TN 20 (10-91)
NL 00804.174 Blind or Disabled Children Overseas
Manual Paragraphs
DCOMO1. Situation Where Used:
Use under caption 1926, “Things To Remember” on ALL notices to children overseas.
Contact your local Social Security office when (1) to the United States.
Fill-ins:
-
(1)
Choice 1 - you return
Choice 2 - she returns
Choice 3 - he returns
DCOMO2. Situation Where Used:
Use as the closing paragraph under “If You Have Any Questions” on ALL notices to children overseas.
If you have any questions, you can contact the U.S. Embassy or the closest U.S. Consular
Office. Or, you may contact the Social Security Administration, ATTENTION: International
Coordinator, Suite 274, 1262 Vocke Road, Cumberland, MD 21502-7548.
When Payments Are Due
DCOMO3. Situation Where Used:
IC: Use on an SSA-L8025-U2, Notice of Award, under caption 1905, “Information About ( Recipient's Name ) Payments,” when eligible under P.L. 101-239.
PE: Use on an SSA-L8151-U2, Notice of Change in Payment, or an SSA-L8100-U2, Notice
of Revised Determination, under caption 1904, “Why ( Recipient's Name ) Payments Changed,” when eligible under P.L. 101-239.
We usually cannot pay SSI to people who live outside the United States. However, since
April 1, 1990, we can pay SSI to some children of Armed Forces personnel who live
with their parent(s) overseas. (1) is eligible for these payments for April 1990 on. (2)
Fill-ins:
-
(1)
Choice 1 - She
Choice 2 - He
-
(2)
Optional—Use if last SSI payment included federally administered State supplementation.
“However, (she/he) is not due money from (name of State) because States do not pay
people who live overseas.”
NOTE: When a child receives direct payments, use “you” pronouns where appropriate.
DCOMO4. Situation Where Used:
Use under caption 1907, “( Recipient's Name ) Payment Is Based On These Facts.”
-
•
(1) living overseas with a parent who is in the Armed Forces and:
(2)
—eligible for SSI payments in the month before the month (3) parent(s) reported for
overseas duty.
Fill-ins:
-
(1)
Choice 1 - You are
Choice 2 - She is
Choice 3 - He is
-
(2)
(Use when a child is over age 18 and is own payee.)
Choice 1 - a citizen of the United States who is under age 22 and a student and, were
(Use when a child is over age 18 and has a payee.)
Choice 2 - a citizen of the United States who is under age 22 and a student and, was
Choice 3 - a citizen of the United States who is under age 18 (or under age 22 if
a student)
and, was
-
(3)
Choice 1 - your
Choice 2 - her
Choice 3 - his
DCOMO5. Situation Where Used:
Use under caption 1908, “Information About ( Recipient's Name ) Back Payments,” for those eligible under P.L. 101-239.
We are sending ( Recipient's Name ) a check for (1) in (2) . (3) . We will not count the part of this money which was due for back payments as (4) resource for 6 months. If the money is not spent before (5) , we will count any money left over as part of (6) resources. But things bought with this money may count as resources the month after
they are bought. Your Social Security contact while you are overseas can tell you
what things count as resources. (7) cannot get SSI if the resources we count have a value of more than $2,000.
Fill-ins:
-
-
-
(3)
Optional- (Use for retroactive payments when the disabled child is currrently age
18/22 and has become ineligible under P.L. 101-239 due to loss of child/student status
and continued residence abroad.)
If (she/he) reapplies for SSI when (she/he) returns to the U.S., we will not count
this money as (her/his) resource for 6 months after (she/ he) received it.
(If the above sentence is used, omit the sentence that follows it in the paragraph
above.)
-
(4)
Choice 1 - her
Choice 2 - his
-
-
(6)
Choice 1 - her
Choice 2 - his
-
(7)
Choice 1 - She
Choice 2 - He
NOTE: When a child receives direct payments, use “you” pronouns where appropriate.
