Get Ssa-789-u4 2003

The SSA-789-U4 form is essential for requesting a reconsideration of your disability benefits decision. This guide provides clear, step-by-step instructions to assist you in completing this form online, ensuring you articulate your case effectively.

Follow the steps to fill out the SSA-789-U4 form online.

1. Click ‘Get Form’ button to access the SSA-789-U4 form and open it in the editor.
2. Begin by filling in the claimant's name and social security number in the designated fields at the top of the form.
3. If applicable, provide the name and social security number of the wage earner or self-employed person, if different from the claimant.
4. Complete the spouse's name and social security number fields only if this request pertains to a Supplemental Security Income case.
5. Indicate the type of benefit you are requesting reconsideration for by checking the appropriate box.
6. Clearly express your disagreement with the decision to stop benefits in the section provided. Be specific about your reasons, and if applicable, explain why you did not request reconsideration within 65 days.
7. In the additional information section, include any extra details relevant to your case or write 'NONE' if applicable.
8. Select either Block 1 or Block 2 to indicate your preference for attending a face-to-face hearing or not, providing details as necessary.
9. Ensure that the signature section is completed by either the claimant or a designated representative, including their address and contact details.
10. If the form was signed by mark (X), ensure that two witnesses sign the document, providing their addresses as required.
11. Review all entered details for accuracy before saving your changes, then download, print, or share the completed form as needed.

Take action today and complete your SSA-789-U4 form online to ensure timely processing of your request.