Request for Reconsideration

OMB 0960-0622

Individuals use the SSA-561-U2, the associated MCS or MSSICS interview, or the Internet application (i561) to initiate a request for reconsideration of a denied claim. SSA uses the information to document the request and to determine an individual's eligibility or entitlement to Social Security benefits (Title II), SSI payments (Title XVI), Special Veterans Benefits (Title VIII), Medicare (Title XVIII), and for initial determinations regarding Medicare Part B income-related premium subsidy reductions. The respondents are individuals filing for reconsideration. This is a non-substantive Change Request to update the Terms of service for the iAppeals screens.

The latest form for Request for Reconsideration expires 2021-01-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form SSA-561-U2 Request for Reconsideration--Paper and MCS/SSI Claims System Form and Instruction
Addendum -0960-0622.docx Supplementary Document
Supporting Statement - 0622 (final).docx Supporting Statement A
Request for Reconsideration--Paper and MCS/SSI Claims System Form and Instruction
Disability Determination Ready Claim (DDRC) Certification Statement (for DDRC Pilot) Other-Certification Statement
Request for Reconsideration--Internet version (i561) Other-Current iAppeals Screens

All Historical Document Collections

202412-0960-001	Revision of a currently approved collection	2025-03-19
202411-0960-005	No material or nonsubstantive change to a currently approved collection	2024-11-06
201910-0960-003	Revision of a currently approved collection	2019-10-11
201907-0960-004 Approved without change	No material or nonsubstantive change to a currently approved collection	2019-08-01
201902-0960-003 Approved without change	No material or nonsubstantive change to a currently approved collection	2019-02-04
201712-0960-008 Approved without change	No material or nonsubstantive change to a currently approved collection	2017-12-28
201607-0960-006 Approved without change	Revision of a currently approved collection	2016-10-21
201308-0960-011 Approved without change	Revision of a currently approved collection	2014-08-14
201111-0960-008 Approved without change	Revision of a currently approved collection	2012-01-31
201110-0960-011 Approved without change	No material or nonsubstantive change to a currently approved collection	2011-11-01
201002-0960-025 Approved without change	Revision of a currently approved collection	2010-06-17
200706-0960-004 Approved without change	Revision of a currently approved collection	2007-06-29
200607-0960-010 Approved without change	Revision of a currently approved collection	2006-07-10
200308-0960-007 Approved without change	Revision of a currently approved collection	2003-08-22
200006-0960-003 Approved without change	Existing collection in use without an OMB Control Number	2000-06-30

OMB Details

Request for Reconsideration--Paper and MCS/MSSICS

Federal Enterprise Architecture: Income Security - General Retirement and Disability

Form SSA-561-U2

Request for Reconsideration

Paper Only

Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.