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Requests a reconsideration of SSA's decision that your disability has ended and that you are no longer entitled to disability benefits.
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Requests a reconsideration of SSA's decision that your disability has ended and that you are no longer entitled to disability benefits.
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Use this form to appeal if SSA says your disability ended and you disagree. You have 60 days from SSA's notice to file.
Submission Date
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Personal Info
2 items
Your full legal name.
Your SSN.
Appeal
3 items
The date on SSA's cessation notice.
Explain why you believe your disability has not ended.
Do you want to continue receiving benefits during the appeal?
Signature
1 items
Your signature.
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Use this form to appeal if SSA says your disability ended and you disagree. You have 60 days from SSA's notice to file.
SSDI or SSI recipients who received a notice that their disability has ceased and want to appeal.
A formal appeal requesting SSA to review the decision that your disability ended.
Must be filed within 60 days of receiving SSA's notice of cessation (plus 5 days for mail).
Submit to your local Social Security office.
Complete the form and include any new medical evidence supporting the continuation of your disability. Request benefit continuation during appeal if applicable.
Filing timely preserves your right to continue receiving benefits during the appeal process.
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