Get SSA SSA-561-U2 Form

Get SSA SSA-561-U2 Form

The SSA SSA-561-U2 form is a request for reconsideration of a Social Security Administration (SSA) decision regarding benefits. This form allows individuals to appeal decisions they believe are incorrect, ensuring their voices are heard in the benefits determination process. To take the next step in appealing your decision, consider filling out the form by clicking the button below.

Structure

The SSA SSA-561-U2 form plays a crucial role in the Social Security Administration's process for individuals seeking to appeal decisions regarding their benefits. This form is specifically designed for those who have received a notice of unfavorable decision regarding their Social Security benefits, such as disability or retirement claims. By completing the SSA-561-U2, individuals can formally request a reconsideration of the decision made by the Social Security Administration. The form requires personal information, details about the original decision, and the reasons for the appeal. It is essential for applicants to provide accurate and thorough information to support their case. Understanding the nuances of this form can significantly impact the outcome of an appeal, making it vital for individuals to approach the process with care and attention to detail. Additionally, timely submission of the SSA-561-U2 is critical, as there are strict deadlines for appeals. Overall, this form serves as a key tool for individuals seeking to navigate the complexities of Social Security appeals and secure the benefits they believe they are entitled to.

SSA SSA-561-U2 Preview

Form SSA-561 (08-2025) UF

 

Page 1 of 3

Discontinue Prior Editions

 

 

 

OMB No. 0960-0622

Social Security Administration

REQUEST FOR RECONSIDERATION

NAME OF CLAIMANT:

CLAIMANT SSN:

CLAIM NUMBER: (If different than SSN)

ISSUE BEING APPEALED: (Specify if retirement, disability, hospital or medical, SSI, SVB, overpayment, etc.) I do not agree with the Social Security Administration's (SSA) determination and request reconsideration.

My reasons are:

CONTACT INFORMATION

CLAIMANT SIGNATURE - OPTIONAL:

 

NAME OF CLAIMANT'S REPRESENTATIVE: (If any)

 

 

 

 

 

 

MAILING ADDRESS:

 

 

MAILING ADDRESS:

 

 

 

 

 

 

 

 

 

CITY:

STATE:

ZIP CODE:

CITY:

STATE:

ZIP CODE:

 

 

 

 

 

 

TELEPHONE NUMBER:

DATE:

 

TELEPHONE NUMBER:

DATE:

 

(Include area code)

 

 

(Include area code)

 

 

 

SUPPLEMENTAL SECURITY INCOME (SSI) OR SPECIAL VETERANS BENEFITS (SVB)

RECONSIDERATION ONLY

THREE WAYS TO APPEAL

I want to appeal your determination about my claim for SSI or SVB. I have read about the three ways to appeal. I have checked the box below:

CASE REVIEW - You can pick this kind of appeal in all cases. You can give us more facts to add to your file. Then we will decide your case again. You do not meet with the person who decides your case.

INFORMAL CONFERENCE - You can pick this kind of appeal in all SSI cases except for medical issues. In SVB cases, you can pick this kind of appeal only if we are stopping or lowering your SVB payment. You will meet with a person who will decide your case. You can tell that person why you think you are right. You can give us more facts to help prove you are right. You can bring other people to help explain your case.

FORMAL CONFERENCE - You can pick this kind of appeal only if we are stopping or lowering your SSI or SVB payment. This meeting is like an informal conference, but we can also get people to come in and help prove you are right. We can do this even if they do not want to help you. You can question these people at your meeting.

TO BE COMPLETED BY SOCIAL SECURITY ADMINISTRATION

1. HAS INITIAL DETERMINATION

Yes

No

FIELD OFFICE DEVELOPMENT (GN 03102.300)

BEEN MADE?

 

 

NO FURTHER DEVELOPMENT REQUIRED

2. IS THIS REQUEST FILED TIMELY?

Yes

No

REQUIRED DEVELOPMENT ATTACHED

(If "NO", attach claimant's explanation for delay.