DCOM06. Situation Where Used:
Use under caption 1915, “Information About Medicaid,” for those eligible under P.L. 101-239.
There (1) a change in (2) Medicaid eligibility while (3) overseas. For further information, contact (4) .
Fill-ins:
-
(1)
Choice 1 - may be
Choice 2 - may have been
-
(2)
Choice 1 - her
Choice 2 - his
-
(3)
Choice 1 - she lives
Choice 2 - she lived
Choice 3 - he lives
Choice 4 - he lived
-
NOTE: When a child receives direct payments, use “you” pronouns where appropriate.
EXHIBITS:
1. Notice of Award
2. Notice of Change in Payment
3. Notice of Revised Determination
When No Payments Are Due
DCOMO7. Situation Where Used:
Use this lead-in paragraph when cases in suspense have been reviewed and the FO determines
that no payments are due under P.L. 101-239. Follow the instructions in NL 00803.055 to complete the SSA-L8166-U2, Notice of Important Information.
Because of a change in the law effective April 1, 1990, we looked at (1) supplemental security income record and decided we do not owe (2) any money.
Fill-ins:
-
(1)
Recipient's Name, possessive
-
(2)
Choice 1 - her
Choice 2 - him
NOTE: When a child receives direct payments, use “you” pronouns where appropriate.
No Payment is Due/Payment is Being Stopped
DCOM08. Situation Where Used:
Use on an initial claim denial under caption 1903, “Why We Can't Pay ( Recipient's Name )” when a child is ineligible because of residence abroad and because P.L. 101-239 does
not apply.
To receive SSI payments while living overseas, a child must be living with a parent
who is a member of the Armed Forces and be:
-
—a citizen of the United States and under age 18 (or under age 22 if a student) and
was
—eligible for SSI payments in the month before the month (1) parent(s) reported for overseas duty.
Because (2) (3) , (4) is not eligible to receive SSI payments. The rest of this letter will tell you more
about our decision.
Fill-ins:
-
(1)
Choice 1 - her
Choice 2 - his
-
(2)
Choice 1 - her
Choice 2 - his
Choice 3 - she
Choice 4 - he
-
(3)
Choice 1 - parent is no longer a member of the Armed Forces
Choice 2 - does not live with a parent who is in the Armed Forces
Choice 3 - became age 18/22 before April 1990
Choice 4 - was not eligible to receive SSI in the month before (her/ his) parent reported
for
overseas duty
Choice 5 - (Any other reason; e.g., income, resources, etc., as applicable.)
-
(4)
Choice 1 - she
Choice 2 - he
NOTE: When a child receives direct payments, use “you” pronouns where appropriate.
EXHIBIT:
-
4.
Notice of Important Information
DCOM09. Situation Where Used:
Use under caption 1904, “Why ( Recipient's Name ) Payments Changed,” when a child loses eligibility under P.L. 101-239 and still resides abroad.
A child living overseas can receive SSI payments as long as (1) lives with a parent who is in the Armed Forces and:
-
—is a citizen of the United States who is under age 18 (or under age 22 if a student);
and
—was eligible for SSI payments in the month before the month (2) parent(s) reported for overseas duty.
We are stopping (3) payments because our records show (4) (5) (6) .
Fill-ins:
-
(1)
Choice 1 - he
Choice 2 - she
-
(2)
Choice 1 - his
Choice 2 - her
-
-
(4)
Choice 1 - he
Choice 2 - she
Choice 3 - his
Choice 4 - her
-
(5)
Choice 1 - became age 18/22
Choice 2 - parent is no longer a member of the Armed Forces
Choice 3 - stopped being a student
Choice 4 - got married
-
(6)
Choice 1 - on Month/Day/Year
Choice 2 - beginning Month/Day/Year
NOTE: When a child receives direct payments, use “you” pronouns where appropriate.
