TN 27 (03-99)
1598. Situation Where Used:
The FO determined that either no title II benefits are payable or, if the individual
is receiving title II, no additional title II benefits are payable. See SI 00601.030 for notice input instructions. This paragraph replaced paragraph 1599 in January
1991.
The application (you) filed for SSI was also a claim for Social Security benefits. We looked into this,
and decided (you) can't get any Social Security benefits (1) . If (you) disagree with the decision, (you) have the right to appeal. A case review, described later in this letter, is the only
kind of appeal (you) can have regarding Social Security benefits.
| (1) |
Choice 1 - except the benefit (you) are already getting
|
| |
Choice 2 - Null |
APIM50. Situation Where Used:
Use on an SSA-L8165-U2 (Important Information) to close out a written statement of
intent to file. Also, use to close out a written statement or oral inquiry when you
cannot schedule an appointment, the appointment is not kept and you cannot reschedule
it, or the rescheduled appointment is not kept. Add paragraph MISM53 in NL 00804.240 as the closing paragraph.
We are writing to tell you that before we can make a decision about your request for
Supplemental Security Income (SSI) payments, you must file an application.
What To Do Next
You should get in touch with us right away because the date you file an application
can make a difference in the amount of your SSI payments.
If you file the application by (1) , we will use (2) , the date of the written request, as the filing date.
Call or visit any Social Security office. We will help you fill out the application
for SSI payments.
What Will Happen
If you file an application, we will review the case and make a decision. If you do
not agree with what we decide, you will be able to appeal the decision.
| (1) |
(Month/Day/Year) (enter the 60th day after the date of this notice) |
| (2) |
(Month/Day/Year) |
APIM51. Situation Where Used:
Use on an SSA-L8165-U2 (Important Information) to the inquirer to close out a protective
filing on behalf of a child under age 18 or legally incompetent adult. Also, use when
you cannot schedule an appointment, the appointment is not kept and you cannot reschedule
it, or the rescheduled appointment is not kept. Add paragraph MISM53 in NL 00804.240 as the closing paragraph.
We are writing to tell you that before we can make a decision about your request for
Supplemental Security Income (SSI) payments for (1) , you must file an application.
What To Do Next
You should get in touch with us right away because the date you file an application
can make a difference in the amount of (2) SSI payments.
If you file the application by (3) , we will use (4) , the date of the request, as the filing date.
Call or visit any Social Security office. We will help you fill out the application
for SSI payments.
What Will Happen
If you file an application, we will review the case and make a decision. If you do
not agree with what we decide, you will be able to appeal the decision.
| (1) |
Choice 1 - (name of child under age 18) |
| |
Choice 2 - (name of legally incompetent adult) |
| (2) |
Choice 1 - (name of child under age 18 (possessive)) |
| |
Choice 2 - (name of legally incompetent adult (possessive)) |
| (3) |
(Month/Day/Year) (enter the 60th day after the date of this notice) |
| (4) |
(Month/Day/Year) |
APIM52. Situation Where Used:
Use on an SSA-L8165-U2 (Important Information) to the claimant to close out a written
statement of intent to file when someone other than the claimant inquires on his/her
behalf. Also, use to close out a written statement or oral inquiry when you cannot
reschedule an appointment, the appointment is not kept and you cannot reschedule it,
or the rescheduled appointment is not kept. Add paragraph MISM53 in NL 00804.240 as the closing paragraph.
We are writing to tell you that we received a written request for Supplemental Security
Income (SSI) payments on your behalf. Before we can make a decision about this request
for SSI payments, you must file an application.
What To Do Next
You should get in touch with us right away because the date you file an application
can make a difference in the amount of your SSI payments.
If you file the application by (1) , we will use (2) , the date of the request, as the filing date.
Call or visit any Social Security office. We will help you fill out the application
for SSI payments.
What Will Happen
If you file an application, we will review the case and make a decision. If you do
not agree with what we decide, you will be able to appeal the decision.
|
(1)
|
(Month/Day/Year) (enter the 60th day after the date of this notice)
|
|
(2)
|
(Month/Day/Year)
|
APIM53. Situation Where Used:
Use on an SSA-L8165-U2 (Important Information) to the survivor eligible to receive
the underpayment to close out a written statement of intent to file or oral inquiry.
Also, use to close out a protective filing when you cannot schedule an appointment,
an appointment is not kept and you cannot reschedule it, or the rescheduled appointment
is not kept. Add paragraph MISM53 in NL 00804.240 as the closing paragraph.
NOTE: Add the optional fill-in (5) when the notice is issued to the surviving spouse.
We have a request for Supplemental Security Income (SSI) payments for (1) , but (2) did not file an application for SSI payments before (3) death. Before we can decide whether or not we can make any payment for the months
before (4) death, an application must be filed.
(5)
What To Do Next
You should get in touch with us right away because the date you file an application
can make a difference in the amount of your SSI payments.
If you file the application by (6) , we will use (7) , the date of the request, as the filing date. If you do not file, we cannot pay
you any past due payments.
Call or visit any Social Security office. We will help you fill out the application
for SSI payments.
What Will Happen
If you file an application, we will review the case and make a decision. If you do
not agree with what we decide, you will be able to appeal the decision.
|
(1)
|
(full name of deceased claimant)
|
|
(2)
|
Choice 1 - he
Choice 2 - she
|
|
(3)
|
Choice 1 - his
Choice 2 - her
|
|
(4)
|
Choice 1 - his
Choice 2 - her
|
|
(5)
|
(Optional) Sentence for surviving spouse
Choice 1 - We also need to decide if you are eligible for monthly SSI payments.
Choice 2 -Null
|
|
(6)
|
(Month/Day/Year) (enter the 60th day after the date of this notice)
|
|
(7)
|
(Month/Day/Year)
|
APIM54. Situation Where Used:
Use on an SSA-L8165-U2, Important Information, to close out a protective filing when
an appointment is rescheduled for the second time. Use paragraph MISM53 in NL 00804.240 as the closing paragraph.
We are writing to tell you that before we can make a decision about (1) request for Supplemental Security Income (SSI) (2) you (3) must file an application.
What To Do Next
It is important that you keep the appointment on (4) . The date an application is filed can make a difference in the amount of (your) SSI payments.
If the application is filed by (5) , we will use (6) , the date of the request, as the filing date.
What Will Happen
If you file an application, we will review the case and make a decision. If you do
not agree with what we decide, you will be able to appeal the decision.
| (1) |
Choice 1 - your |
| |
Choice 2 - inquirer's name (possessive) |
| (2) |
Choice 1 - , |
| |
Choice 2 - on (name of claimant (possessive) behalf, |
| |
Choice 3 - on your behalf, |
| (3) |
Choice 1 - , or someone on your behalf, |
| |
Choice 2 - Null |
| (4) |
Month/Day/Year (date of rescheduled appointment) |
| (5) |
Month/Day/Year (the 60th day after the date on this notice) |
| (6) |
Month/Day/Year (date of request) |