When your Social Security or SSI claim has been denied, access here the necessary forms for filing reconsideration, hearing, and Appeals Council appeals.

The base forms used to file appeals are the SSA-561-U2 Request for Reconsideration (usually the first appeal), the HA-501-U5 Request for Hearing (usually second appeal, when your claim has been denied twice) and the HA 520-U5 for an Appeals Council review of a hearing denial. If you have been receiving benefits and your claim has been closed because it has been determined you are no longer disabled as defined by Social Security law, the appeal form for first appeal is the SSA-789-U4. (The appeal will be a hearing within the Disability Determination Services (DDS) instead of only a DDS file review.)

Submit an SSA-827 with all appeals to re-authorize SSA to gather information to process your appeal. Use additional forms provided in this grouping to update your medical and vocational information when you file the appeal, to appoint an attorney or non-attorney representative, or to request a change of hearing date or location. We recommend, if you have a representative, that you discuss the pros and cons of requesting a change of hearing date before taking that action.

Please click on the link below to open your desired form in a separate browser window. You can then download the form from Benefits.com directly to your computer.

SSA-561-U2 Request for Reconsideration

HA-501-U5 Request for Hearing by Administrative Law Judge

HA-520-U5 Request for Review of Hearing Decision/Order (Appeals Council review)

SSA-769-U4 Request for Change in Time/Place of Disability Hearing

SSA-827 Authorization to Disclose Information to the Social Security Administration

SSA-789 Request for Reconsideration – Disability Cessation

SSA-1696-U4 Appointment of Representative

SA-3441-BK Disability Report – Appeal

Use to submit additional or updated medical information for reconsideration appeal

HA-4631 Claimant’s Recent Medical Treatment

To submit additional or updated information for a hearing

HA-4632 Claimant’s Medications

To submit additional or updated medication information for a hearing

HA-4633 Claimant’s Work Background

To submit additional or updated work activity or information about work for a hearing