Ssa Form Ha-501-U5

All forms are FREE. Not all forms are listed. If you can`t find the form you need or need help filling out a form, please call us at 1-800-772-1213 (TTY 1-800-325-0778) or contact your local Social Security office and we`ll help. If you are downloading, printing and filling out a paper form, please mail it or take it to your local social security office or the office that requested it. If you have additional evidence relating to the time elapsed on or before the date of the hearing decision, you must inform it or submit it to the Board of Appeal. If you have a representative, your representative must help you obtain the evidence, unless the evidence falls under an exception. You may also submit other additional evidence to the Appeal Board. If you need more time to present evidence or legal arguments, you must now request an extension of time in writing. This ensures that the Appeal Board has the opportunity to consider additional evidence before taking action. If you do not present legal evidence or arguments now or within a time limit granted by the Appeal Board, the Appeal Board will take action based on the evidence currently on file.

Submit the completed form to your local Social Security office or appeal board, 5107 Leesburg Pike, Falls Church, VA 22041-3255. If you have any questions, you can call us toll-free at 1-800-772-1213 Monday to Friday from 7.m a.m to 7 p.m. .m.m. If you are deaf or hard of hearing, you can call our TTY number 1-800-325-0778. Note: If you are using a screen reader, we recommend that you open the form in Adobe Reader. If you do not have Adobe Reader, please click on the following link. Thank you very much! You can also use the form below, write a letter or fax. If the notice doesn`t say so or you`re still having trouble filing an appeal, you should call 1-800-772-1213 or your local Social Security office and they`ll help you fill out the correct appeal form. The preferred method to appeal the ALJ`s decision or order is to use the secure online process SSA AC iAppeal Online. HA-520, Application for Reconsideration of Decision or Hearing Order Please grant me an extension for the presentation of evidence or arguments: Select this box to request an extension of time for the submission of evidence or arguments.

Tell us why you disagree with the hearing decision or order. If you need extra space, you can attach a separate sheet of paper. Include your name and social security number and, if applicable, the claim number on all additional pages and in any correspondence you send us. Appeal Board, SSA/OARO 5107 Leesburg Pike Falls Church, VA 22041-3255 You must file your appeal within 60 days of the date you received the hearing decision or order. We will assume that you have received the hearing decision or order within 5 days of the date indicated on the notification, unless you can prove to us that you did not receive it within the 5-day period. If you do not agree with the decision or order of an Administrative Judge (ALJ) on your application, you can ask the Board of Appeal (AC) to examine the ALJ`s application. In the notice you received, you will learn how to appeal the ALJ`s decision or order. .