 

 

REQUIRED DEVELOPMENT PENDING, WILL

Refer to GN 03101.020)

 

 

FORWARD OR ADVISE STATUS WITHIN 30 DAYS

SOCIAL SECURITY OFFICE ADDRESS AND DATE

 

SSI CASES ONLY - GOLDBERG KELLY (GK)

APPEAL RECEIVED:

 

 

(SI 02301.310) RECIPIENT APPEALED AN ADVERSE

 

 

 

ACTION:

 

 

 

WITHIN 10 DAYS AFTER RECEIVING THE

 

 

 

ADVANCE NOTICE;

 

 

 

AFTER THE 10-DAY PERIOD AND GOOD CAUSE

 

 

 

EXISTS FOR EXTENDING THE TIME LIMIT

 

 

 

PAYMENT CONTINUATION APPLIES AND INPUT

 

 

 

MADE TO SYSTEM

NOTE: Take or mail the completed original to your local Social Security office, the Veterans Affairs Regional Office in Manila, or any U.S. Foreign Service post and keep a copy for your records.

Form SSA-561 (08-2025) UF

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ADMINISTRATIVE ACTIONS THAT ARE INITIAL DETERMINATIONS

(See GN03101.070, GN03101.080, and SI04010.010)

NOTE: These lists cover the vast majority of administrative actions that are initial determinations. However, they are not all inclusive.

Title II

1.Entitlement or continuing entitlement to benefits;

2.Reentitlement to benefits;

3.The amount of benefit;

4.A recomputation of benefit;

5.A reduction in disability benefits because benefits under a worker's compensation law were also received;

6.A deduction from benefits on account of work;

7.A deduction from disability benefits because of claimant's refusal to accept rehabilitation services;

8.Termination of benefits;

9.Penalty deductions imposed because of failure to report certain events;

10.Any overpayment or underpayment of benefits;

11.Whether an overpayment of benefits must be repaid;

12.How an underpayment of benefits due a deceased person will be paid;

13.The establishment or termination of a period of disability;

14.A revision of an earnings record;

15.Whether the payment of benefits will be made, on the claimant's behalf to a representative payee, unless the claimant is under age 18 or legally incompetent;

16.Who will act as the payee if we determine that representative payment will be made;

17.An offset of benefits because the claimant previously received Supplemental Security Income payments for the same period;

18.Whether completion of or continuation for a specified period of time in an appropriate vocational rehabilitation program will significantly increase the likelihood that the claimant will not have to return to the disability benefit rolls and thus, whether the claimant's benefits may be continued even though the claimant is not disabled;

19.Nonpayment of benefits because of claimant's confinement for more than 30 continuous days in a jail, prison, or other correctional institution for conviction of a criminal offense;

20.Nonpayment of benefits because of claimant's confinement for more than 30 continuous days in a mental health institution or other medical facility because a court found the individual was not guilty for reason of insanity; a court found that he/she was incompetent to stand trial or was unable to stand trial for some other similar mental defect; or, a court found that he/she was sexually dangerous.

Title XVI

1.Eligibility for, or the amount of, Supplemental Security Income benefits;

2.Suspension, reduction, or termination of Supplemental Security Income benefits;

3.Whether an overpayment of benefits must be repaid;

4.Whether payments will be made, on claimant's behalf to a representative payee, unless the claimant is under age 18, legally incompetent, or determined to be a drug addict or alcoholic;

5.Who will act as payee if we determine that representative payment will be made;

6.Imposing penalties for failing to report important information;

7.Drug addiction or alcoholism;

8.Whether claimant is eligible for special SSI cash benefits;

9.Whether claimant is eligible for special SSI eligibility status;

10.Claimant's disability; and

11.Whether completion of or continuation for a specified period of time in an appropriate vocational rehabilitation program will significantly increase the likelihood that claimant will not have to return to the disability benefit rolls and thus, whether claimant's benefits may be continued even though he or she is not disabled.

NOTE: Every redetermination which gives an individual the right of further review constitutes an initial determination.