EXHIBIT:
5. Notice of Planned Action
6. Notice of Planned Action (Failure to Confirm Eligibility (NO5))
EXHIBIT 1
SOCIAL SECURITY ADMINSTRATION
Supplemental Security Income
Notice of Award
| |
Office Address: |
| |
Telephone Number: |
| |
Date: August 10, 1990 |
| |
Social Security Number: |
| REPRESENTATIVE PAYEE NAME FOR |
|
| RECIPIENT'S NAME |
|
| Street Address |
|
| City/State/ZIP Code |
|
| |
Type of Payment: |
| |
Child—Disabled |
This is to notify you that (Recipient's Name) is eligible to receive supplemental
security Income (SSI) payments under the provisions of title XVI of the Social Security
Act. The rest of this letter will tell you more about our decision.
HOW MUCH WE WILL PAY
| Beginning |
Through |
Amount Due Each Month |
| March 8, 1990 |
March 31, 1990 |
$386.09
(This includes $87.48 from the State of California.)
|
| April 1, 1990 |
June 30, 1990 |
$499.00
(This includes $113.00 from the State of California.)
|
| July 1, 1990 |
Continuing |
$386.00 |
Page 2
OUR DECISION ABOUT HOW WE WILL PAY (RECIPIENT'S NAME)
We have decided that SSI payments for (Recipient's Name) will be sent to you. All
payments are to be used for her well-being and benefit. As representative payee for
this individual, you have certain reporting responsibilities. You should read the
enclosed pamphlet carefully.
INFORMATION ABOUT (RECIPIENT'S NAME) PAYMENTS
We usually cannot pay SSI to people who live outside the United States. However, since
April 1, 1990, we can pay SSI to some children of Armed Forces personnel who live
with their parent(s) overseas. She is eligible for these payments for April 1990 on.
However, she is not due money from California because States do not pay people who
live overseas.
-
•
We are sending her a check for $2655.09. This money is due her for March 8, 1990 through
August 1990.
-
•
You should receive this check no later than August 25, 1990.
(RECIPIENT'S NAME) PAYMENT IS BASED ON THESE FACTS
-
•
She is living overseas with a parent who is in the Armed Forces and:
—Is a citizen of the United States who is under age 18; and
—Was eligible for SSI payments in the month before the month her parent reported for
overseas duty.
-
•
She was living in the State of California from March 1990 through June 1990.
-
•
Her parent had monthly income of $1386.00 in March 1990 through May l990, and $1407.30
for June 1990 and continuing.
INFORMATION ABOUT (RECIPIENT'S NAME) BACK PAYMENTS
We are sending (Recipient's Name) a check for $2655.09 in August 1990. We will not
count the part of this money which was due for back payments as her resource for 6
months. If the money is not spent before March 1, 1991, we will count any money left
over as part of her resources. But things bought with this money may count as resources
the month after they are bought. Your Social Security contact while you are overseas
can tell you what things we count as resources. She cannot get SSI if the resources
we count have a value of more than $2000.00.
Page 3
INFORMATION ABOUT MEDICAID
There may be a change in her Medicaid eligibility while she lives overseas. For further
information, contact the county welfare department in the State of California.
THINGS TO REMEBER
-
•
Payments may change if her circumstances change. Therefore, you are required to report
any change in her situation that may affect her SSI payment. For example, you should
tell us if she moves, if anyone else moves from or into her household, if her marital
status changes, if income or resources for her or her parents change, if she stops
or starts attending school regularly, if her medical condition improves, or if her
parent leaves the Armed Forces. Read the booklet, When You Get SSI—What You Need to
Know, carefully for additional information about this requirement.
-
•
Contact your local Social Security office when she returns to the United States.
DO YOU DISAGREE WITH THE DECISION?
If you disagree with the decision, you have the right to appeal. We will review your
case and consider any new facts you have. Then, a person who did not make the first
decision will decide her case. We may also review those parts of her case that you
believe are correct and may make them unfavorable or less favorable to her.
-
•
You have 60 days to ask for an appeal.
