General Appeals Information

Published 10/29/2024

If you are dissatisfied 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. The table shown below includes information on each of the appeal levels, the 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

Reconsideration requests should be mailed directly to the QIC. The address for the QIC is included in the redetermination letter. You should include a copy of the redetermination decision letter with your reconsideration request. 

Administrative Law Judge (ALJ)

60 days from receipt of the QIC decision.

$180 for requests filed on or before December 31, 2024.

$190 for requests filed on or after January 1, 2025.
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.

$1,840 for requests filed on or before December 31, 2024. 

$1,900 for requests filed on or after January 1, 2025.

 

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