Title VIII (See VB 02501.035)

1.Meeting or failing to meet the qualifying and/or entitlement factors for special veterans benefits (SVB);

2.Reduction, suspension or termination of SVB payments;

3.Applicability of a disqualifying event prior to SVB entitlement;

4.Administrative actions in SVB cases similar to those listed under Title II-items 3, 4, 10, 11 & 16.

Title XVIII

1.Entitlement to hospital insurance benefits and to enrollment for supplementary medical insurance benefits;

2.Disallowance (including denial of application for HIB and denial of application for enrollment for SMIB);

3.Termination of benefits (including termination of entitlement to HI and SMI).

4.Initial determinations regarding Medicare Part B income-related premium subsidy reductions.

Form SSA-561 (08-2025) UF

Page 3 of 3

HOW TO APPEAL YOUR SUPPLEMENTAL SECURITY INCOME (SSI)

OR SPECIAL VETERANS BENEFIT (SVB) DECISION

Now that you picked the kind of appeal that fits your case, fill out this form or we'll help you fill it out. You can have a lawyer, friend, or someone else help you with your appeal. There are groups that can help you with your appeal. Some can give you a free lawyer. We can give you the names of these groups.

NOTE: DON'T FILL OUT THIS FORM IF WE SAID WE'LL STOP YOUR DISABILITY CHECK FOR MEDICAL REASONS OR BECAUSE YOU'RE NO LONGER BLIND. WE'LL GIVE YOU THE RIGHT FORM (SSA-789) FOR YOUR APPEAL.

The information on this form is authorized by regulation (20 CFR 404.907 - 404.921 and 416.1407 - 416.1421) and Public Law 106-169 (section 809(a)(1) of section 251(a)). While your response to these questions is voluntary, the Social Security Administration cannot reconsider the decision on this claim unless the information is furnished.

Privacy Act Statement

Collection and Use of Personal Information

Sections 205, 702(a)(5), 809, 1631, 1633, and 1869(b) of the Social Security Act, as amended, allow us to collect this information. Furnishing us this information is voluntary. However, failing to provide all or part of the information may prevent us from re-evaluating the decision on your claim.

We will use the information to determine your eligibility for benefits and administer our programs. We may also share your information for the following purposes, called routine uses:

To third party contacts in situations where the party to be contacted has, or is expected to have, information relating to the individual’s capability to manage his/her affairs or his/her eligibility for or entitlement to benefits under the Social Security program; and

To the Center for Medicare & Medicaid Services (CMS), for the purpose of administering Medicare Part A, Part B, Medicare Advantage Part C, and Medicare Part D, including but not limited to: Medicare Part C enrollment and premium collection processes; Part D enrollment and premium collection processes; Medicare Part B premium reduction based on participation in a Part C plan; and Medicare Part B enrollment and income-related monthly adjustment amount determinations, appeals of determinations, and premium collections.

In addition, we may share this information in accordance with the Privacy Act and other Federal laws. For example, where authorized, we may use and disclose this information in computer matching programs, in which our records are compared with other records to establish or verify a person’s eligibility for Federal benefit programs and for repayment of incorrect or delinquent debts under these programs.

A list of additional routine uses is available in our Privacy Act System of Records Notices (SORN) 60-0089, entitled Claims Folder System, as published in the Federal Register (FR) on April 1, 2003, at 68 FR 15784 and 60-0321, entitled Medicare Database File, as published in the FR on July 25, 2006, at 71 FR 42159. Additional information, and a full listing of all of our SORNs, is available on our website at www.ssa.gov/privacy/.

Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget control number. We estimate that it will take about 8 minutes to read the instructions, gather the facts, and answer the questions. SEND OR BRING THE COMPLETED FORM TO YOUR LOCAL SOCIAL SECURITY OFFICE. You can find your local Social Security office through SSA’s website at www.socialsecurity.gov. Offices are also listed under U. S. Government agencies in your telephone directory or you may call Social Security at 1-800-772-1213 (TTY 1-800-325-0778). You may send comments on our time estimate above to: SSA, 6401 Security Blvd, Baltimore, MD 21235-6401. Send only comments relating to

our time estimate to this address, not the completed form.

