The “Request for Reconsideration” form (SSA-561) is one page long and asks for your name and claim number (usually your Social Security Number), the type of claim being appealed, the reason for filing an appeal, and the addresses for you and your representative.¹ The claim number and type of claim is listed on your notice of decision. Either you or your representative may sign the “Request for Reconsideration”; however, a signature is not required to process the reconsideration. If your whereabouts are not known at the time that the form must be filed, a representative can turn in a “Request for Reconsideration” for you. When entering the reason for filing an appeal, you and your representative should state the specific reasons why you feel that the determination made on the claim is incorrect. If you need additional space, use a separate sheet and make copies to attach to each copy of the appeal form.

¹ The “Request for Reconsideration” form also states that for nondisability issues, the SSI applicants can choose whether their appeals will be handled through a “case review,” an “informal conference”, or a “formal conference”. In SSI cases, this does not apply to cases where the issue is whether or not a person is disabled. Instead, it only applies to certain types of cases, such as cases where the question has to do with non-disability issues like income and resources.

Last Revised: Apr. 19, 2010