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Administrative Law Judge

Form To Request An ALJ Hearing

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Form HA-501 is used to request a hearing before an Administrative Law Judge. It is available at: offsite link

There are some things to keep in mind as you complete the form:

  1. Prepare before sending it in. Think about how you intend to present your arguments to the ALJ before you complete the Request form.
  2. If you plan to use an attorney, find the attorney and let him/her assist you with the form. The attorney will be able to help you clarify the issues. Also, more paperwork is required if you send in this form without an attorney and engage one later.
  3. Question #5 "I REQUEST A HEARING BEFORE AN ADMINISTRATIVE LAW JUDGE. I disagree with the determination made on my claim because…:" Here you can write (or on a separate sheet of paper if needed) why you believe your claim should be approved. Include all the arguments you can think of that help prove your case. Look at the guidance noted in Request For Reconsideration.
  4. Question #6 asks about what new evidence you intend to provide. The more new evidence you can present, the more likely you are to win your appeal. New evidence may be in the form of medical records, third party testimony, or written statements by doctors, therapists and other health care providers. (See Statements By Doctors, and Affidavits and Statements From Friends and Co-Workers).
  5. Question #7 asks if you intend to attend the hearing. You should say "Yes". It is important that you attend the hearing and participate as much as possible -- with your attorney's advice, if you use one.

If you are requesting a hearing on the denial of a claim for disability benefits, you must complete and sign additional forms. These forms are the SSA-3441, Disability Report - Appeal offsite link, (available at offsite link) and SSA-827, Authorization to Disclose Information to SSA offsite link, offsite link). You should also complete an HA-4631, Claimant's Recent Medical Treatment offsite link, ( offsite link) and an HA-4632, Claimant's Medications offsite link, ( offsite link). If you have worked since you filed your application for disability benefits, complete an HA-4633, Claimant's Work Background offsite link, ( offsite link). You may also need to complete a form SSA-1696, Appointment of Representative offsite link, ( offsite link) if you are appointing a representative. Your representative should also sign the SSA-1696 before you send it to Social Security.

Depending on the state, getting a hearing date takes between 3 and 12 months.

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