TN 56 (10-26)

NL 00730.136 “R” Paragraphs and Captions

List of “R” Paragraphs and Captions

A. "RCY" - Recovery

RCYC01 – CAPTION

How to Pay Us Back

RCYC05 – CAPTION

Reduction To Collect Your SSI Overpayment

RCY002 – CROSS PROGRAM RECOVERY FOR SUPPLEMENTAL SECURITY INCOME (SSI) OVERPAYMENT

We paid you more in Supplemental Security Income (SSI) payments in the past than you were due. Our records show that you still owe us (1) in SSI payments. By law, we can collect SSI overpayments from the Social Security benefits that you receive. We withheld (2) from your Social Security benefits to collect (3) the SSI payments that you owe.

Fill-in values:

 

Fill-in (1)

Cross Program Recovery Overpayment Amount (CPR-OPAMT) in the format $$$$$$.¢¢

Fill-in (2)

Cross Program Recovery Underpayment Amount (CPR-UPAMT) in the format $$$$$$.¢¢

Fill-in (3)

 

Choice 1

some of

Choice 2

Null

RCY006 – BENEFITS RAISED - PARTIAL RECOVERY ENDS

We have raised your benefits back to your regular monthly payment amount. This is because you repaid the overpayment money you owed us.

RCY007 – PARTIAL RECOVERY ENDS - NO REMAINING OVERPAYMENT

We are withholding (1) from your benefits. This is the remaining balance you owed on your overpayment.

B. "REF" – Referral

REF020 – DEFERRAL - ADVANCE FILE MATURING

To make sure you get the correct amount of benefits, you need to promptly report any changes in the amount you earn or you expect to earn. You should also report any other changes that may affect your payment.

The pamphlet (1) describes the events you need to report. Refer to the Publication section of this notice to access the pamphlet.

 

Fill-in values:

 

Fill-in (1)

 

Choice 1

SSA Pub 05-10137, Your Payments While You Are Outside The United States

Choice 2

SSA Pub 05-10153, What You Need To Know When You Get Social Security Disability Benefits

Choice 3

SSA Pub 05-10077, What You Need To Know When You Get Retirement or Survivors Benefits

REF196 – STANDARD REFERRAL INFO FOR DOMESTIC ADDRESS

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)

(4)

(5)

(6)

(7)

How are we doing? Go to www.ssa.gov/feedback to tell us.

Fill-in values:

 

Fill-in (1)

Field office telephone number in format 1-XXX-XXX-XXXX

Fill-in (2)

Field office address line 1 from DOORS database

Fill-in (3)

Field office address line 2 from DOORS database

Fill-in (4)

Field office address line 3 from DOORS database

Fill-in (5)

Field office address line 4 from DOORS database

Fill-in (6)

City, State and ZIP code from DOORS database

Fill-in (7)

Null (for future use)

REF197 – STANDARD REFERRAL INFO FOR FOREIGN ADDRESS

Need more help?

  1. 1. 

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

  2. 2. 

    If you are in the United States, American Samoa, Guam, Northern Mariana Islands, Puerto Rico, or the U.S. Virgin Islands, call us at 1-800-772-1213. If you are deaf or hard of hearing, call TTY 1-800-325-0778.

  3. 3. 

    You may also call your local Social Security office.

If you are outside the United States or its territories:

  • •

    If you are in Canada, visit (1) to find the office that services your area.

  • •

    Contact your nearest Federal Benefits Unit (FBU). Visit (2) for a list of FBUs.

  • •

    Write to the Social Security Administration at:

P.O. Box 17769

Baltimore, Maryland 21235-7769, USA

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.

Fill-in values:

 

Fill-in (1)

www.ssa.gov/foreign/canada.htm

Fill-in (2)

www.ssa.gov/foreign/foreign.htm

REF198 – REFERRAL INFO FOR RAILROAD RETIREMENT

If you have any questions about railroad annuities or about your monthly check, please contact your local Railroad District Office or the Railroad Retirement Board. The address is U.S. Railroad Retirement Board, 844 Rush Street, Chicago, Illinois 60611-2092. You can also reach the Railroad Retirement Board on their website at www.rrb.gov or by calling 1-877-772-5772. If you are deaf or hard of hearing, please call the TTY number at 312-751-4701.

REF208 – REFERRAL INFO FOR STATE BUY-IN/BUY-OUT

If you have any questions about the State Medicaid program, please contact your State public assistance office.

