This form is a sample letter in Word format covering the subject matter of the title of the form.
[Your Name] [Your Address] [City, State, Zip] [Email Address] [Phone Number] [Date] [Social Security Administration] [Appeals Council] [City, State, Zip] Subject: Notification of Representation in an Appeal for Disability Benefits Dear Sir/Madam, I am hereby writing to formally notify the Social Security Administration (SSA) and the Appeals Council of my representation in an appeal for disability benefits on behalf of my client, [Client's Name], who is a resident of Hawaii. I, as the duly authorized representative for [Client's Name], understand the complexity of the appeals process and the importance of thorough and professional representation. Consequently, I am committed to providing my client with the utmost dedication and expertise necessary to ensure a fair evaluation of their disability claim. Key Details: Client's Name: [Client's Full Name] Social Security Number: [Client's SSN] Date of Application: [Date of Initial Application] Date of Denial: [Date of Denial Decision] Decision Under Appeal: [Briefly describe the decision being appealed] I request your assistance in providing all relevant and necessary documentation related to my client's disability claim, including detailed medical records, evaluations, and any additional information that could support the argument for their eligibility for disability benefits. Additionally, in accordance with the applicable regulations and guidelines, I respectfully request a reasonable extension of time to allow for the thorough preparation and submission of the appeal brief. I believe this extension is crucial to providing the Appeals Council with a comprehensive and compelling argument to reconsider the prior denial decision. I kindly request that all future correspondence related to this appeal be sent to my attention at the address provided above. Furthermore, please include my contact information, including email and phone number, should you need to reach me with any updates or inquiries related to this case. Thank you for your prompt attention to this matter. I trust that, with my client's best interests in mind and supported by the necessary documentation, the Social Security Administration and the Appeals Council will carefully reconsider this appeal and grant my client the disability benefits they deserve. Yours sincerely, [Your Name] [Your Title/Role] [Your Law Firm/Organization Name]
[Your Name] [Your Address] [City, State, Zip] [Email Address] [Phone Number] [Date] [Social Security Administration] [Appeals Council] [City, State, Zip] Subject: Notification of Representation in an Appeal for Disability Benefits Dear Sir/Madam, I am hereby writing to formally notify the Social Security Administration (SSA) and the Appeals Council of my representation in an appeal for disability benefits on behalf of my client, [Client's Name], who is a resident of Hawaii. I, as the duly authorized representative for [Client's Name], understand the complexity of the appeals process and the importance of thorough and professional representation. Consequently, I am committed to providing my client with the utmost dedication and expertise necessary to ensure a fair evaluation of their disability claim. Key Details: Client's Name: [Client's Full Name] Social Security Number: [Client's SSN] Date of Application: [Date of Initial Application] Date of Denial: [Date of Denial Decision] Decision Under Appeal: [Briefly describe the decision being appealed] I request your assistance in providing all relevant and necessary documentation related to my client's disability claim, including detailed medical records, evaluations, and any additional information that could support the argument for their eligibility for disability benefits. Additionally, in accordance with the applicable regulations and guidelines, I respectfully request a reasonable extension of time to allow for the thorough preparation and submission of the appeal brief. I believe this extension is crucial to providing the Appeals Council with a comprehensive and compelling argument to reconsider the prior denial decision. I kindly request that all future correspondence related to this appeal be sent to my attention at the address provided above. Furthermore, please include my contact information, including email and phone number, should you need to reach me with any updates or inquiries related to this case. Thank you for your prompt attention to this matter. I trust that, with my client's best interests in mind and supported by the necessary documentation, the Social Security Administration and the Appeals Council will carefully reconsider this appeal and grant my client the disability benefits they deserve. Yours sincerely, [Your Name] [Your Title/Role] [Your Law Firm/Organization Name]