-
•
The 60 days start the day after you get this letter.
-
•
You must have a good reason for waiting more than 60 days to ask for an appeal.
-
•
To appeal, you must fill out a form called “Request for Reconsideration”. The form number is SSA-561. To get this form, contact one of our offices. We can
help you fill out the form.
HOW TO APPEAL
There are two ways to appeal. You can pick the one you want. If you meet with us in
person, it may help us decide her case.
Page 4
-
•
Case Review. You have a right to review the facts in her file. You can give us more facts to add
to her file. Then we'll decide her case again. You won't meet with the person who
decides her case. This is the only kind of appeal you can have to appeal a medical
decision.
-
•
Informal Conference. You'll meet with the person who decides her case. You can tell that person why you
think you're right. You can give us more facts to help prove you're right. You can
bring other people to help explain her case.
IF YOU WANT HELP WITH YOUR APPEAL
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 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 he or she can collect it.
IF YOU HAVE ANY QUESTIONS
If you have any questions, you can contact the U.S Embassy or the closest U.S. Consular
Office. Or, you may contact the Social Security Administration, ATTENTION: International
Coordinator, Suite 274, 1262 Vocke Road, Cumberland, MD. 21502-7548.
FO Manager
Enclosure
EXHIBIT 2
SOCIAL SECURITY ADMINISTRATION
Supplemental Security Income
Notice of Change in Payment
| |
Office Address: |
| |
Telephone Number: |
| |
Date: August 1, l990 |
| |
Social Security Number: |
| REPRESENTATIVE PAYEE NAME FOR |
|
| RECIPIENT NAME |
|
| Street Address |
|
| City/State/ZIP Code |
|
| |
|
| |
Type of Payment: |
| |
Child—Disabled |
We are writing to tell you about changes in (Recipient'S Name) supplemental security
income (SSI) payments. The following chart shows the SSI money due her for the months
we changed. As you can see from the chart, we are changing payments for both past
and future months. The rest of this letter will tell you more about this change.
(RECIPIENT'S NAME) PAYMENTS WILL BE CHANGED AS FOLLOWS:
| From |
Through |
Amount Due Each Month |
| April 1, 1990 |
Continuing |
$386.00 |
WHY (RECIPIENT'S NAME) PAYMENTS CHANGED
We usually cannot pay SSI to people who live outside the United States. However, since
April 1, l990, we can pay SSI to some children of Armed Forces personnel who live
with their parent(s) overseas. She is eligible for these payments for April 1990 on.
However, she is not due money from the State of California because States do not pay
people who live overseas.
-
•
We are sending her a check for $1930.00. This money is due her for April 1990 through
August 1990.
-
•
You should receive the check no later than August 14, l990.
Page 2
(RECIPIENT'S NAME) PAYMENT IS BASED ON THESE FACTS
-
•
She is living overseas with a parent who is in the Armed Forces and:
—Is a citizen of the United States who is under age 18; and
—Was eligible for SSI payments in the month before the month her parent(s) reported
for
overseas duty.
-
•
Her parents had monthly income of $1250.36 for April 1990 and continuing. This amount
does not affect her SSI payment.
INFORMATION ABOUT (RECIPIENT'S NAME) BACK PAYMENTS
We are sending (Recipient's Name) a check for $1930 in August 1990. We will not count
the part of this money which was due for back payments as her resource for 6 months.
If the money is not spent before March 1, 1991, we will count any money left over
as part of her resources. But things bought with this money may count as resources
the month after they are bought. Your Social Security contact while you are overseas
can tell you what things we count as resources. She cannot get SSI if the resources
we count have a value of more than $2000.00.
INFORMATION ABOUT MEDICAID
There may be a change in her Medicaid eligibility while she lives overseas. For further
information, contact the county welfare department in the State of California.