If you have any questions about items that Social Security handles, please contact us.

REF209 – REFERRAL INFO FOR STATE RETIREMENT

If you have any questions about the State retirement system, please contact that office.

REF210 – REFERRAL INFO - NO FIELD OFFICE PHONE NUMBER IN DOORS FOR PUBLIC USE

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. 

    The office that serves your area is located at:

(1)

(2)

(3)

(4)

(5)

(6)

How are we doing? Go to www.ssa.gov/feedback to tell us.

Fill-in values:

 

Fill-in (1)

Field office address line 1 from DOORS database

Fill-in (2)

Field office address line 2 from DOORS database

Fill-in (3)

Field office address line 3 from DOORS database

Fill-in (4)

Field office address line 4 from DOORS database

Fill-in (5)

City, State and ZIP code from DOORS database

Fill-in (6)

Null (for future use)

REF211 – REFERRAL INFO - NO FIELD OFFICE DETAILS IN DOORS (INVALID ZIP/OFFICE CLOSED)

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.

How are we doing? Go to www.ssa.gov/feedback to tell us.

C. "REP" – Claimant Representation

REPC01 – CAPTION

If You Want Help With Your Appeal

REP002 – APPEALS INFORMATION - NOT USED ON END-STAGE RENAL DISEASE (ESRD) TERMINATION NOTICE

You may choose to have a representative help you. 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 receive benefits. Others may represent you for free. Usually, your representative may not charge a fee unless we approve it. Your local Social Security office can give you a list of groups that can help you find a representative.

If you get a representative, you or that person must notify us in writing. You may use our Form SSA-1696 “Appointment of Representative.” Any local Social Security office can give you this form.

REP005 – APPEALS INFORMATION FOR AN END-STAGE RENAL DISEASE (ESRD) TERMINATION NOTICE

You can have a friend, lawyer, or someone else help you. There are groups that can help you find a lawyer or give you free legal services if you qualify. There are also lawyers who do not charge unless you win your appeal. Your Social Security office has a list of groups that can help you with your appeal. If you get someone to help you, you should let us know.

D. "RFU" - Refund

RFU001 – OVERPAYMENT REQUESTED FROM TERMINATED BENEFICIARY

You should refund this overpayment of (1) within 30 days. Please see the "Payment Options" page for the ways to make a payment.

If you cannot refund the full amount of (2) now, you may request to repay in monthly installments. Please contact us promptly at (3) to discuss a repayment plan.

Fill-in values:

 

Fill-in (1)

Overpayment amount in the format $$$$$$.¢¢

Fill-in (2)

Overpayment amount in the format $$$$$$.¢¢

Fill-in (3)

 

Choice 1

1-888-280-9419 toll-free

Choice 2

1-800-527-4400 toll-free

Choice 3

1-866-601-9679 toll-free

Choice 4

1-888-231-3939 toll-free

Choice 5

1-800-227-8835 toll-free

Choice 6

1-800-821-5012 toll-free

RFU002 – OVERPAYMENT REQUESTED - FOREIGN ADDRESS

If you are unable to make a payment using one of the methods on the “Payment Options” page, please call our International Number promptly at 1-855-522-6936 (7am - 5pm Eastern Time) if you are outside the United States or its territories. You may also contact your nearest Federal Benefits Unit (FBU). Visit www.ssa.gov/foreign/foreign.htm for a list of FBUs. If you are in Canada, visit www.ssa.gov/foreign/canada.htm to find the office that services your area. They will help you make the refund.

RFU004 – SUPPLEMENTAL SECURITY INCOME (SSI) IS DETERMINED AND SOCIAL SECURITY RETROACTIVE BENEFITS ARE GREATER THAN THE SSI WINDFALL OFFSET AMOUNT

We compared your Social Security and SSI benefits. We found we should have paid you (1) less in SSI benefits. We will withhold this amount from your Social Security benefits.

Fill-in values:

 

Fill-in (1)

Deductions Additions History Amount (DAH-AMOUNT) that corresponds to the Deductions Additions History Type of Payment (DAH-TOP) = PMA (P) and Deductions Additions History Item (DAH-ITEM) = 345 (DIB SSI offset) or the DAH ITEM = 346 (RIB SSI offset) in the format $$$$$$.¢¢

RFU006 – SUPPLEMENTAL SECURITY INCOME (SSI) IS DETERMINED AND THE SOCIAL SECURITY RETROACTIVE BENEFITS ARE LESS OR EQUAL TO THE WINDFALL OFFSET AMOUNT

We compared your Social Security and SSI benefits. We found that we should have paid you (1) less SSI benefits. As a result, we cannot pay your any of the Social Security benefits we withheld.

