NL 00705.600 Model LetterQ—Medicare Coverage Only—CDB—Lack Of Severity

(Prepare on SSA-L951-U2)

 

Social Security Notice

 

                              Date:

 

                              Claim Number:

 

This notice refers to your claim for Medicare as a disabled child based on   (NH's Name)   Federal employment.

We have determined that you cannot be reentitled to Medicare as a disabled child. After carefully studying the medical evidence in your case and your statements, it has been determined that your condition was not severe enough to meet the disability requirements of the law.

A disabled child may be eligible for Medicare only if he/she has a physical or mental impairment so severe that it prevents him/her from performing any substantial gainful work. The disability must have lasted or be expected to last 12 months.

The disability must start not later than 7 years after the person's prior period of disability ended. The 7 year period in your case ends on  (MO/DA/YR) . If your condition should worsen before that date, you should write or call any Social Security office about filing another application.

If you believe that this determination is not correct, you may request that your case be reexamined. If you want this reconsideration, you must request it not later than 60 days from the date you receive this notice. You may make any such request through any Social Security office. If additional evidence is available, you should submit it with your request. Please read the enclosed leaflet for a full explanation of your right to question the determination made on your claim.

If you do not request reconsideration of your case within the prescribed time period, you still have the right to file another application at any time.

If you have any questions about your claim, you should get in touch with any Social Security office. If you call in person, please take this notice with you.

 

ENCLOSURE:
SSA Publication No. 70-10058