SPOUSE'SNAME(CompleteONLYinSSIcases) CLAIMFOR(Specifytype,e.g.,retirement,disability,hospital/medical,SSI,SVB,etc.) SOCIALSECURITYADMINISTRATIONTOE710 TELEPHONENUMBER(Includeareacode)TELEPHONENUMBER(Includeareacode) ()-()- ODO,BALTIMORE OIO,BALTIMORE ...
Appeal: Request for reconsideration of a previous decision, determination, or finding. This should be performed via the Provider Appeal process.An appeal can be requested via InTouch for Providers (preferred) or by submitting a ProviderAppeal RequestForm. ...