THINGS TO REMEMBER
-
•
Payments may change if her circumstances change. Therefore, you are required to report
any change in her situation that may affect her SSI payment. For example, you should
tell us if she moves, if anyone else moves from or into her household, if her marital
status changes, if income or resources for her or her parents change, if she stops
or starts attending school regularly, if her medical condition improves, or if her
parent leaves the Armed Forces.
-
•
Contact your local Social Security office when she returns to the United States.
Page 3
DO YOU DISAGREE WITH THE DECISION?
If you disagree with the decision, you have the right to appeal. We will review her
case and consider any new facts you have.
-
•
You have 60 days to ask for an appeal.
-
•
The 60 days start the day after you get this letter.
-
•
You must have a good reason for waiting more than 60 days to ask for an appeal.
-
•
To appeal, you must fill out a form called “Request for Reconsideration”. The form number is SSA-561. To get this form, contact one of our offices. We can
help you fill out the form.
HOW TO APPEAL
There are two ways to appeal. You can pick the one you want. If you meet with us in
person, it may help us decide her case.
-
•
Case Review. You have a right to review the facts in her file. You can give us more facts to add
to her file. Then we'll decide her case again. You won't meet with the person who
decides her case. This is the only kind of appeal you can have to appeal a medical
decision.
-
•
Informal Conference. You'll meet with the person who decides her case. You can tell that person why you
think you're right. You can give us more facts to help prove you're right. You can
bring other people to help explain her case.
IF YOU WANT HELP WITH YOUR APPEAL
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 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 he or she can collect it.
Page 4
IF YOU HAVE ANY QUESTIONS
If you have any questions, you can contact the U.S. Embassy or the closest U.S. Consular
Office. Or, you may contact the Social Security Administration, ATTENTION: International
Coordinator, Suite 274, 1262 Vocke Road, Cumberland, MD. 21502-7548.
FO Manager
EXHIBIT 3
| SOCIAL SECURITY ADMINISTRAION |
|
| Supplemental Security Income |
|
| Notice of Revised Determination |
|
| |
Office Address: |
| |
Telephone Number: |
| |
Date: September 12, l990 |
| |
Social Security Number: |
| REPRESENTATIVE PAYEE NAME FOR |
|
| RECIPIENT NAME |
|
| Street Address |
|
| City/State/ZIP Code |
|
| |
|
| |
Type of Payment: |
| |
Child—Disabled |
We are writing to tell you about changes in (Recipient's Name) supplemental security
income (SSI) payments. The following chart shows the SSI money due him for the months
we changed. As you can see from the chart, we are only changing his payments for months
in the past. The rest of this letter will tell you more about this change.
(RECIPIENT'S NAME) PAYMENTS WILL BE CHANGED AS FOLLOWS:
| From |
Through |
Amount Due Each Month |
| April 1, 1990 |
June 30, 1990 |
$386.00 |
WHY (RECIPIENT'S NAME) PAYMENTS CHANGED
We usually cannot pay SSI to people who live outside the United States. However, since
April 1, 1990, we can pay SSI to some children of Armed Forces personnel who live
with their parent(s) overseas. He is eligible for these payments for April 1990 through
June 1990.
-
•
We are sending him a check for $1158.00. This money is due him for April 1990 through
June 1990.
-
•
You should receive the check no later than September 25, 1990.
Page 2
(RECIPIENT'S NAME) PAYMENT IS BASED ON THESE FACTS
-
•
He was living overseas with a parent who was in the Armed Forces and:
—Was a citizen of the United States who was under age 18, and
—Was eligible for SSI payments in the month before the month his parent(s) reported
for
overseas duty.
-
•
His parents had monthly income of $1167.90 for April 1990, $1216.20 for May 1990 and
$1269.90 for June 1990. These amounts do not affect his SSI payment.
INFORMATION ABOUT (RECIPIENT'S NAME) BACK PAYMENTS
We are sending ( Recipient's Name ) a check for $1158.00 in September 1991. We will not count this money as his resource
for 6 months after he received it. If the money is not spent before April 1992, we
will count any money left over as part of his resources. But things bought with this
money may count as resources the month after they are bought. Your Social Security
contact while you are overseas can tell you what things we count as resources. He
cannot get SSI if the resources we count have a value of more than $2000.00.
