RCYC01 – CAPTION

How to Pay Us Back

RCYC04 – CAPTION

Do You Think That You Do Not Owe This Money?

RCYC05 – CAPTION

Reduction To Collect Your SSI Overpayment

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

We paid (1) more in Supplemental Security Income (SSI) payments in the past than (2) due. Our records show that (3) us (4) in SSI payments. By law, we can collect SSI overpayments from the Social Security benefits that (5). We withheld (6) from (7) Social Security benefits to collect (8) the SSI payments that (9).

RCY003 – CROSS PROGRAM RECOVERY FOR SUPPLEMENTAL SECURITY INCOME (SSI) OVERPAYMENT - USED WITH RCY002

You may ask us to review our finding that you still owe the money. You may have evidence to show that you already paid some or all of the money or that we previously waived collection of it. If so, give us this evidence when you ask for review. We will review the evidence you give us and the information we have. We will send you a letter with our decision. If we find that you do not owe us this amount, then we will correct our records.

For more information on requesting review, see "If You Disagree With The Decision" below.

RCY006 – BENEFITS RAISED - PARTIAL RECOVERY ENDS

We have raised (1) benefits back to (2) regular monthly payment amount. This is because (3) repaid the overpayment money (4) owed us.

RCY007 – PARTIAL RECOVERY ENDS - NO REMAINING OVERPAYMENT

We are withholding (1) from (2) benefits. This is the remaining balance (3) owed on (4) overpayment.

REFC01 – CAPTION

Suspect Social Security Fraud?

Please visit http://oig.ssa.gov/r or call the Inspector General’s Fraud Hotline at 1-800-269-0271 (TTY 1-866-501-2101).

If You Have Questions

REF020 – DEFERRAL - ADVANCE FILE MATURING

To make sure (1) the correct amount of benefits, you need to promptly report any changes in the amount (2) or (3) to earn. You should also report any other changes that may affect (4) payment.

The pamphlet (5) describes the events you need to report. Visit www.ssa.gov for a copy of the pamphlet.

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.

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.

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.

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.

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.

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.

RFU001 – OVERPAYMENT REQUESTED FROM TERMINATED BENEFICIARY

You should refund this overpayment of (1) within 30 days. Please make your check or money order payable to “Social Security Administration,” and send it to us in the enclosed envelope.

Always include (2) Social Security claim number on your check or money order.

If you cannot refund the full (3) now, please send:

• A partial payment

• An explanation of why you cannot pay the full amount now, and

• A plan to repay the money

RFU002 – OVERPAYMENT REQUESTED - FOREIGN ADDRESS

If (1) us by check or money order, make sure that the check or money order is in United States (U.S.) dollars or in local currency equal to U.S. dollars. When (2) us in local currency, we use the exchange rates in effect at the time we get (3) payment. If this causes a difference between the amount (4) us and the amount (6) us, we will let you know. If you cannot mail your payment to us, please contact your nearest Federal Benefits Unit (FBU). Visit (7) for a list of FBUs. If you are in Canada, visit (8) 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 (1) Social Security and SSI benefits. We found we should have paid (2) (3) less in SSI benefits. We will withhold this amount from (4) Social Security benefits.

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

We compared (1) Social Security and SSI benefits. We found that we should have paid (2) (3) less SSI benefits. As a result, we cannot pay (4) any of the Social Security benefits we withheld.

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 (1) did not get SSI money for (2). We can refund all of the Social Security money withheld.

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 make your check or money order payable to the "Social Security Administration," and send it to us in the enclosed envelope.

Always include (2) Social Security claim number on your check or money order.

If we do not receive your refund within 30 days, we will withhold 10 percent of (3) total monthly benefit or $10 (whichever is more) starting with the payment you will receive (4) on or about (5). If the total benefit is less than $10, we will withhold the entire benefit. We will continue withholding from (6) benefits until we recover the overpayment.