Fill-in values:

 

Fill-in (1)

Deductions Additions History Amount (DAH-AMOUNT) that corresponds to the Deductions Additions History Type of Payment Code (DAH-TOP) = PMA (P) and [Deductions Additions History Item Code (DAH-ITEM) = 345 (DIB SSI offset or DAH-ITEM=346 (RIB SSI offset)] in the format $$$$$$.¢¢.

RFU007 – SUPPLEMENTAL SECURITY INCOME (SSI) WINDFALL OFFSET IS DETERMINED AND THERE IS NO SSI OFFSET APPLIED TO SECURITY BENEFITS THEREFORE RETRO BENEFITS ARE PAYABLE TO THE BENEFICIARY

Our records show that you did not get SSI money for (1). We can refund all of the Social Security money withheld.

Fill-in values:

 

Fill-in (1)

 

Choice 1

History Start date of the first month where Reason for Suspension = WINFAL in the format Month CCYY

Choice 2

Start date that corresponds to the Reason for Suspension = WINFAL plus ”through” plus the stop date of the last WINFAL Suspension month

RFU012 – TITLE II OVERPAYMENT ADJUSTMENT FROM BENEFITS WHEN OVERPAYMENT AMOUNT IS GREATER THAN MONTHLY BENEFIT AMOUNT (MBA)

You should refund this overpayment of (1) within 30 days. Please see the “Payment Options" page for the ways to make a payment.

If we do not receive your refund within 30 days, we will withhold 50 percent of your total monthly benefit starting with the payment you will receive on or about (2). If you would like us to recover the overpayment from cross program adjustment notify us promptly at the phone number located at the bottom of this letter. We will continue to withhold the overpayment from the monthly benefit until we recover the entire overpayment.

If you cannot refund the full amount within 30 days or cannot afford to have us withhold 50 percent, you may request that we withhold a smaller amount each month. Notify us promptly if you would like to adjust the withholding rate for the overpayment by contacting us at the phone number located at the bottom of this letter. We may ask you questions regarding your resources, monthly expenses, and monthly income.

Fill-in values:

 

Fill-in (1)

Overpayment amount due in format $$$$$$.¢¢

Fill-in (2)

Date of payment in the format Month DD, CCYY

RFU036 – TITLE II OVERPAYMENT ADJUSTMENT FROM BENEFITS WHEN OVERPAYMENT AMOUNT IS DUE TO FRAUD OR OTHER EXCLUSIONS ARE INVOLVED

Please refund this overpayment of (1) within 30 days. Please see the “Payment Options" page for the ways to make a payment.

If we do not receive your refund within 30 days, we will recover the overpayment by withholding your full monthly benefit starting with the payment you will receive on or about (2). We will continue withholding your monthly benefits until we fully recover the overpayment.

Fill-in values:

 

Fill-in (1)

Overpayment amount due in format $$$$$$.¢¢

Fill-in (2)

Date full payment withholding begins in the format Month DD, CCYY

E. "RIN" – Rate Information

RIN006 – EXPLAINS ADJUSTMENT REDUCTION FACTOR INCREASE

Because you retired early, we reduced your monthly Social Security benefit. The amount that we reduced it was based on the number of months you would receive benefits before (1). However, you didn't receive benefits some of these months because (2) worked and earned over certain limits. So, we must increase your benefit amount to give credit for these months.

Fill-in values:

 

Fill-in (1)

 

Choice 1

full retirement age

Choice 2

age 62

Choice 3

age 60

Fill-in (7)

 

Choice 1

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)

Choice 2

you

Choice 3

you and your choose

RIN007 – EXPLAINS DELAYED RETIREMENT CREDIT INCREASE

When you filed for Social Security benefits, we figured the benefit amount based on your earnings history at that time. If after becoming entitled to benefits, you continue to work, you may earn credit for this additional work. So, we must increase (5) benefit amount to give credit for these months.

We apply the increase sometime after it is due. This is because earnings information is not available until after each tax year.

