HA-520 Form PDF Download – Request for Review of Hearing Decision/Order 2024

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HA-520 Form PDF Download
HA-520 Form PDF Download

Form HA-520 | Request for Review of Hearing Decision/Order 2024

If you do not agree with the decision or order of an Administrative Law Judge (ALJ) on your claim, you may ask the Appeals Council (AC) to review the ALJ’s action. The notice you received will tell you how to appeal the ALJ’s decision or order. The preferred method for appealing the ALJ’s decision or order is by using the SSA secure online process AC i Appeal Online. You may also use the form below, write a letter or fax.

What is HA-520 form? go

The HA-520 Form, officially known as the “Request for Review of Hearing Decision/Order,” is a crucial document in the Social Security Disability appeals process. It is used by claimants who disagree with the decision made by an Administrative Law Judge (ALJ) after a disability hearing. The purpose of this form is to formally request a review of the ALJ’s decision.

How to fill Out HA-520 form

  • CLAIMANT NAME: Enter your name or the name of the person on whose behalf you are filing the request for review.
  • CLAIMANT SSN: Enter your Social Security number (SSN) or the SSN of the person on whose behalf you are filing the request for review.
  • CLAIM NUMBER (if different than SSN): The claimant claim number depends on the type of claim you are appealing. If you are appealing a claim for:
  • Social Security benefits on your work record, do not re-enter your SSN.
  • Social Security benefits on someone else’s work record (a wage earner), enter that person’s SSN.
  • Social Security benefits on your work record and on another person’s work record, enter the wage earner’s SSN but do not re-enter your SSN.
  • Supplemental Security Income (SSI), do not re-enter your SSN.
  • Social Security benefits on another person’s work record and SSI, enter the wage earner’s SSN but do not re-enter your SSN.
  • SSI only or SSI and Social Security benefits on your work record, enter your husband’s or wife’s SSN here.
  • I request that the Appeals Council review the Administrative Law Judge’s action on the above claim because: Tell us why you disagree with the hearing decision or order. If you need additional space, you can attach a separate sheet of paper. Include your name and your SSN, and the claim number if applicable, on any additional pages, and on all correspondence, you send to us. Please grant me an extension of time to submit evidence or argument: Mark this checkbox to request an extension of time to submit evidence or argument.
  • CLAIMANT’S SIGNATURE: Sign and date the form and fill in your address and telephone number. If you are filing on behalf of a child or an incompetent adult, enter your relationship to the claimant (for example, parent or legal guardian).
  • REPRESENTATIVE’S SIGNATURE: If you have a representative, he or she should sign and complete this section. Do not delay filing your request for review to get your representative’s signature. If you are represented and your representative is unavailable to complete this form, you should also print his or her name and address in this section. If you do not have a representative and would like someone to represent you (for example, an attorney), your local Social Security office can provide you with a list of representatives for your area.

Where to Send this HA-520 Form PDF

Send the completed form to your local Social Security office or to the Appeals Council, 5107 Leesburg Pike, Falls Church, VA 22041-3255. If you have any questions, you may call us toll-free at 1-800-772-1213 Monday through Friday from 7 a.m. to 7 p.m. If you are deaf or hard of hearing, you may call our TTY number, 1-800-325-0778.

HA-520 Form PDF Download

What is the key information on the HA-520 form?

  • Basic Information: The HA-520 Form requires the claimant to provide basic information such as their name, Social Security Number, mailing address, and contact information. This information is crucial for the Social Security Administration (SSA) to identify and process the appeal.
  • Hearing Decision/Order Details: Claimants must specify the details of the hearing decision or order they wish to appeal. This includes the date of the decision, the name of the ALJ, and the specific decision they are appealing (e.g., denial of benefits).
  • Grounds for Appeal: Claimants must clearly state the reasons for their appeal on the HA-520 Form. This is a critical section where individuals should outline why they believe the ALJ’s decision was incorrect or unjust. Providing specific and well-documented reasons can significantly strengthen the appeal.
  • Evidence and Supporting Documents: The HA-520 Form provides space for claimants to list any new evidence or documents they want to submit in support of their appeal. This could include medical records, statements from physicians, or any other relevant information that was not presented at the initial hearing.
  • Representative Information: If the claimant has legal representation, their attorney’s information must be included on the form.
  • Signature and Certification: Claimants must sign and date the form to certify that the information provided is accurate and complete to the best of their knowledge.

Submitting the HA-520 Form PDF Download

Once the HA-520 Form is completed, it should be submitted to the SSA’s Office of Disability Adjudication and Review (ODAR). The form can be sent via mail, fax, or electronically through the SSA’s secure online portal. It is advisable to keep copies of all documents related to the appeal for personal records.