If you cannot refund the full overpayment now or cannot afford to have us withhold 10 percent of (7) benefit, you may ask us to withhold a smaller amount each month. Contact us to discuss your plan for repaying the balance. You may need to show us proof of (8) assets, monthly income, and expenses. The minimum withholding amount we will accept is $10.

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

You should refund this overpayment of (1) within 30 days. Please make your check or money order payable to the "Social Security Administration," and send it to us in the enclosed envelope.

Always include (2) Social Security claim number on your check or money order.

If we do not receive your refund within 30 days, we will withhold (3) full benefit starting with the payment you will receive (4) on or about (5). We will continue withholding from (6) benefits until we recover the overpayment.

RIN006 – EXPLAINS ADJUSTMENT REDUCTION FACTOR INCREASE

Because (1) retired early, we reduced (2) monthly Social Security benefit. The amount that we reduced it was based on the number of months (3) would receive benefits before (4). However, (5) didn't receive benefits some of these months because (6) worked and earned over certain limits. So, we must increase (7) benefit amount to give credit for these months.

RIN007 – EXPLAINS DELAYED RETIREMENT CREDIT INCREASE

When (1) filed for Social Security benefits, we figured the benefit amount based on (2) earnings history at that time. If after becoming entitled to benefits, (3) to work, (4) 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 (1) monthly benefit to (2) starting (3). We made this change because we (4) paying benefits to another person on this record.

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

We raised (1) monthly benefit to (2) beginning (3) because the cost of living increased.

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

We changed (1) monthly benefit to (2) starting (3). We changed (4) benefit because of the death of (5).

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

We changed (1) monthly benefit to (2) beginning (3) because we started paying another person(s) on this record. This change also includes the cost of living increase.

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

We changed (1) monthly benefit to (2) beginning (3) because benefits to another entitled person(s) stopped. This change also includes the cost of living increase.

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

We changed (1) monthly benefit to (2) beginning (3).

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

We changed (1) monthly benefit to (2) starting (3). We gave (4) credit for benefits that we did not pay at the full rate before (5) reached (6).

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

We raised (1) monthly benefit amount beginning (2) to (3). We changed (4) benefit amount to give (5) credit for the past months that (6) delayed receiving retirement benefits.

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

We changed (1) monthly benefit to (2) as of (3). We found that (4) prior amount was incorrect.

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

We changed (1) monthly benefit amount to (2) starting (3). We changed the amount because (4) also entitled on another record.

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

We are changing (1) benefits to give (2) credit for time (3) spent in military service. This time was not included when we figured (4) benefit before.

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

We changed (1) benefit amount to give (2) credit for (3) (4) earnings. We did not include these earnings when we figured (5) benefit amount before.

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 (1) due more money. We increased (2) benefits to give (3) credit for the earnings of (4) that we did not count before.

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 (1) benefits. We increased (2) benefits because we gave (3) credit for earnings that we did not count before.

(4) benefits on (5) own record and as a (6) on another record. Since (7) benefits are now higher on (8) own record, we stopped the benefits (9) on the other record.

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 (1) on (2) own record, we decreased the amount we pay (3) 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 (1), we subtract the new benefit on (2) 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 (1) on (2) own record, we decreased the amount we pay (3) on (4) 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 (1) record and found that (2) earnings changed. These changes caused (3) monthly benefit amount to decrease effective (4).

RPAC01 – CAPTION

It Is Important To Keep Track Of This Money

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) checks sent to another payee.

RPY016 – FORMER PAYEE NOTICE

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

RPY038 – PAYEE CHANGE TO SELF

We will begin to send your checks directly 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.

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.

RPY048 – NEW PAYEE SELECTED - NO BENEFITS PAYABLE

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

RPY073 – PAYEE CHANGE - BENEFICIARY'S NOTICE

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

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.

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.

RRBC01 – CAPTION

What The Railroad Retirement Board Will Do

RSD003 – MEDICARE DISALLOWANCE - RESIDENCY

(1) cannot qualify for Medicare because (2) 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 (3) applied for Medicare.