Form SSA-561-U2: Request for Reconsideration
Upload your blank Form SSA-561 from SSA (Social Security Administration), let AI auto-detect every field, type or dictate your data, and download the completed PDF in seconds. Your first clean download has no watermark, and there is nothing to install.
Upload your form
Choose a PDF or an image from your files, or photograph a paper form.
PDF, JPG, PNG, WebP, HEIC, GIF and BMP. Free account required, no credit card.
Your first download is free, with no watermark. After that: a watermark, or a $7 one-time pack (25 clean PDF downloads + 25 AI credits). AI detection covers up to 15 pages per run.
By uploading, you confirm you have the legal right to use this document.
JustFill helps you fill out the SSA-561 reconsideration request — it does NOT submit your appeal to SSA or decide your claim. You file the completed form with the Social Security Administration yourself, and SSA alone reviews the determination.JustFill is not affiliated with SSA (Social Security Administration). This is an independent third-party tool to help you complete Form SSA-561. Always download the current blank form from the official source and verify your completed copy before signing or submitting. Official Form SSA-561 from SSA (Social Security Administration)
Form SSA-561-U2, Request for Reconsideration, is the Social Security Administration form used to appeal an SSA determination you disagree with — a denied claim, an overpayment, or a benefit reduction. The claimant or their representative files it within 60 days of receiving the notice — SSA presumes you received it five days after the date on it. The same appeal can be started online at ssa.gov, or the completed PDF can be uploaded from a my Social Security account. With JustFill you upload the blank SSA-561 (08-2025) PDF, the AI detects each field, you type or dictate your reasons, and the first clean completed PDF download is included at no charge.
Form SSA-561-U2 is the Request for Reconsideration, the form that starts the first level of the Social Security appeals process. If SSA denied your retirement, disability, SSI, or Medicare-related claim — or decided you were overpaid or reduced your payments — this form asks SSA to take a fresh look at that determination. The form itself is short: you identify yourself (name, SSN, claim number), name the issue being appealed, and explain in your own words why the determination is wrong. A contact block collects your address, phone, and date (the claimant signature is optional on the current edition), with a parallel column for your representative. SSI and Special Veterans Benefits (SVB) appellants also pick one of three ways to appeal: case review, informal conference, or formal conference. The rest is completed by the Social Security office. The current edition is Form SSA-561 (08-2025) UF, OMB 0960-0622, marked "Discontinue Prior Editions" — three pages, with the contact block now placed above the SSI/SVB appeal-method section. The older four-page 12-2016 file is still served at ssa.gov/forms/ssa-561.pdf, so download the 08-2025 file (ssa-561-u2.pdf) that the SSA form page links to. With JustFill, the AI detects each field on the PDF so you can type or dictate your reasons and finish without Adobe Acrobat.
The official Form SSA-561 (08-2025) PDF is free from Social Security at ssa.gov/forms/ssa-561-u2.pdf, linked from ssa.gov/forms/ssa-561.html. A superseded 12-2016 edition is still served at ssa.gov/forms/ssa-561.pdf — use the 08-2025 file. Open it in JustFill to type the issue you are appealing and your reasons, then download the completed form; the first clean completed PDF download is included at no charge. Take or mail it to your local Social Security office, or upload it from your my Social Security account.
Get the official Form SSA-561 PDF from SSA (Social Security Administration)What each section of Form SSA-561 asks for. JustFill’s AI will detect these fields automatically when you upload the PDF — review the breakdown below so you know what to enter.
Name of claimant, claimant SSN, and the claim number if it differs from the SSN.
Which determination you are appealing — the form asks you to specify retirement, disability, hospital or medical, SSI, SVB, overpayment, etc. One form serves Social Security disability (SSDI), retirement, survivors, SSI and Medicare determinations alike; name the program and the issue as the notice describes them.
The heart of the form: why you disagree with SSA's determination. Be specific — reference the notice, dates, amounts, or medical facts.
Optional claimant signature, mailing address, city, state, ZIP code, telephone number, and date.
Name, mailing address, phone, and date for your representative, if you have one.
