Parties dissatisfied with an initial claim determination 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
|
You must file a Redetermination Request before filing a Reconsideration Request with the QIC.
|
|
Reconsideration -
Qualified Independent Contractor (QIC)
|
180 days from receipt of the redetermination
|
None
|
Please include a copy of the redetermination notice with any QIC request. The address for the QIC is located on the form.
|
|
Administrative Law Judge (ALJ)
|
60 days from receipt of the QIC decision
|
At least $120 remains in controversy for requests made on, or after January 1, 2009. For request made before January 1, 2009, at least $120 remains in controversy.
|
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
|
At least $1,220 remains in controversy for requests made on, or after January 1, 2009. For request made on, or after January 1, 2008, at least $1,180 remains in controversy.
|
|