RIN008 – MONTHLY BENEFIT AMOUNT (MBA) CHANGE - ANOTHER BENEFICIARY IS TERMINATED OR BECOMES ENTITLED ON THE RECORD

We changed your monthly benefit to (1) starting (2). We made this change because we (3) paying benefits to another person on this record.

Fill-in values:

 

Fill-in (1)

 

Choice 1

Post-MBR Monthly Benefit Amount (MBA) associated with the Effective Date (EFD) of the MBA increase

Choice 2

NA-HIST-POST-MBA in the format $$$$$.¢¢

Fill-in (2)

 

Choice 1

Effective Date (EFD) on the Post-MBR associated with the Monthly Benefit Amount (MBA) increase

Choice 2

 

NA-HIST-START month in the format Month CCYY

Fill-in (3)

 

Choice 1

started

Choice 2

stopped

RIN012 – MONTHLY BENEFIT AMOUNT (MBA) CHANGE - COST OF LIVING INCREASE

We raised your monthly benefit to (1) beginning (2) because the cost of living increased.

Fill-in values:

 

Fill-in (1)

 

Choice 1

Post-MBR Monthly Benefit Amount (MBA) associated with the Effective Date (EFD) of the MBA decrease

Choice 2

NA-HIST-POST-MBA in the format $$$$$.¢¢

Fill-in (2)

 

Choice 1

Effective Date (EFD) on the Post-MBR associated with the Monthly Benefit Amount (MBA) increase

Choice 2

NA-HIST-START month in the format Month CCYY

RIN013 – AUXILIARY'S MONTHLY BENEFIT AMOUNT (MBA) CHANGE DUE TO ANOTHER BENEFICIARY'S DEATH

We changed your monthly benefit to (1) starting (2). We changed your benefit because of the death of (3).

Fill-in values:

 

Fill-in (1)

 

Choice 1

Post-MBR Monthly Benefit Amount (MBA) associated with the Effective Date (EFD) of the MBA increase

Choice 2

NA-HIST-POST-MBA in the format $$$$$.¢¢

Fill-in (2)

 

Choice 1

Effective Date (EFD) on the Post-MBR associated with the Monthly Benefit Amount (MBA) increase due to death

Choice 2

NA-HIST-START month in the format Month CCYY

Fill-in (3)

 

Choice 1

Deceased Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

Choice 2

another person entitled on this record

RIN044 – AUXILIARY MONTHLY BENEFIT AMOUNT (MBA) CHANGE - ANOTHER BENEFICIARY ENTITLED AND COST-OF-LIVING ADJUSTMENT (COLA)

We changed your monthly benefit to (1) beginning (2) because we started paying another person(s) on this record. This change also includes the cost of living increase.

Fill-in values:

 

Fill-in (1)

 

Choice 1

Post-MBR Monthly Benefit Amount (MBA) associated with the Effective Date (EFD) of the MBA change in the format $$$$$.¢¢

Choice 2

NA-HIST-POST-MBA in the format $$$$$.¢¢

Fill-in (2)

 

Choice 1

Effective Date (EFD) on the Post-MBR associated with the Monthly Benefit Amount (MBA) change in the format Month CCYY

Choice 2

NA-HIST-START month in the format Month CCYY

RIN045 – MONTHLY BENEFIT AMOUNT (MBA) CHANGE - ANOTHER BENEFICIARY TERMINATES AND COST-OF-LIVING ADJUSTMENT (COST-OF-LIVING ADJUSTMENT (COLA))

We changed your monthly benefit to (1) beginning (2) because benefits to another entitled person(s) stopped. This change also includes the cost of living increase.

Fill-in values:

 

Fill-in (1)

 

Choice 1

Post-MBR Monthly Benefit Amount (MBA) associated with the Effective Date (EFD) of the MBA change in the format $$$$$.¢¢

Choice 2

NA-HIST-POST-MBA in the format $$$$$.¢¢

Fill-in (2)

 

Choice 1

Effective Date (EFD) on the Post-MBR associated with the Monthly Benefit Amount (MBA) change in the format Month CCYY

Choice 2

NA-HIST-START month in the format Month CCYY

RIN046 – NUMBER HOLDER NOTICE WORKERS’ COMPENSATION (WC)/PUBLIC DISABILITY BENEFIT (PDB) INVERSE OFFSET POSTPONED MONTHLY BENEFIT AMOUNT (MBA) CHANGE

We changed your monthly benefit to (1) beginning (2).

