Last Update: 9/1/05 (Transmittal II-6-13)
SOCIAL SECURITY ADMINISTRATION _____________________________________________________________ | ||
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]]:
Re: [Claimant's Name and Address]
On [insert date], the Appeals Council [denied a request for review of an Administrative Law Judge's decision] OR [issued a decision]. The Council has now received your request for more time to file a civil action (ask for court review).
We Have Denied Your Request For More Time to File a Civil Action
Under our rules, we may extend the time to file a civil action if you have a good reason for filing late.
[You have not stated any reason for not filing on time.] OR [You stated that you could not file on time because [insert good cause explanation and AC's reasons for rejecting explanation.]]
[Insert the following if materials are enclosed:
After considering the facts in this case, we find no reason under our rules to extend the time to file a civil action. Therefore, we have denied your request for more time.
As requested, we are enclosing [enter description of enclosures].
If You Have Any Questions
If you have any questions, you may call, write, or visit any Social Security office. If you do call or visit an office, please have this notice with you. The telephone number of the local office that serves your area is [Insert area code and number of servicing Field Office]. Its address is:
[Field Office Address]
[City, State ZIP]
[Name] | |
Administrative Appeals Judge |
Enclosures:
[Identify
enclosures]
cc:
[Claimant's Name]
[Address]
[City, State
Zip]
[If claimant is unrepresented, letter will be addressed to claimant and “Re” line and “cc” will be deleted.]