Last Update: 9/1/05 (Transmittal II-6-13)
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SOCIAL SECURITY ADMINISTRATION _____________________________________________________________ | |
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Refer to: TAHB [SSN] [XSSN] |
Office of Hearings and Appeals 5107 Leesburg Pike Falls Church, VA 22041-3255] | |
[Representative's First Name, Middle Initial and Last
Name]
[Address]
[City, State
Zip]
Dear [Mr./Ms. [Representative's Last Name]]:
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Re: |
[Claimant's Name] v. Commissioner of Social Security U.S.D.C. for the [selects District, if appropriate] District of [State] [,] [Division] Civil Action Number [enter number] |
This is about your request for more time to send us written exceptions explaining the reasons you disagree with the Administrative Law Judge's decision dated [insert date]. You asked for [insert number] days to send us exceptions.
After considering your reasons for asking for more time, the Council finds that [insert explanation why the AC is denying request for more than 30 days].
We Will Not Act For 30 Days
If you have exceptions, you must send them to us within 30 days of the date of this letter. We assume you received this letter 5 days after the date on it unless you show us that you did not receive it within the 5-day period. We will not allow more time to send exceptions except for very good reasons.
Our address and FAX number are:
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ADDRESS: |
Appeals Council |
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FAX: |
[FAX #], Attn: Branch [#]. |
Put the Social Security Number shown at the top of this letter on your request.
If you send us anything by fax, do not send duplicates by mail. That may delay processing your claim.
What Happens Next
If we do not hear from you within 30 days, we will assume that you do not want to send us more information. We will then make our decision.
If You Have Any Questions
If you have any questions, you may call or write the Appeals Council. Our telephone number and address are shown at the top of this letter. If you do call, please have this notice with you.
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[Name] | |
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Hearings and Appeals Analyst |
Enclosure:
Self-addressed envelope
cc:
[Claimant's
Name]
[Address]
[City, State
Zip]
[If claimant is unrepresented, letter will be addressed to claimant and “cc” will be deleted.]