For SSI or SVB reconsiderations only: check one box. Case review is available in every case; an informal conference in all SSI cases except medical issues (in SVB cases only when payments are being stopped or lowered); a formal conference only when SSA is stopping or lowering your SSI or SVB payment.
Timeliness, field office development, and Goldberg Kelly boxes the Social Security office completes — leave these blank.
A fictional retired worker received a notice dated July 14, 2026 saying they were overpaid $2,140 in retirement benefits for January to March 2026 because of wages. They believe SSA used the wrong stop-work date and file a non-medical reconsideration on paper. Identifiers are masked.
JORDAN EXAMPLE
Exactly as it appears on the SSA notice.
•••-••-4321 / left blank
The claim number box is only for a number that differs from your own SSN — for example when you receive benefits on a spouse's record.
Retirement — overpayment
The form asks you to specify retirement, disability, hospital or medical, SSI, SVB, overpayment, etc. Copy the wording from the notice.
Your notice dated July 14, 2026 says I was overpaid $2,140 for January–March 2026 because of wages. My last day of work was December 19, 2025 and I reported it by phone on December 22, 2025. The wages paid in January 2026 were my final paycheck for December work. My final pay stub is attached. Please recalculate the overpayment.
Specific dates, amounts and documents. SSA's Handbook says to state the specific reasons the determination is wrong and to attach a separate sheet if you need more space.
Jordan Example / 08/05/2026
The signature is optional on the 08-2025 edition. August 5 is well inside the deadline: 60 days from July 19, 2026 (the notice date plus the five presumed mailing days) ends September 17, 2026.
100 Sample Street, Springfield, IL 62701 · (217) 555-0142
Where SSA sends the reconsideration decision.
Left blank
Only for an appointed representative. Appointing one takes Form SSA-1696, not this form.
Left blank
This block applies only to Supplemental Security Income and Special Veterans Benefits reconsiderations. A retirement overpayment is a Title II case.
Left blank
Timeliness, field office development and Goldberg Kelly boxes are for the office that receives the form.
Handed in at the local Social Security office with a copy of the notice and the pay stub; copy kept
The form says to take or mail the original to your local office and keep a copy. It could also be uploaded from a my Social Security account. No SSA-827 is needed because this is not a medical appeal.
These values are made up. They are here to show what belongs on each line, not to be copied — every name, number, and address on your own Form SSA-561 has to be your own.
Upload your blank Form SSA-561 PDF and our AI maps every fillable region — no manual drawing required.
Fill Form SSA-561 once, save the layout, then reuse it instantly for the next client, employee, or filing.
GDPR compliant. Export or delete all your data anytime from your account settings.
Drop your blank Form SSA-561 PDF below. Free account, no credit card.
Upload your form
Choose a PDF or an image from your files, or photograph a paper form.
PDF, JPG, PNG, WebP, HEIC, GIF and BMP. Free account required, no credit card.
Your first download is free, with no watermark. After that: a watermark, or a $7 one-time pack (25 clean PDF downloads + 25 AI credits). AI detection covers up to 15 pages per run.
By uploading, you confirm you have the legal right to use this document.
Authorization to Disclose Information to the Social Security Administration (SSA)
Form SSA-44: Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event
Form SS-5: Application for a Social Security Card
Upload any document — a scan, a photo, a Word export, a form from another agency — and the same editor puts fields on it.
Turn a flat, scanned or exported PDF into a fillable form — draw the fields once, or let AI detect them.
Keep the original layout and get real, clickable form fields back out the other side.
Six methods compared (browser, Acrobat, Word, Mac, Google, scans), with a tested example and what each one costs.
Type straight onto any PDF in the browser. No Adobe or install; your first clean download has no watermark.
Upload a form and preview its fields before paying. Your first clean download has no watermark, and no credit card is required.
Adobe retired Fill & Sign. This is the free browser replacement for the same job.
Official source: Form SSA-561 on SSA (Social Security Administration)’s website
Edition checked: Form SSA-561 (08-2025) UF, "Discontinue Prior Editions", OMB No. 0960-0622. Verified against the official source on .
JustFill is an independent product and is not affiliated with, endorsed by, or sponsored by SSA (Social Security Administration) or any government agency. Always verify your completed form on the official version before signing or submitting.