Fill-in values:

 

Fill-in (1)

Post-MBR Monthly Benefit Amount (MBA) associated with the Effective Date (EFD) of the MBA change in the format $$$$$.¢¢

Fill-in (2)

Effective Date (EFD) on the Post-MBR associated with the Monthly Benefit Amount (MBA) change in the format Month CCYY

RIN047 – MONTHLY BENEFIT AMOUNT (MBA) CHANGE - AGE REDUCTION FACTOR (ARF)

We changed yourmonthly benefit to (1) starting (2). We gave you credit for benefits that we did not pay at the full rate before you reached (3).

Fill-in values:

 

Fill-in (1)

 

Choice 1

Post-MBR Monthly Benefit Amount (MBA) associated with the Effective Date (EFD) of the MBA change in the format $$$$$.¢¢

Choice 2

Show the NA-HIST-POST-MBA in the format $$$$$.¢¢

Fill-in (2)

 

Choice 1

Effective Date (EFD) on the Post-MBR associated with the Monthly Benefit Amount (MBA) change in the format Month CCYY

Choice 2

NA-HIST-START month in the format Month CCYY

Fill-in (3)

 

Choice 1

age 60

Choice 2

age 62

Choice 3

full retirement age

RIN048 – MONTHLY BENEFIT AMOUNT (MBA) CHANGE - DELAYED RETIREMENT CREDIT (DRC)

We raised your monthly benefit amount beginning (1) to (2). We changed your benefit amount to give you credit for the past months that you delayed receiving retirement benefits.

Fill-in values:

 

Fill-in (1)

 

Choice 1

Effective Date (EFD) on the Post-MBR associated with the Monthly Benefit Amount (MBA) change in the format Month CCYY

Choice 2

TDA-RETAP-EVENT-DATE that corresponds to the TDA-EVENT-INDICATOR = A602 in the format Month CCYY

Fill-in (2)

 

Choice 1

Post-MBR Monthly Benefit Amount (MBA) associated with the Effective Date (EFD) of the MBA change in the format $$$$$.¢¢

Choice 2

TDA-RETAP-EVENT-DATE that corresponds with TDA-EVENT-INDICATOR = A602 in the format $$$$$.¢¢

RIN049 – MONTHLY BENEFIT AMOUNT (MBA) CHANGE DUE TO INCORRECT MBA

We changed your monthly benefit to (1) as of (2).

Fill-in values:

 

Fill-in (1)

 

Choice 1

Post-MBR Monthly Benefit Amount (MBA) associated with the Effective Date (EFD) of the MBA change in the format $$$$$.¢¢

Choice 2

NA-HIST-POST-MBA in the format $$$$$.¢¢

Fill-in (2)

 

Choice 1

Effective Date (EFD) on the Post-MBR associated with the Monthly Benefit Amount (MBA) change in the format Month CCYY

Choice 2

NA-HIST-START month in the format Month CCYY

RIN053 – MONTHLY BENEFIT AMOUNT (MBA) CHANGE DUE TO DUAL ENTITLEMENT (BENEFITS COMBINED OR DECOMBINED)

We changed your monthly benefit amount to (1) starting (2). We changed the amount because you are also entitled on another record.

Fill-in values:

 

Fill-in (1)

Post-MBR Monthly Benefit Amount (MBA) associated with the Effective Date (EFD) on the MBA change in the format $$$$$$.¢¢

Fill-in (2)

Effective Date (EFD) on the Post-MBR associated with the Monthly Benefit Amount (MBA) change in the format Month CCYY

Fill-in (3)

 

Choice 1

you are

Choice 2

he is

Choice 3

she is

RIN059 – PRIMARY INSURANCE AMOUNT (PIA) CHANGE DUE TO CREDITABLE MILITARY SERVICE

We are changing your benefits to give you credit for time you spent in military service. This time was not included when we figured your benefit before.

RIN060 – IDENTIFIES SPECIFIC YEAR(S) OF EARNINGS CREDITED TO THE NUMBER HOLDER, RESULTING IN A PRIMARY INSURANCE AMOUNT (PIA) INCREASE

We changed your benefit amount to give you credit for your (4) earnings. We did not include these earnings when we figured your benefit amount before.

