Published 03/02/2021

Appeals may be submitted for partially or fully denied services, as long as the service has “appeal rights.” 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. There are time limits for filing the appeal. Find tools here to determine timeliness of your appeal.

Appeals Time Limit
Redetermination (initial appeal) 120 days from the date of receipt of the initial claim determination notice. The notice of initial determination is presumed to be received 5 days from the date of the notice.
Reconsideration -
Qualified Independent Contractor (QIC)
180 days from receipt of the redetermination
Administrative Law Judge (ALJ) 60 days from receipt of the QIC decision
Departmental Appeals Board Review (DAB)/Appeals Council 60 days from the date of the ALJ decision or dismissal
Federal District Court Review 60 days from the date of the Appeals Council decision

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