Document Data

Fact Name Details
Purpose The SSA-561-U2 form is used to request a reconsideration of a Social Security Administration (SSA) decision.
Who Can Use It? Anyone who disagrees with a decision made by the SSA regarding disability benefits or other claims can use this form.
Filing Deadline You must file the SSA-561-U2 form within 60 days of receiving the notice of the decision you wish to appeal.
How to Submit The form can be submitted online, by mail, or in person at your local SSA office.
Information Required You will need to provide personal information, details about the decision, and any additional evidence supporting your case.
State-Specific Forms Some states may have additional requirements or forms. Check local SSA offices for state-specific information.
Processing Time It typically takes a few months for the SSA to process the reconsideration request and issue a decision.
Legal Basis The SSA-561-U2 form is governed by federal law under the Social Security Act, Title II and Title XVI.

How to Use SSA SSA-561-U2

After obtaining the SSA-561-U2 form, you will need to provide specific information to complete it accurately. This form is used for appealing a decision made by the Social Security Administration. Once the form is filled out, it should be submitted according to the instructions provided by the SSA.

  1. Begin by entering your personal information at the top of the form. This includes your name, Social Security number, and contact information.
  2. In the next section, provide details about the decision you are appealing. Include the date of the decision and any reference numbers associated with it.
  3. Clearly state the reasons for your appeal. Be concise but thorough in explaining why you believe the decision should be reconsidered.
  4. If applicable, list any additional evidence or documents you are submitting with the appeal. This could include medical records or other relevant information.
  5. Review the completed form for accuracy. Ensure all sections are filled out and that there are no errors in your personal information.
  6. Sign and date the form at the designated area. Your signature is necessary to validate the appeal.
  7. Make a copy of the completed form and any supporting documents for your records before submitting.
  8. Submit the form and any attachments to the address specified in the SSA instructions. Ensure you send it via a method that provides tracking, if possible.

Key Facts about SSA SSA-561-U2

What is the SSA SSA-561-U2 form?

The SSA SSA-561-U2 form is a request for reconsideration of a Social Security Administration (SSA) decision. Individuals use this form when they disagree with a decision made by the SSA regarding their benefits, such as Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). By submitting this form, claimants can formally ask the SSA to review and potentially change its previous decision.

Who should use the SSA SSA-561-U2 form?

This form is intended for individuals who have received a notice of denial for their Social Security benefits. If you believe that the SSA has made an error in its decision or if you have new information that supports your claim, you should consider using the SSA-561-U2 form. It is important to act promptly, as there are deadlines for filing a request for reconsideration.

How do I fill out the SSA SSA-561-U2 form?

To complete the SSA-561-U2 form, provide accurate personal information, including your name, Social Security number, and contact details. Clearly state the reasons for your disagreement with the SSA's decision. If you have new evidence or documentation, include that information as well. Ensure that you sign and date the form before submitting it to the SSA, as an unsigned form may delay the review process.

What happens after I submit the SSA SSA-561-U2 form?

After submitting the SSA-561-U2 form, the SSA will review your request for reconsideration. This process may take several weeks. During this time, the SSA may contact you for additional information or clarification. Once the review is complete, you will receive a written notice informing you of the decision. If the SSA upholds its original decision, you have the option to appeal further by requesting a hearing before an administrative law judge.

Common mistakes

When filling out the SSA-561-U2 form, which is used to request reconsideration of a Social Security decision, many people inadvertently make mistakes that can delay their case. Understanding these common pitfalls can help ensure a smoother process.

One frequent error is not providing enough detail in the explanation section. When explaining why you disagree with the decision, it’s crucial to be as specific as possible. Simply stating that you disagree isn’t sufficient. Instead, include relevant facts and evidence that support your claim. This helps the reviewer understand your perspective better.

Another mistake is failing to sign and date the form. It may seem like a minor detail, but without your signature, the SSA cannot process your request. Always double-check that you’ve signed and dated the form before submitting it.

