TN 34 (09-26)

NL 00705.251 Reopening Notice 11 – Fully Favorable or Partially Favorable Onset to a Later Onset – Title XVI

 

We are writing to you about _(1)_ Supplemental Security Income (SSI) payments. We recently looked at (2) claim again to make sure our decision was correct. After reviewing all the information carefully, we are changing our decision. Based on our rules, we now find that (3) disability did not begin until (4) .

Fill-ins:

(1) your/claimant’s name (possessive)

(2) your/his/her

(3) your/his/her

(4) established onset date (MM/DD/YYYY)

 

The Decision

See the enclosed Explanation

Enter the Personalized Disability Explanation (PDE) language per DI 26530.020 and DI 26530.055, including a list of the evidence, an explanation of what the evidence shows, and the detailed, personalized reasons for the determination. For additional guidance, see Reopening of Prior Determination DI 27536.015.

 

If concurrent claims are involved, include:

This decision refers only to (1) SSI payments. You will get a separate letter about (2) Social Security Disability Insurance (SSDI) benefits.

Fill-ins:

(1) your/his/her

(2) your/his/her

 

If You Disagree With The Decision

 

If you do not agree with this decision, you have the right to appeal. A person who did not make the first decision will decide the case. We will review _the case and look at any new facts you give us. We will review the parts of the decision that you think are wrong and correct any mistakes. We may also review the parts of the decision that you think are right. We will make a decision that may or may not be in your favor.

• •

  You have 60 days to ask for an appeal.

• •

  The 60 days start the day after you receive this letter. We assume you got this letter 5 days after the date on it unless you show us that you did not get it within the 5-day period.

• •

  You must have a good reason if you wait more than 60 days to ask for an appeal.

• •

  You must ask for an appeal in writing. Please use our "Request for Reconsideration" form, SSA-561. You can go to our website at https://www.ssa.gov/forms to locate the form. Or, you can submit your appeal request online at www.ssa.gov/disability/appeal. You can also contact us to request the form, or if you need help filling out the form.

 

If You Want Help With Your Appeal

 

You may choose to have a representative help you with your case. We will work with this person just as we would work with you. If you decide to have a representative, you should find one quickly so that person can start preparing your case.

Many representatives charge a fee only if you win your case. Others may represent you for free. Generally, your representative cannot charge a fee we approve it. Your local Social Security office can give you a list of groups that can help you find a representative. If you hire a representative who is eligible for direct pay, we will withhold up to 25 percent of any past-due benefits to pay their fee.

If you get a representative, you or that person must notify us in writing using our form. You can go to https://secure.ssa.gov/ssa1696/front-end / to complete the form with your representative online, download the form SSA-1696 "Claimant’s Appointment of a Representative" at www.ssa.gov/forms, or contact us to request a form.

 

You can also log into your my Social Security account for information and online service options regarding your representation.

Suspect Social Security Fraud?

Please visit https://oig.ssa.gov/report or call the Inspector General's Fraud Hotline at (800) 269-0271. If you are deaf or hard of hearing, call TTY (866) 501-2101.

 

Need more help?

 

1. 1. 

   Visit www.ssa.gov for fast, simple, and secure online service.

2. 2. 

   Call us at 1-800-772-1213, weekdays from 8:00 am to 7:00 pm. If you are deaf or hard of hearing, call TTY 1-800-325-0778. Please mention this letter when you call.

3. 3. 

   You may also call your local office at _(1).

(2)

(3)

Fill-ins (per DOORS):

(1) Field Office (FO) phone number

(2) FO name

(3) FO address

If you contact us, please refer to this letter. It will help us answer your questions.

How Are We Doing? Go to www.ssa.gov/feedback to tell us.

 

Enclosure(s):

Explanation

Multi-Language Insert, if needed