Free Social Security Disability Appeal Letter [Sample]

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Learn how to write a social security disability appeal letter. Use our sample social security disability appeal letter as a template for your appeal letter.

Social Security Disability Appeal Letter Sample


[Social Security Administration]
[Box 8973900]
[Kansas City, MO 98056]
Attn: Appeals Department

To Whom It May Concern:

I applied for Social Security Disability for my son, [Jesse Thomas], who suffers from [Autism Spectrum]. We have filed this claim four times and all four times have been declined.

I have provided the agency updated documentation of the child’s need for services and yet we still receive a decline. 

Jesse is classified as having a major illness that will last 6 or more month. We are asking that the application should be reconsidered.

[Jesse] is classified as having [ADHD], [Autism Spectrum, Mood Disorder, Cognitive Delays and Post Traumatic Stress Disorder]. 

While it appears that he may function somewhat well in a classroom, he has major cognitive problems that require a lot of one on one attention.

[Jesse] has social interaction problems that make attending a normal school system next to impossible. He has to have monitoring 24×7 due to lack of impulse control. 

I have to pay for caregivers to be able to even go to the grocery store. He requires a dedicated person to be with him at all times.

We keep being denied for this assistance, yet according to the Social Security guidelines, a person with [Autism Spectrum] falls under the category for assistance.

We have provided diagnosis information from his doctors stating he has this condition. There should be no problem getting this claim through, as we clearly have the criteria met for allowing its approval.

Thank you for your time and consideration in this matter. I can be reached anytime at [740-710-8596]. We look forward to settling this matter in a timely fashion.


[Carolyn Thomas]

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