Some individuals also overlook the importance of submitting the form within the designated time frame. The SSA typically requires that you file for reconsideration within 60 days of receiving the initial decision. Missing this deadline can result in having to start the process all over again.

Inaccurate personal information is another common issue. Ensure that your name, Social Security number, and other identifying details are correct. Even a small typo can lead to confusion and delays in processing your request.

People often forget to include supporting documents. If you have additional evidence that strengthens your case, such as medical records or letters from doctors, include those with your SSA-561-U2 form. This documentation can significantly impact the outcome of your reconsideration.

Moreover, neglecting to keep a copy of the completed form for your records can be a costly mistake. Always make a copy before sending it off. This way, you have a reference point if any questions arise later.

Lastly, some individuals submit the form without reviewing it thoroughly. Taking the time to read through your answers can help catch errors or omissions that could hinder your case. A careful review can make a significant difference in the outcome.

Documents used along the form

The SSA-561-U2 form is essential for individuals seeking to appeal a decision made by the Social Security Administration (SSA) regarding their benefits. However, there are several other forms and documents that may be necessary to support your appeal or provide additional information. Here’s a list of some commonly used documents that often accompany the SSA-561-U2 form.

  • SSA-827: This form is used to authorize the SSA to obtain medical records and other information from your healthcare providers. It helps ensure that the SSA has all the necessary documentation to evaluate your case.
  • SSA-3368: The Adult Disability Report collects detailed information about your medical conditions, work history, and daily activities. This form is crucial for establishing your eligibility for benefits.
  • SSA-3373: This form, known as the Function Report, asks about how your disability affects your daily life. It provides insight into your limitations and helps the SSA understand your situation better.
  • SSA-4164: This form is a Request for Reconsideration. If you are appealing a decision, this document formally requests that the SSA review their previous determination.
  • Medical Records: These documents from your healthcare providers offer evidence of your medical conditions and treatments. They are vital for substantiating your claim.
  • Work History Report: This report details your employment history, including job titles, duties, and dates of employment. It helps the SSA assess your ability to work.
  • Income Statements: Documentation of your income, including pay stubs or tax returns, can support your financial need for benefits.
  • Personal Statements: A personal statement from you or someone who knows you well can provide additional context about your disability and its impact on your life.
  • Witness Statements: Statements from friends, family, or coworkers can also be helpful. They can describe how your condition affects your daily activities and interactions.

Each of these documents plays a significant role in strengthening your appeal. By providing thorough and accurate information, you can help the SSA make a more informed decision about your case. Always ensure that you keep copies of everything you submit, as this will help you track your appeal process effectively.

Similar forms

The SSA SSA-561-U2 form, used for requesting a reconsideration of a Social Security Administration (SSA) decision, shares similarities with several other documents related to appeals and claims processes. Below is a list of ten documents that exhibit comparable characteristics and purposes.

  • SSA-3441: This form is used to appeal a decision regarding Social Security disability benefits. Like the SSA-561-U2, it allows individuals to present additional evidence and request a review of their case.
  • SSA-827: This document authorizes the SSA to obtain medical records from healthcare providers. Similar to the SSA-561-U2, it is often necessary for supporting an appeal or claim.
  • SSA-3368: This form collects information about a claimant's work history and medical conditions. It serves a similar function in gathering pertinent information for reconsideration requests.
  • Form 1040: While primarily a tax form, it can be relevant for SSA claims, especially when income or financial status is in question. Both forms require accurate reporting of personal information for decision-making.
  • Form 1099: This tax document reports income from various sources, including Social Security benefits. It may be used in appeals to clarify financial situations, akin to the SSA-561-U2's role in reevaluating claims.
  • SSA-5000: This is a request for a copy of Social Security records. Similar to the SSA-561-U2, it facilitates the process of gathering information necessary for an appeal or reconsideration.
  • Form SSA-2: This application for Social Security benefits requires detailed information about the claimant. It parallels the SSA-561-U2 in its focus on providing necessary details for the SSA’s review process.
  • Form SSA-4: This application for Social Security benefits can be similar in function when appealing a denied claim, as it requests essential information for the SSA’s consideration.
  • SSA-21: This form is used to report changes in income or living arrangements, which can affect eligibility. It shares the SSA-561-U2’s goal of ensuring accurate information is available for reconsideration.
  • Form SSA-16: This application for disability insurance benefits requires comprehensive details about the claimant's situation. Like the SSA-561-U2, it plays a critical role in the decision-making process regarding benefits.

