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How to fill out SSA form HA-501

If you have been denied for Social Security disability benefits, and your request for a redetermination has also been denied, you can request a hearing by an administrative law judge. In order to do so, you must fill out Form HA-501 “REQUEST FOR HEARING BY ADMINISTRATIVE LAW JUDGE.”

Your hearing before an administrative law judge represents your best opportunity to be approved for Social Security Disability benefits. It is the one opportunity you will have to stand in front of another person, face to face, and explain how and why your disabilities preclude you from substantial gainful activity. If you have not already contacted a Social Security lawyer about your claim, now would be a good time to do so.

Following are brief instructions and tips for filling out the sections of Form HA-501:

  1. CLAIMANT: This section should be filled out with the name of the disabled person. If you are filing on someone else’s behalf, use their name.
  2. WAGE EARNER, IF DIFFERENT: If the claimant’s eligibility for Social Security is through someone else (i.e., claimant is a widow or dependent), enter the name of the wage earner.
  3. SOCIAL SECURITY CLAIM NUMBER: This will be the Social Security number of the claimant, followed by a suffix. You can find the suffix on prior correspondence from the SSA (it will be on all SSA correspondence with you).
  4. SPOUSE’s CLAIMS NUMBER. If you are filing for SSI and are married, fill in your spouse’s claim number here.
  5. I REQUEST A HEARING…: Here, you should state, in detail, why you disagree with the denial of your claim. It is important that all medical conditions be stated in terms of how they hinder you from working or performing daily activities. Having a Social Security attorney help with this section can help increase your chances of having your disability benefits approved.
  6. ADDITIONAL EVIDENCE. You will want to include any evidence you didn’t already include on your initial claim and request for redetermination. This should include additional medical evidence as well as anything else that can help build your case for disability. Here again, a Social Security lawyer can be invaluable in helping you determine which types of evidence will help your claim.
  7. ATTENDANCE AT HEARING. In this block, you simply check that you do or do not want to appear in person at your hearing. Unless you have been advised by legal counsel not to attend, you should make every effort to attend your hearing.

Sections 8 and 9 are fairly self-explanatory. You sign your name and fill in your personal information in Section 8. Your representative, if you have one, fills in Section 9. The rest of the form is filled out by SSA personnel. Make sure that you don’t fill out sections of the form that you’re not supposed to.