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  • Form Ssa-789 Request For Reconsideration--disability ...

Get Form Ssa-789 Request For Reconsideration--disability ...

ICE) NAME OF CLAIMANT SOCIAL SECURITY NUMBER NAME OF WAGE EARNER OR SELF-EMPLOYED PERSON (if different from Claimant) SOCIAL SECURITY NUMBER Page 1 of 2 OMB No. 0960-0349 FOR SOCIAL SECURITY OFFICE USE ONLY (DO NOT WRITE IN THIS SPACE) FO Code Benefit Continuation SPOUSE'S NAME AND SOCIAL SECURITY NUMBER (COMPLETE ONLY IN SUPPLEMENTAL SECURITY INCOME CASE) TYPE OF BENEFIT DISABILITY WORKER WIDOW Foreign Language Notice SSI CHILD DISABILITY BLIND CHILD I DO NOT AGREE WITH THE DETERMI.

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How to fill out the Form SSA-789 Request For Reconsideration--Disability online

This guide provides a clear and detailed process for filling out the Form SSA-789, which is used to request reconsideration of a disability cessation decision. By following the outlined steps, users can navigate the form efficiently and ensure that all necessary information is submitted correctly.

Follow the steps to complete the form accurately.

  1. Press the ‘Get Form’ button to access the form and open it in the editing interface.
  2. Complete the 'Name of Claimant' field by entering the full name of the individual requesting reconsideration. Ensure that spelling is accurate and formatted correctly.
  3. Enter the 'Social Security Number' of the claimant in the designated field. Double-check this information to prevent any processing delays.
  4. If different from the claimant, fill in the 'Name of Wage Earner or Self-Employed Person,' along with their 'Social Security Number.' This is necessary for cases involving a spouse or a dependent.
  5. Indicate the 'Type of Benefit' by selecting the relevant option, such as Disability Worker, Widow, Child Disability, etc. This clarifies the benefits being reconsidered.
  6. In the section stating ‘I do not agree with the determination to stop disability benefits and I request reconsideration,’ explain your reasons in detail. Be specific about your circumstances related to the cessation.
  7. If the notice regarding your benefits was received over 65 days ago, explain the reason for the delay in submitting this request. Include the date of the notice to provide context.
  8. Include any ‘Additional Information’ you wish to submit by either writing it directly or attaching a separate page if necessary. If there’s no additional information, write 'NONE.'
  9. Choose to check either Block 1 or Block 2, indicating your preference for a hearing or not. If you need an interpreter for the hearing, specify the language required.
  10. Complete the address fields for both the claimant and the representative, if applicable. Ensure the 'Street Address,' 'City,' 'State,' and 'ZIP Code' are correctly filled in.
  11. Enter the telephone numbers for both the claimant and the representative, along with their respective dates.
  12. Review all information for accuracy. Once confirmed, proceed to save changes, download, print, or share the form as necessary.

Take action today by completing your Form SSA-789 online to ensure your benefits are reconsidered promptly.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232