Fill-in values:

 

Fill-in (1)

 

Choice 1

Year of earnings in format CCYY

Choice 2

Year of earnings and year of earnings in format CCYY and CCYY

Choice 3

Year of earnings, year of earnings and year of earnings in format CCYY, CCYY and CCYY

Choice 4

Year of earnings, year of earnings, year of earnings and year of earnings in format CCYY, CCYY, CCYY and CCYY

Choice 5

Null

RIN061 – DUALLY ENTITLED BENEFICIARY RECEIVING PRIMARY INSURANCE AMOUNT (PIA) INCREASE ON THE OTHER RECORD – NO INCREASE DUE ON OWN PIA

We reviewed our records to see if you are due more money. We increased your benefits to give you credit for the earnings of (1) that we did not count before.

Fill-in values:

 

Fill-in (4)

 

Choice 1

your spouse

Choice 2

his spouse

Choice 3

her spouse

Choice 4

Number Holder's (NH) Name (not possessive)

RIN062 – DUALLY ENTITLED BENEFICIARY RECEIVING PRIMARY INSURANCE AMOUNT (PIA) INCREASE ON OWN ACCOUNT – BENEFITS ON OTHER RECORD ARE ENDING BECAUSE BENEFICIARY’S OWN BENEFIT IS LARGER

We reviewed our records and found that we can increase your benefits. We increased your benefits because we gave you credit for earnings that we did not count before.

You receive benefits on your own record and as a (1) on another record. Since your benefits are now higher on your own record, we stopped the benefits you receive on the other record.

Fill-in values:

 

Fill-in (1)

 

Choice 1

spouse

Choice 2

parent

Choice 3

surviving spouse

Choice 4

divorced spouse

Choice 5

surviving former spouse

RIN063 – DUALLY ENTITLED BENEFICIARY’S ONGOING MONTHLY PAYMENT AMOUNT REMAINS THE SAME OR IS SLIGHTLY DIFFERENT DUE TO ROUNDING – SMALLER PRIMARY INSURANCE AMOUNT (PIA) AND BENEFIT INCREASE ON OWN RECORD WHILE LARGER PIA ON OTHER RECORD REMAINS THE SAME BUT THE AMOUNT PAYABLE DECREASES

Since we increased the amount we pay you on your own record, we decreased the amount we pay you on another record.

RIN064 – DUALLY ENTITLED BENEFICIARY RECEIVES PRIMARY INSURANCE AMOUNT (PIA) INCREASE ON OWN RECORD AND ON THE OTHER RECORD

We increased the benefits on both Social Security records. To get the amount we can pay you, we subtract the new benefit on your own record from the new benefit on the other record.

RIN065 – DUALLY ENTITLED BENEFICIARY RECEIVES PRIMARY INSURANCE AMOUNT (PIA) INCREASE ON OWN ACCOUNT – ONGOING MONTHLY PAYMENT AMOUNT REMAINS THE SAME OR IS SLIGHTLY DIFFERENT DUE TO ROUNDING – SMALLER PIA AND BENEFIT INCREASE ON OWN ACCOUNT WHILE LARGER PIA ON OTHER RECORD REMAINS THE SAME BUT AMOUNT PAYABLE DECREASES

Since we increased the amount we pay you on your) own record, we decreased the amount we pay you on your spouse’s record.

RIN066 – MONTHLY BENEFIT AMOUNT (MBA) DECREASED BECAUSE ACTUAL EARNINGS WERE LESS THAN THE EXPECTED EARNINGS ORIGINALLY USED TO CALCULATE THE PRIMARY INSURANCE AMOUNT (PIA)

We reviewed your record and found that your earnings changed. These changes caused your monthly benefit amount to decrease effective (1).

Fill-in values:

 

Fill-in (1)

 

Choice 1

 

Post-MBR History Effective Date (EFD) associated with the first Primary Insurance Amount Effective Date (PIED) occurrence of Primary Insurance Amount (PIA) decrease in the format Month CCYY

F. "RPA" – Representative Payee Annual Accounting

RPAC01 – CAPTION

It Is Important To Keep Track Of This Money

G. "RMT" - Remittances

RMT001 - REFER TO PAYMENT OPTION PAGE FOR T2 OVERPAYMENTS AND RETURN OF CONSERVED FUNDS NL 00730.200

RMT005 - REFER TO PAYMENT OPTION PAGE FOR T2 OVERPAYMENTS AND RETURN OF CONSERVED FUNDS NL 00730.200

RMT006 - REFER TO PAYMENT OPTION PAGE FOR T2 OVERPAYMENTS AND RETURN OF CONSERVED FUNDS NL 00730.200

RMT007 - REFER TO PAYMENT OPTION PAGE FOR T2 OVERPAYMENTS AND RETURN OF CONSERVED FUNDS NL 00730.200

RMT008 - REFER TO PAYMENT OPTION PAGE FOR T2 OVERPAYMENTS AND RETURN OF CONSERVED FUNDS NL 00730.200

H. "RPY" – Representative Payee

RPY002 – SUSPENSION - HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF PAYEE DEVELOPMENT (DEVPYE) OR DEATH OF PAYEE (DTHPYE)