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What Happens After Submission? 2024

After receiving the HA-520 Form, the SSA will assign the appeal to a different ALJ for review. This new ALJ will consider the claimant’s reasons for appeal, review any new evidence presented, and make a decision on whether to grant or deny the appeal. The ALJ may hold another hearing if deemed necessary, but this is not guaranteed.

It’s important to note that the appeal process can be lengthy, often taking several months or even years to reach a final decision. Claimants should be prepared for this wait and continue to provide any requested information promptly.

Time to Submit New Evidence HA-520 Form PDF

If you have additional evidence that relates to the period on or before the date of the hearing decision, you must inform the Appeals Council about it or submit it. If you have a representative, then your representative must help you obtain the evidence unless the evidence falls under an exception. You may also submit any other additional evidence to the Appeals Council.

If you need additional time to submit evidence or legal argument, you must request an extension of time in writing now. This will ensure that the Appeals Council has the opportunity to consider the additional evidence before taking its action. If you submit neither evidence nor legal argument now or within any extension of time the Appeals Council grants, the Appeals Council will take its action based on the evidence currently in your file.

Please Send Your Request To 2024

Appeals Council, SSA/OARO
5107 Leesburg Pike
Falls Church, VA 22041-3255

Or, Fax to: 1-833-509-0817

If the notice does not say this, or you are still experiencing issues filing an appeal, you should call 1-800-772-1213 or your local Social Security Office and they will help you complete the right appeal form. You must file your appeal within 60 days after the date you got the hearing decision or order. We assume that you got the hearing decision or order within 5 days after the date shown on the notice unless you can show us you did not get it within the 5-day period.

Conclusion – SSA HA-520 Request for Review Form 2024

The HA-520 Form, Request for Review of Hearing Decision/Order, is a critical tool for individuals seeking to appeal a denial of Social Security Disability benefits. When completing this form, it’s essential to be thorough, specific, and provide supporting evidence for the reasons of appeal. While the process can be time-consuming, it offers a crucial opportunity for individuals to have their cases reevaluated and potentially receive the benefits they deserve. Claimants are encouraged to seek legal assistance or guidance if needed during this complex appeals process.

FAQs about SSA Form HA-520

Q 1. What is Form HA-520?

Form HA-520, “Request for Review of Hearing Decision/Order,” is used to request that the Social Security Administration’s (SSA) Appeals Council review the decision of an Administrative Law Judge (ALJ) in a Social Security disability case.

Q 2. Who can file Form HA-520?

Anyone who has received an unfavorable decision from an ALJ in a Social Security disability case can file Form HA-520.

Q 3. When must I file Form HA-520?

You must file Form HA-520 within 60 days after the date you receive the ALJ’s decision. If you do not file Form HA-520 within 60 days, you will generally lose your right to have the Appeals Council review the ALJ’s decision.

Q 4. How do I file Form HA-520?

You can file Form HA-520 online, by mail, or in person at a local Social Security office. If you file Form HA-520 online, you will need to create a my Social Security account. If you file Form HA-520 by mail, you should send it to the following address:

Social Security Administration Appeals Council 6401 Security Boulevard Baltimore, MD 21235-6401

If you file Form HA-520 in person, you can take it to any local Social Security office.

Q 5. What information do I need to include on Form HA-520?

You will need to include the following information on Form HA-520:

  • Your name, Social Security number, and claim number
  • The date you received the ALJ’s decision
  • The reason you disagree with the ALJ’s decision
  • Any additional evidence or argument you would like the Appeals Council to consider

Q 6. Can I submit additional evidence or argument after I file Form HA-520?

Yes, you can submit additional evidence or argument to the Appeals Council after you file Form HA-520. However, you should submit any additional evidence or argument as soon as possible. The Appeals Council will generally not consider any additional evidence or argument that is submitted after the Appeals Council has issued a decision in your case.

Q 7. How long will it take the Appeals Council to review my case?

The Appeals Council may take several months to review your case. The amount of time it takes the Appeals Council to review your case will depend on a number of factors, including the complexity of your case and the number of cases that the Appeals Council has pending.

Q 8. What happens after the Appeals Council reviews my case?

After the Appeals Council reviews your case, the Appeals Council may issue one of the following decisions:

  • Affirm the ALJ’s decision: The Appeals Council may affirm the ALJ’s decision, which means that the Appeals Council agrees with the ALJ’s decision.
  • Reverse the ALJ’s decision: The Appeals Council may reverse the ALJ’s decision, which means that the Appeals Council disagrees with the ALJ’s decision and finds that you are disabled.
  • Vacate the ALJ’s decision and remand the case to the ALJ for further proceedings: The Appeals Council may vacate the ALJ’s decision and remand the case to the ALJ for further proceedings. This means that the Appeals Council is not sure whether or not you are disabled and needs more information from the ALJ to make a decision.

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