GN 03101.020.
NOTE: A dismissal of a request for an appeal or a new initial determination is not a determination
subject to further administrative or judicial review. A dismissal of a new initial
determination request may be a basis for good cause for late filing of an appeal request.
For the policy on the reconsideration process for IRMAA, see HI 01140.005A.
NOTE: If a beneficiary has a representative payee, the payee can request reconsideration
on the beneficiary’s behalf. When a payee is involved, be sure to check the MBR to
verify the person making the request is the correct representative payee for the beneficiary.
Document the Remarks field on the IRMA (Tax Information) screen with a statement showing
the representative payee's information as follows: representative payee name for beneficiary's name.
The beneficiary, the legal guardian, the parent of a minor child who is a beneficiary,
or the legal executor of the estate of the beneficiary may request an appeal beyond
the reconsideration using the HA-501-U5 (Request for Hearing by Administrative Law
Judge). For the policy on the hearing process for IRMAA, see HI 01140.010A.
See Also:
GN 03910.001 Representation of Claimants – Overview