OMB control number

Request for Reconsideration

OMB 0960-0622 · SSA.

OMB 0960-0622

The Social Security Act states those individuals who are dissatisfied with the results of an initial determination regarding their Title II disability; Tile XVI disability (SSI); Title VIII (Special Veterans benefits); or Title XVIII (Medicare benefits), can request a reconsideration hearing. Individuals use Form SSA-561-U2; the associated MCS or SSI Claims System interview; or the Internet application (i561) to initiate a request for reconsideration of a denied claim. SSA uses the information to document the request and to determine an individual’s eligibility or entitlement to Social Security benefits (Title II); SSI payments (Title XVI); Special Veterans Benefits (Title VIII); Medicare (Title XVIII); and for initial determinations regarding Medicare Part B income-related premium subsidy reductions. The respondents are applicants, claimants, beneficiaries, or recipients filing for reconsideration of an initial determination.

The latest form for Request for Reconsideration expires 2028-04-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form SSA-561-U2 Request for Reconsideration--Paper and MCS/SSI Claims System Form and Instruction
Addendum -0960-0622.docx Supplementary Document
Supporting Statement - 0622 (final).docx Supporting Statement A
Request for Reconsideration--Paper and MCS/SSI Claims System Form and Instruction
Disability Determination Ready Claim (DDRC) Certification Statement (for DDRC Pilot) Other-Certification Statement
Request for Reconsideration--Internet version (i561) Other-Current iAppeals Screens

All Historical Document Collections

202412-0960-001	Revision of a currently approved collection	2025-03-19
202411-0960-005	No material or nonsubstantive change to a currently approved collection	2024-11-06
201910-0960-003	Revision of a currently approved collection	2019-10-11
201907-0960-004 Approved without change	No material or nonsubstantive change to a currently approved collection	2019-08-01
201902-0960-003 Approved without change	No material or nonsubstantive change to a currently approved collection	2019-02-04
201712-0960-008 Approved without change	No material or nonsubstantive change to a currently approved collection	2017-12-28
201607-0960-006 Approved without change	Revision of a currently approved collection	2016-10-21
201308-0960-011 Approved without change	Revision of a currently approved collection	2014-08-14
201111-0960-008 Approved without change	Revision of a currently approved collection	2012-01-31
201110-0960-011 Approved without change	No material or nonsubstantive change to a currently approved collection	2011-11-01
201002-0960-025 Approved without change	Revision of a currently approved collection	2010-06-17
200706-0960-004 Approved without change	Revision of a currently approved collection	2007-06-29
200607-0960-010 Approved without change	Revision of a currently approved collection	2006-07-10
200308-0960-007 Approved without change	Revision of a currently approved collection	2003-08-22
200006-0960-003 Approved without change	Existing collection in use without an OMB Control Number	2000-06-30

OMB Details

Request for Reconsideration--Paper and MCS/SSI Claims System

Federal Enterprise Architecture: Income Security - General Retirement and Disability

Form SSA-561-U2

Request for Reconsideration

Fillable Printable

Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.