Get Ssa-789-u4 2019-2026

The SSA-789-U4 form, also known as the request for reconsideration for disability cessation, is an essential document for individuals seeking to contest the termination of their disability benefits. This guide will provide clear, step-by-step instructions on how to accurately complete the form online.

Follow the steps to successfully complete the SSA-789-U4 online.

1. Click the ‘Get Form’ button to obtain the form and open it in your editing interface.
2. Fill in the claimant’s name and social security number in the designated fields at the top of the form. Ensure that this information is accurate as it is crucial for identifying your case.
3. If applicable, enter the name and social security number of the wage earner or self-employed person in the next provided fields, ensuring this information is also correct.
4. Complete the section for the spouse's name and social security number only if you are applying under Supplemental Security Income (SSI).
5. Indicate the type of benefit you are requesting reconsideration for by selecting one of the options available: disability, widow, SSI, child, etc.
6. In the space provided, clearly state that you do not agree with the determination to stop your disability benefits and outline your reasons for this request. Be specific and relate your reasons directly to the decision that was made.
7. If your notice was dated more than 65 days ago, include your reason for the delay in filing this request along with the date you received the notice.
8. List any additional information you are submitting with this form. If you have none, write 'NONE' in the space provided.
9. Choose between Block 1 or Block 2 regarding whether you wish to appear at a disability hearing. If selecting Block 1, specify if you need an interpreter and the language required. If selecting Block 2, acknowledge your understanding of foregoing the hearing.
10. Sign and date the form. Ensure that either the claimant or the representative, if applicable, signs the form. Enter the necessary address and contact details.
11. If the form is signed by mark (X), make sure two witnesses provide their signatures and addresses in the section provided.
12. Review the completed form for accuracy before submission. Once verified, save your changes, and consider downloading or printing a copy for your records and sharing as necessary.

Take the next step in your process by completing the SSA-789-U4 online.