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How can you appeal the decision Social Security made on your application for extra help?

 If you want to appeal the determination Social Security made about your eligibility for Extra Help with Medicare prescription drug plan costs, visit www.socialsecurity.gov/extrahelp or call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) and ask for an Appeal of Determination for Extra Help with Medicare Prescription Drug Plan Costs (Form SSA-1021). You can mail the request to Wilkes-Barre Data Operations Center, P.O. Box 1030, Wilkes-Barre, PA 18767-1030. You also can call, write, or visit your local Social Security office.

What will happen when you appeal?

When you request the appeal, Social Security will ask you to tell them why you think their decision is wrong. Usually Social Security will set up an appointment for a hearing, to review your case with you by telephone. To set up the hearing appointment, Social Security will ask you for two preferred times for them to call. Then, they will send you a hearing appointment notice that will give you the time and date scheduled for your hearing.

If you choose not to participate in a telephone hearing, Social Security will decide your case by looking at the information they have on file and any new information you give them to be sure that a proper decision was made. Social Security calls this a hearing by case review.

Whether you request a hearing by telephone or a hearing by case review, Social Security will send you another notice as soon as the necessary work has been completed on your claim.

Is there a time frame for the appeal?

You have 60 days from the date you receive the notice telling you about Social Security’s decision to request an appeal. If you do not appeal within the 60-day time limit, you may lose your right to appeal and the decision Social Security made becomes final. If you have a good reason for not appealing your case within the time limits, they may give you more time. You can request an extension by calling 1-800-772-1213 (TTY 1-800-325-0778).

Can you get help to request an appeal?

You may choose to have someone help you with your appeal or to represent you. Your representative may be a lawyer or other qualified person familiar with you and the Social Security program. Social Security will work with your representative just as they would work with you. He or she can act for you in most Social Security matters.

What can you do if you do not agree with the decision made on your appeal?

If you disagree with the decision Social Security makes on your appeal, you may file a lawsuit in a Federal district court. The letter Social Security sends you about the decision on your appeal also will tell you how to ask a court to look at your case.

Also see:

(Source: Social Security Administration: Understanding The Extra Help With Your Medicare Prescription Drug Plan publication 10508, January 2011. Additional examples and links from Q1Group LLC)


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