INFORMATION ABOUT MEDICAID
There may have been a change in his Medicaid while he lived overseas. For further
information, contact the Texas Department of Human Resources.
THINGS TO REMEMBER
-
•
Payments may change if his circumstances change. Therefore, you are required to report
any change in his situation that may affect his SSI payment. For example, you should
tell us if he moves, if anyone else moves from or into his household, if his marital
status changes, if income or resources for him or his parents change, if he stops
or starts attending school regularly, if his medical condition improves, or if his
parent leaves the Armed Forces.
-
•
Contact your local Social Security office when he returns to the United States.
Page 3
DO YOU THINK WE'RE WRONG?
If you think we're wrong, you have the right to appeal. A person who hasn't seen his
case will look at it. That person will be an Administrative Law Judge. In the rest
of our letter we'll call this person an ALJ. The ALJ will correct mistakes and look
at any new facts you have before deciding his case. We call this a hearing.
-
•
You have 60 days to ask for a hearing.
-
•
The 60 days start the day after you get this letter.
-
•
You'll have to have a good reason for waiting more than 60 days to ask for a hearing.
-
•
You have to ask for an appeal in writing. We'll ask you to sign an SSA form HA-501,
called “Request for Hearing.” Contact one of our offices if you want help.
HOW A HEARING WORKS
A hearing works like this.
-
The ALJ will tell you the time and place for the hearing.
The ALJ will explain the law in his case. The ALJ will state the known facts and tell
you what has to be decided.
You can tell the ALJ why you think we're wrong. You can give the ALJ more facts. And
you can bring people to say why you're right.
The ALJ can make people come to your hearing and bring important papers. You can question
these people at the hearing.
We'll ask if you want to go to the hearing in person. If you say you want to go, you
should attend if at all possible. If you change your mind or if you can't get to the
hearing, you should tell us. You should know that your being there may help the ALJ
decide his case.
IF YOU WANT HELP WITH YOUR HEARING
You can have a friend, lawyer or someone else help you. There are groups that can
help find you 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 local Social Security office
has a list of groups that can help you with your hearing.
Page 4
If you get someone to help you, you should let us know. If you hire someone, we must
approve the fee before he or she can collect it.
IF YOU HAVE ANY QUESTIONS
If you have any questions, you can contact the U.S. Embassy or the closest U.S. Consular
Office. Or, you may contact the Social Security Administration, ATTENTION: International
Coordinator, Suite 274, 1262 Vocke Road, Cumberland, MD. 21502-7548.
FO Manager
EXHIBIT 4
| SOCIAL SECURITY ADMINISTRATION |
|
| Supplemental Security Income |
|
| Important Information |
|
| |
Office Address: |
| |
Telephone Number: |
| |
Date: |
| |
Social Security Number: |
| REPRESENTATIVE PAYEE NAME FOR |
|
| RECIPIENT NAME |
|
| Street Address |
|
| City/State/ZIP Code |
|
| |
|
| |
Type of Payment: |
| |
Child—Disabled |
Because of a change in the law effective April 1, 1990, we looked at (Recipient's
Name) supplemental security income (SSI) record and decided we do not owe her any
money.
WHY WE CAN'T PAY (RECIPIENT'S NAME)
To receive SSI payments while living overseas, a child must be living with a parent
who is a member of the Armed Forces and be:
-
—a citizen of the United States and under age 18 (or under age 22 if a student); and
—eligible for SSI payments in the month before the month her parent reported for overseas
duty.
Because her parent is no longer a member of the Armed Forces, she is not eligible
to receive SSI payments. The rest of this letter will tell you more about our decision.
OUR DECISION IS BASED ON THESE FACTS
She did not live with a parent who was in the Armed Forces.
