Request for Hearing By Administrative Law Judge

OMB 0960-0269

OMB 0960-0269

When SSA denies applicants' or beneficiaries' requests for new or continuing benefits, those applicants or beneficiaries are entitled to request a hearing to appeal the decision. To request a hearing, individuals use Form HA–501, the associated Modernized Claims System (MCS) or Modernized Supplemental Security Income Claims System (MSSICS) interview, or the Internet application (i501). SSA uses the information to determine if the individual filed the request within the prescribed time; is the proper party; and has taken the steps necessary to obtain the right to a hearing. SSA also uses the information to determine the individual's reason(s) for disagreeing with SSA's prior determinations in the case; if the individual has additional evidence to submit; if the individual wants an oral hearing or a decision on-the-record; and whether the individual has (or wants to appoint) a representative. The respondents are Social Security benefit applicants and recipients who want to appeal SSA's denial of their request for new or continued benefits and Medicare Part B recipients who must pay the Medicare Part B Income-Related Monthly Adjustment Amount. This is a non-substantive Change Request to update the Terms of service for the iAppeals screens.

The latest form for Request for Hearing By Administrative Law Judge expires 2021-01-31 and can be found here.

All Historical Document Collections
Revision of a currently approved collection 2019-10-11
Approved without change
No material or nonsubstantive change to a currently approved collection 2019-08-01
Approved without change
No material or nonsubstantive change to a currently approved collection 2019-02-04
Approved without change
No material or nonsubstantive change to a currently approved collection 2018-06-05
Approved without change
No material or nonsubstantive change to a currently approved collection 2017-12-28
Approved without change
Revision of a currently approved collection 2016-10-21
Approved without change
Revision of a currently approved collection 2014-08-14
Approved without change
Revision of a currently approved collection 2012-01-31
Approved without change
No material or nonsubstantive change to a currently approved collection 2011-11-01
Approved without change
Revision of a currently approved collection 2011-06-02
Approved without change
Revision of a currently approved collection 2010-06-10
Approved without change
Revision of a currently approved collection 2007-06-29
Approved without change
Revision of a currently approved collection 2007-02-22
Approved with change
Revision of a currently approved collection 2006-10-19
Approved without change
Extension without change of a currently approved collection 2004-11-24
Approved without change
Revision of a currently approved collection 2001-10-11
Approved without change
No material or nonsubstantive change to a currently approved collection 2001-09-24
Approved without change
No material or nonsubstantive change to a currently approved collection 1999-09-23
Approved without change
Extension without change of a currently approved collection 1999-06-04
Approved without change
No material or nonsubstantive change to a currently approved collection 1998-09-30
Approved without change
Revision of a currently approved collection 1996-05-01
Approved without change
Revision of a currently approved collection 1993-03-04
Approved without change
Revision of a currently approved collection 1990-01-11
Approved with change
No material or nonsubstantive change to a currently approved collection 1989-08-25
Approved without change
Revision of a currently approved collection 1986-12-24
Approved with change
No material or nonsubstantive change to a currently approved collection 1985-11-01
Approved with change
No material or nonsubstantive change to a currently approved collection 1985-08-15
Approved without change
Revision of a currently approved collection 1984-02-15
Approved without change
New collection (Request for a new OMB Control Number) 1981-12-23
OMB Details

Request for Hearing By Administrative Law Judge--Paper/MCS/MSSICS Versions

Federal Enterprise Architecture: Income Security - General Retirement and Disability

Form HA-501Request for Hearing By Administrative Law JudgePaper OnlyForm and instruction

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


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