TN 6 (09-22)
DI 29025.008 Notice of Title XVI Childhood Continuing Disability Review (CDR) Reconsideration Involving
Age 18 Redetermination - Exhibit
Social Security Administration
Supplemental Security Income
Important Information
Date: _______________
[Case Number or BNC #]
John Payee for
Jane G. Beneficiary
101 Main Street
My City, ST 00001
This letter is about your SSI. You do not need to call us.
Earlier you asked that we reconsider our decision that you were no longer disabled.
We are writing now to tell you that because you are over age 18 or soon to turn age
18, we will use the same disability rules we use for adults who file new claims to
decide your case for the period after you turned age 18. However, we will not apply
the rule that says we must deny your claim if you are working.
At any time during the reconsideration process, if you think of new information which
might be important, such as a visit to a doctor or a hospital, let us know right away.
We Will Let You Know What We Decide
Trained staff who had no part in making the original decision that you aren’t disabled
will decide if you are disabled. The disability rules for adults are different than
the disability rules for children. We will evaluate the period prior to age 18 under
the child rules and we will evaluate the period after age 18 under the adult rules.
When we decide we will let you know our decision. Our letter will explain your right
to appeal the decision. If you appeal the decision you can also choose to have us
continue to make payments until we decide the appeal.
See Next Page
Page 2 of 2
[Case number or BNC #]
Information About Work
If you work or want to work but are concerned about losing your SSI or medical assistance,
your local Social Security office can tell you more about work incentives and how
work and earnings can affect your SSI.
Need More
Help?
1. Visit www.ssa.gov for fast, simple, and secure online service.
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. You may also call your local office at *F1 (Field Office General Inquiry Line phone
number).
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*F2 (Office name)
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*F3
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*F4
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*F5
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*F6
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*F7
How Are We
Doing? Go to www.ssa.gov/feedback to tell us.
Social Security Administration
Fill-ins:
F1- FO Phone contact info
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C1 – Business Number from DOORS (Preferred choice when present)
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C2 – T2 Number from DOORS for T2 Notices (Use only when Business Number is not present)
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C3 – T16 Number from DOORS for SSI Notices (Use only when Business Number is not present)
F2 – Line 1 of FO Address in DOORS
F3 – Line 2 of FO Address in DOORS
F4 – Line 3 of FO Address in DOORS
F5 – Line 4 of FO Address in DOORS
F6 – Line 5 of FO Address in DOORS
F7 – Line 6 of FO Address in DOORS
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C1 - Line 6 of FO Address in DOORS
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C2 – Null (use when address is less than 6 lines)