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Jurisdiction 1 Part B
Appeals

If you are dissatified with an initial claim determination, you have the right to request an appeal. There are several appeal levels and each level must be processed before proceeding to the next level. Following are the available appeal levels, amount in controversy thresholds and the time limits for filing an appeal.

Appeals
Time Limit
Minimum Amount in Controversy
Notes
Redetermination (initial appeal) 120 days from the date of the initial claim determination notice None A Redetermination Request must be completed before filing a Reconsideration Request with the QIC
Reconsideration -
Qualified Independent Contractor (QIC)
180 days from receipt of the redetermination None Include a copy of the redetermination notice with any QIC request
Administrative Law Judge (ALJ) 60 days from receipt of the QIC decision Requests made before January 1, 2008 - $120 The QIC decision letter will provide the HHS OMHA office to which an ALJ request is mailed
Departmental Appeals Board Review (DAB) / Appeals Council 60 days from the date of the ALJ decision or dismissal None
Federal District Court Review 60 days from the date of the Appeals Council decision Requests made on or after January 1, 2008 - $1,180.
Requests made on or after January 1, 2009 -  $1,220.

Looking for forms?
Forms for the various levels of appeal are located at the bottom of this page.

Want to avoid appeals? Check out the
Denial Finder tool.

 

last updated on 07/23/2009
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