If you know someone who can be your payee, please call us at either of the telephone numbers shown at the end of this letter. We will consider this person for your new payee. Also, if you believe you are able to manage your own money, please let us know. Call us within the next 30 days if you do not hear from us. You may be able to get some payments directly while we make our decision.

RPY003 – SUSPENSION - HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF PAYEE DEVELOPMENT (DEVPYE) OR DEATH OF PAYEE (DTHPYE)

If you know someone who can be your payee, please call us at either of the telephone numbers shown at the end of this letter. We will consider this person for your payee. Also, call us within the next 30 days if you do not hear from us. You may be able to keep getting some payments directly while we make our decision.

RPY015 – FORMER PAYEE NOTICE

Thank you for your willingness to serve as a representative payee. We have decided that it would be best for (1) to have (2) payments sent to another payee.

Fill-in values:

 

Fill-in (1)

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)

Fill-in (2)

 

Choice 1

his

Choice 2

her

RPY016 – FORMER PAYEE NOTICE

We have decided that it would be best for (1) to have (2) payments sent to (3).

Fill-in values:

 

Fill-in (1)

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)

Fill-in (2)

 

Choice 1

his

Choice 2

her

Fill-in (3)

 

Choice 1

him

Choice 2

her

RPY038 – PAYEE CHANGE TO SELF

We will begin to send your paymentsdirectly to you. The rest of this letter will give you more information about your benefits.

RPY039 – NEW PAYEE SELECTED

We have chosen you to be (1) representative payee. The rest of this letter will give you information about the checks you will receive while you are the payee.

Fill-in values:

 

Fill-in (1)

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)

RPY041 – NEW PAYEE SELECTED

Please read the enclosed pamphlet, “A Guide for Representative Payees.” It lists the things you will need to know because you have been chosen as payee.

RPY042 – NEW PAYEE SELECTED

You will need to keep track of how you use all of the money we send you for (1). Each year we will ask you to report on how you used the money. We call this a representative payee accounting.

Fill-in values:

 

Fill-in (1)

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)

RPY048 – NEW PAYEE SELECTED - NO BENEFITS PAYABLE

We have chosen you to be (1) representative payee. However, we cannot pay benefits at this time.

Fill-in values:

 

Fill-in (1)

Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)

RPY073 – PAYEE CHANGE - BENEFICIARY'S NOTICE

We have chosen (1) to be your representative payee. Your payee will receive your payments each month and will use this money for your needs.

Fill-in values:

 

Fill-in (1)

New Payee Name

RPY086 – BENEFICIARY DIES - PAYEE TOLD ABOUT CONSERVED FUNDS

You may have saved some Social Security money for (1). Any money that you have saved, plus any interest on that money, belongs to (2) estate.

Fill-in values:

 

 

Fill-in (1)

BGN plus BLN

Fill-in (2)

 

Choice 1

his

Choice 2

her

RPY087 – BENEFICIARY DIES - PAYEE TOLD OF DISPOSITION OF FUNDS

You need to do one of these things:

  • •

    Give this money to the legal representative of the estate, or

  • •

    If there is no legal representative, contact the state probate court. They will be able to tell you what to do with the money, or

  • •

    If there is no legal representative, and you live outside the United States, contact the authorities who control the estate's money. They will be able to tell you what to do with the money.

I. "RRB" – Railroad Board

RRBC01 – CAPTION

What The Railroad Retirement Board Will Do

J. "RSD" – Not Qualified For Medicare

RSD003 – MEDICARE DISALLOWANCE - RESIDENCY

You cannot qualify for Medicare because you did not live in any of the 50 states, the District of Columbia, the Commonwealth of Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa or the Northern Mariana Islands at the time you applied for Medicare.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900730136
NL 00730.136 - “R” Paragraphs and Captions - 10/14/2026
Batch run: 10/14/2026
Rev:10/14/2026