TN 28 (01-24)
RS 01404.260 Denial Notice in "Ensign" Cases
Process the “Ensign” case in MCS but suppress the notice and manually prepare the
disallowance notice using the Document Processing System (DPS).
The following denial language should be used when denying a Title II claim for
retirement or disability benefits under the caption “Why We Cannot Pay You,” when
it is determined
that the “Ensign Amendment” provisions apply:
“You told us that you worked under a Social Security number that was different from
your own. Our records show that you were convicted in court for violating the Social
Security Act because of that work. The law (Omnibus Appropriations Act of 2009) does
not let us give you credit for that work. You do not have enough credits under your
own Social Security number."
An example of a completed denial notice when the Ensign Amendment provisions apply:
Social Security Administration
Retirement, Survivors and Disability Insurance
Notice of Disapproved Claim
FO address
Date:
Claim Number:
CLAIMANT NAME
ADDRESS
CITY ST ZIP
We are writing to tell you that you do not qualify for retirement benefits. DSL038
Why We Cannot Pay You (SGAC07)
You have not worked long enough under Social Security to receive benefits on your
own record. We count work under Social Security in credits. Please read the enclosed
pamphlet, “How You Earn Social Security Credits.” The pamphlet explains how you earn
credits and how many a person needs to receive benefits.
You told us that you worked under a Social Security number that was different from
your own. Our records show that you were convicted in court for violating the Social
Security Act because of that work. The law (Omnibus Appropriations Act of 2009) does
not let us give you credit for that work. You do not have enough credits under your
own Social Security number.
(NEW UTI)
Other Social Security Benefits (CLOC01)
You are not entitled to any other Social Security benefits based on the application
you filed. In the future, if you think you may be entitled to benefits you will need
to apply again. (CLO001)
Do You Disagree With the Decision? (ALSC02)
If you disagree with this decision you have the right to appeal. We will review your
case and consider any new facts you have. A person who did not make the first decision
will decide your case. We will correct any mistakes. We will review those parts of
the decision which you believe are wrong and will look at any new facts you have.
We may also review those parts which you believe are correct and may make them unfavorable
or less favorable to you.
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•
You have 60 days to ask for an appeal.
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•
The 60 days start the day after you get 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.
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•
You must have a good reason for waiting more than 60 days to ask for an appeal.
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•
You have to ask for an appeal in writing. We will ask you to sign a Form SSA-561-U2
called “Request for Reconsideration”. Contact one of our offices if you want help.
(ALS120)
Please read the enclosed pamphlet, “Your Right to Question the Decision Made on Your
Social Security Claim.” It contains more information about the appeal. (ALS006V01)
New Application (APPC01)
You have the right to file a new application at any time, but filing a new application
is not the same thing as appealing this decision. If you disagree with this decision
and you file a new application instead of appealing:
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•
you might lose some benefits, or not qualify for any benefits, and
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•
we could deny the new application using this decision, if the facts and issues are
the same.
So, if you disagree with this decision, you should file an appeal within 60 days.
(APP001)
If You Want Help With Your Appeal (REPC01)
You can have a friend, representative, or someone else help you. There are groups
that can help you find a representative or give you free legal services if you qualify.
There also are representatives who do not charge unless you win your appeal. Your
local 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. If you hire someone, we must
approve the fee before they can collect it. And 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 toward the fee. REP001
If You Have Any Questions (REFC01)
We invite you to visit our website at www.socialsecurity.gov on the Internet to find general information about Social Security. If you have any
specific questions, you may call us toll-free at 1-800-772-1213, or call your local
Social Security office at 1-800-123-4567. We can answer most questions over the phone.
If you are deaf or hard of hearing, you may call our TTY number, 1-800-325-0778. You
can also write or visit any Social Security office. The office that serves your area
is located at:
SOCIAL SECURITY
65 Happy Acres Lane
Leisureville, FL 00000
If you do call or visit an office, please have this letter with you. It will help
us answer your questions. Also, if you plan to visit an office, you may call ahead
to make an appointment. This will help us serve you more quickly when you arrive at
the office. (REF061)
Ann Jacobosky
Assistant Regional Commissioner
Processing Center Operations