Social Security reinstated my workers comp offset after FRA - what appeal option should I use?

This is a frustrating but common situation with WC offset issues. Based on what you've described, it sounds like SSA issued a reconsideration determination that you disagree with. If you already went through the reconsideration process once on this specific issue, your next step would be to request a hearing before an Administrative Law Judge (ALJ). You have 60 days from the date you received the notice to file the request for hearing. Use Form HA-501-U5.

Thanks for responding. The confusing thing is I'm not sure if this is a NEW reconsideration decision or if they're referring to an old one from months ago. The letter is so vague! If it's new, shouldn't I file a reconsideration first? Or can I skip straight to ALJ? I'm so confused about the proper sequence.

my mom had the EXACT same problem last yr!!!! they kept taking money off for workers comp even tho she was past FRA. took like 6 months to fix and then they did it AGAIN. total nightmare. she ended up having to go to local office with all her papers

Oh no, 6 months? We can't wait that long - we need that money for medications. Did your mom file a reconsideration or go straight to ALJ hearing? The local office is 45 minutes away and I can barely drive after my surgery.

The key is determining whether this is a new initial determination or if they're referencing the previous reconsideration. Look at the letter carefully - does it say \

This person knows what they are talking about! Make sure you look for those specific terms in the heading. Also make sure you keep copies of EVERYTHING you send them. My brother had a similar issue and lost his paperwork and it was a disaster.

Calling SSA directly might save you a lot of headache here. The problem is their phone lines are nearly impossible to get through on - I spent 4 hours on hold last month just to get disconnected. I started using this service called Claimyr (claimyr.com) that gets you connected to an SSA agent usually within 5-20 minutes. Saved me hours of frustration. They have a demo video at https://youtu.be/Z-BRbJw3puU showing how it works. Talking to an agent directly about which appeal form you need might be faster than guessing wrong and waiting months for a response.

Thanks for this suggestion! I hadn't heard of this service before. Spending hours on hold is exactly what I've been dreading, especially since I'm still recovering. I'll check out that video - getting clear direction from an actual agent would be so helpful right now.

The same thing happend to me! It's rediculous how they keep messing things up. Workers comp offset is suppose to STOP at FRA but these people don't know there own rules!!!!! I had to go all the way to a hearing. Make SURE you keep all the payment records showing they payed you correctly after FRA before this new notice. Thats your PROOF they acknowledged it was correct before!!!!

This is excellent advice about keeping the payment records showing the previous correct payments. Make sure you have bank statements showing the deposit amounts from January through April 2025 to demonstrate they were previously calculating the benefit correctly without the WC offset.

You definitely need to appeal, but the question is which type of appeal. Based on my experience helping my father with a similar issue, the determining factor is whether this letter contains a NEW initial determination, or if it's referencing the outcome of a previous reconsideration. If the letter came with an explanation of determination and a paragraph about your appeal rights, it's likely a new initial determination, which means you need to file a Request for Reconsideration (Form SSA-561). If it's referring to a reconsideration you already filed, then you need to request an ALJ hearing (Form HA-501-U5).One important question: did your husband's situation involve a lump sum workers compensation settlement with an offset that was calculated using a formula that spread the settlement across multiple years? Those are particularly prone to errors in the system.

Yes! It was exactly that - a lump sum settlement that they spread across years. They calculated it to end in January 2025 when he reached FRA. And that seemed to work fine until now. The letter does mention appeal rights and has a paragraph about

Based on your latest comment, it does sound like this is a new initial determination, which means you should file a Request for Reconsideration (Form SSA-561). When you file, be very specific in your explanation:1. State that the WC offset must end at FRA according to Section 224(a) of the Social Security Act2. Note that SSA had already correctly implemented this in January 2025 as evidenced by the correct payments received from January-April3. Provide copies of bank statements showing the correct payment amounts during those months4. Specify that this appears to be a systems error where the offset was incorrectly reapplied after it had been properly removedAlso request expedited processing due to your medical situation if you're experiencing financial hardship as a result of the reduced payment.

Thank you so much! This gives me a clear plan. I'll file the SSA-561 form and include all those points you mentioned. I'm definitely going to request expedited processing too - we really can't afford to wait months for this to be resolved. I appreciate everyone's help navigating this mess!

good luck!!! make sure u send it certified mail so they cant say they never got it. thats what happened to my mom the first time!

That's a smart idea! I'll definitely send it certified mail. I wouldn't put it past them to