Request for Reconsideration

OMB 0960-0622

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.

OMB Details

Request for Reconsideration--Paper and MCS/MSSICS

Federal Enterprise Architecture: Income Security - General Retirement and Disability

Form SSA-561-U2Request for ReconsiderationPaper OnlyForm and instruction

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


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