Dos and Don'ts

When filling out the SSA-561-U2 form, it's important to follow certain guidelines to ensure your application is processed smoothly. Here are five things you should and shouldn't do:

  • Do read the instructions carefully before starting the form.
  • Don't leave any required fields blank; incomplete forms can delay processing.
  • Do provide accurate and truthful information to avoid complications.
  • Don't use abbreviations or jargon that may confuse the reviewers.
  • Do double-check your contact information to ensure the SSA can reach you.

By following these tips, you can help facilitate a smoother experience when submitting your form.

Misconceptions

When it comes to the SSA SSA-561-U2 form, there are several misconceptions that can lead to confusion. Here’s a list of nine common misunderstandings, along with clarifications to help you navigate the process more effectively.

  1. It’s only for people who are denied benefits.

    Many believe that the SSA-561-U2 form is exclusively for those who have been denied Social Security benefits. In reality, it can also be used to appeal other unfavorable decisions regarding your Social Security claim.

  2. You must file the form immediately after a denial.

    While there are deadlines for filing an appeal, you don’t have to submit the SSA-561-U2 form the very next day after receiving a denial. You typically have 60 days from the date you receive the notice to file your appeal.

  3. Filing the form guarantees a reversal of the decision.

    Submitting the SSA-561-U2 form does not automatically mean your case will be reviewed favorably. Each appeal is assessed on its own merits, and many factors influence the outcome.

  4. You need a lawyer to fill out the form.

    While having legal assistance can be beneficial, it is not a requirement. Many individuals successfully complete the form on their own, especially if they understand their case and the reasons for the denial.

  5. All appeals are handled in the same way.

    Each appeal may follow a different process depending on the specifics of the case. The SSA has various levels of appeal, and the SSA-561-U2 form is just the first step in that process.

  6. You can’t provide additional evidence.

    Some people think that the SSA-561-U2 form only allows for a simple explanation of why they disagree with the decision. In fact, you can and should include any new evidence or information that supports your case.

  7. The form is only for disability claims.

    While the SSA-561-U2 is often associated with disability claims, it can also be used for appeals related to retirement, survivor, or other Social Security benefits.

  8. You have to submit the form in person.

    Many people believe that they must deliver the SSA-561-U2 form in person at a Social Security office. However, you can submit it by mail or online, depending on your circumstances.

  9. Once submitted, you will hear back immediately.

    It’s a common misconception that you will receive a quick response after submitting the SSA-561-U2 form. The review process can take time, and it’s important to be patient while waiting for a decision.

Understanding these misconceptions can help you approach the SSA-561-U2 form with greater confidence. Always ensure you have the most accurate and up-to-date information when navigating your Social Security appeals.

Key takeaways

The SSA SSA-561-U2 form is essential for individuals seeking to appeal a decision made by the Social Security Administration (SSA) regarding their benefits. Here are some key takeaways to consider when filling out and using this form:

  • Understand the Purpose: The SSA-561-U2 form is specifically designed for appealing a decision that affects your Social Security benefits. Familiarize yourself with the reasons for your appeal before completing the form.
  • Provide Accurate Information: Ensure that all personal information, including your Social Security number and contact details, is accurate. Inaccuracies can delay the processing of your appeal.
  • Include Supporting Documentation: Attach any relevant documents that support your case. This could include medical records, employment history, or any other evidence that may strengthen your appeal.
  • Submit on Time: Pay close attention to deadlines. You must submit the SSA-561-U2 form within the time frame specified in the decision notice you received from the SSA to ensure your appeal is considered.