NL 00705.165 Model Letter — DIB, DWB, or CDB Reconsideration Affirmation — Does Not Wish to Pursue

Prepare on SSA-L976-U2

Social Security Notice of Reconsideration

           Claim for

           (A)

           (B)

           (C)

Since you indicated that you did not want us to continue the processing of your request for reconsideration, we have not made an determination as to whether you are disabled. Therefore, we find that the previous determination denying your claim was proper under the law.

If you believe that this determination is not correct, you may request a hearing before an Administrative Law Judge of the Office of Disability Adjudication and Review. If you want a hearing, you must request it not later than 60 days form the date you receive this notice. You may make your request through any Social Security office. The enclosed leaflet provides a full explanation of your right to appeal.

If you do not request a hearing on your claim within the prescribed time period, you still have the right to file another application at any time.

If you have questions about your claim, you should get in touch with any Social Security office. Most questions can be handled by telephone or mail. If you visit an office, however, please take this letter with you.

 

          

           (A) Disability Insurance Benefits

           (B) Disabled Widow, Widower Benefits

           (C) Childhood Disability Benefits

 

Enclosure:
SSA Publication No. 70-10282