The Appeals Council grants review in only about 10-15% of cases — focus on legal errors, not just disagreement

If the Appeals Council denies review, you can file a civil action in federal district court within 60 days

Having an attorney draft the Appeals Council brief significantly improves your chances

Social Security Disabilityvery hard

Request for Appeals Council Review

HA-520-U5 · SSA

Request for review by the SSA Appeals Council of an Administrative Law Judge decision. Third-level appeal in the disability process.

Form Details

Total fields: 30
Auto-fillable: 20 (67%)
Time without BeneFill: 90 minutes
Time with BeneFill: 25 minutes
Time saved: 65 minutes
Filled by: patient
Frequency: per incident

Fill this form with BeneFill

Auto-fill 67% of fields from your profile. Save 65 minutes. Download a real PDF.

20 of 30 fields67% auto-filled

Start Filling Upload Your Copy Instead Download blank official form

Where to Submit This Form

📬

Mail to your local SSA hearing office (ODAR)

https://www.ssa.gov/appeals/ho_locator.html

File with the Office of Hearings Operations.

🏢

In person at your SSA hearing office

https://www.ssa.gov/appeals/ho_locator.html

Filing Deadline

Within 60 days of receiving the ALJ decision (65 days if mailed).

Required Attachments

📎 Copy of the ALJ decision you are appealing
📎 Written statement explaining why the ALJ decision was incorrect
📎 Any new evidence not previously available (optional but recommended)

Processing Time

6-12 months for the Appeals Council to issue a decision.

What Happens Next

The Appeals Council will review the ALJ's decision for legal errors. They may grant review, deny review, or remand the case back to the ALJ for a new hearing.

Tips for This Form

✓ The Appeals Council grants review in only about 10-15% of cases — focus on legal errors, not just disagreement
✓ If the Appeals Council denies review, you can file a civil action in federal district court within 60 days
✓ Having an attorney draft the Appeals Council brief significantly improves your chances

More Social Security Disability Forms

SSDI Application

SSA-16-BK · SSA

Application for Social Security Disability Insurance Benefits. Requires detailed work history, earnings record, and medical condition documentation.

SSI Application

SSA-8000-BK · SSA

Application for Supplemental Security Income for aged, blind, and disabled individuals with limited income and resources. Must be completed via SSA interview.

Adult Disability Report

SSA-3368-BK · SSA

The most complex patient-facing disability form. 15 pages requiring complete medical history, all diagnoses, medications, treating providers, hospitalizations, and work history.

Work History Report

SSA-3369-BK · SSA

10-page report requiring detailed descriptions of all jobs held in the past 15 years including physical demands, tools used, supervision, and lifting requirements.

Function Report

SSA-3373-BK · SSA

10-page functional assessment covering ADL capacity, daily routines, social functioning, cognitive abilities, and physical limitations.

Authorization to Disclose Information

SSA-827 · SSA

Authorization allowing SSA to collect medical and other information from providers, hospitals, and other sources for disability determination.

Not sure which forms you need?

Tell our assistant about your situation and we'll find the right forms for you.

Chat with Form Assistant

Disclaimer: BeneFill™ provides form-filling assistance and informational guidance only. It is not affiliated with, endorsed by, or sponsored by the SSA or any government agency. The information provided is for general informational purposes and does not constitute legal, medical, financial, or tax advice. Always verify form requirements and submission details directly with the issuing agency.