Sample Social Security Appeal Letter printable pdf download

Sample Social Security Appeal Letter

SAMPLE SOCIAL SECURITY APPEAL LETTER

Appeals Claim Examiner

12225 Greenville Ave

Dallas TX 75243-9382

Telephone 800-352-0611

Mail:

Joe X. Claimant

Ext.1249

1601 Chestnut St.

Fax: 860-731-3211

Philadelphia, Pa. 19192

To:

Joe X. Claimant

1601 Chestnut St.

Philadelphia, Pa. 19192

Re:

Claimant:

Joe X. Claimant

Certholder:

S657000010

Policy Keys:

NHS

0007343000826

Account Name:

Florida Power and Light

Company Name:

Life Insurance Co. of North America

This letter is in reference to your above mentioned long term disability claim.

With your approval, we have retained the services of an attorney who, at our expense, will

represent you in your appeal for Social Security disability benefits. The attorney is:

Joe Legal

123 Main Street

Miami, FL 33109

813-555-1212

The attorney will call you to arrange for an initial consultation. If you do not hear from the

attorney within 2 weeks from the date of this letter, please give the attorney a call. Also, if you

are notified of your actual hearing date before contact with the attorney, please advise me

immediately. (Please disregard if you have already notified us of the hearing date.)

Please feel free to contact me should there be any questions.

Sincerely,

Claim Manager

Sample Social Security Appeal Letter