THINGS TO REMEMBER
Contact your local Social Security office when she returns to the U.S.
Page 2
DO YOU DISAGREE WITH THE DECISION?
If you disagree with the decision, you have the right to appeal. We will review her
case and consider any new facts you have.
-
•
You have 60 days to ask for an appeal.
-
•
The 60 days start the day after you get this letter.
-
•
You must have a good reason for waiting more than 60 days to ask for an appeal.
-
•
To appeal, you must fill out a form called “Request for Reconsideration.” The form number is SSA-561. To get this form, contact one of our offices. We can
help you fill out the form.
HOW TO APPEAL
There are two ways to appeal. You can pick the one you want. If you meet with us in
person, it may help us decide her case.
-
•
Case Review. You have a right to review the facts in her file. You can give us more facts to add
to her file. Then we'll decide her case again. You won't meet with the person who
decides her case. This is the only kind of appeal you can have to appeal a medical
decision.
-
•
Informal Conference. You'll meet with the person who decides her case. You can tell that person why you
think you're right. You can give us more facts to help prove you're right. You can
bring other people to help explain her case.
IF YOU WANT HELP WITH YOUR APPEAL
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 local Social Security office
has a list of groups that can help you with your appeal.
If you get gomeone to help you, you should let us know. If you hire someone, we must
approve the fee before he or she can collect it.
Page 3
IF YOU HAVE ANY QUESTIONS
If you have any questions, you can contact the U.S. Embassy or the closest U.S. Consular
Office. Or, you may contact the Social Security Administration, ATTENTION: International
Coordinator, Suite 274, 1262 Vocke Road, Cumberland, MD. 21502-7548.
FO Manager
EXHIBIT 5
SOCIAL SECURITY ADMINISTRATION
Supplemental Security Income
Notice of Planned Action
| |
Office Address: |
| |
Telephone Number: |
| |
Date: August 10, l990 |
| |
Social Security Number: |
| REPRESENTATIVE PAYEE NAME FOR |
|
| RECIPIENT NAME |
|
| Street Address |
|
| City/State/ZIP Code |
|
| |
|
| |
Type of Payment: |
| |
Child—Disabled |
We are writing to tell you about changes in (Recipient's Name) supplemental security
income (SSI) payments. Our records show that he is no longer eligible for SSI. Therefore,
we are stopping his SSI payments. The rest of this letter will tell you more about
this change.
(RECIPIENT'S NAME) PAYMENTS WILL BE CHANGED AS FOLLOWS:
| From |
Through |
Amount Due Each Month |
| October 1, 1990 |
Continuing |
$00.00 |
WHY (RECIPIENT'S NAME) PAYMENTS CHANGED
A child living overseas can receive SSI payments as long as he lives with a parent
who is in the Armed Forces and:
-
—is a citizen of the United States who is under age 18 (or under age 22 if a student);
and
—was eligible for SSI payments in the month before the month his parent(s) reported
for
overseas duty.
We are stopping (Recipient's Name) payments because our records show he will be age
18 on September 3, 1990.
THINGS TO REMEMBER
Contact your local Social Security office when (Recipient's Name) returns to the U.S.
Page 2
DO YOU DISAGREE WITH THE DECISION?
If you disagree with the decision, you have the right to appeal. We will review his
case and consider any new facts you have.
-
•
You have 60 days to ask for an appeal.
-
•
The 60 days start the day after you get this letter.
-
•
You must have a good reason for waiting more than 60 days to ask for an appeal.
-
•
To appeal, you must fill out a form called “Request for Reconsideration.” The form number is SSA-561. To get this form, contact one of our offices. We can
help you fill out the form.
APPEAL IN 10 DAYS TO KEEP GETTING YOUR SAME CHECK
-
•
We won't change his check if you appeal within 10 days.
-
•
The 10 days start the day after you get this letter.
-
•
If you lose your appeal, you might have to pay back some of all of this money.
HOW TO APPEAL
There are three ways to appeal. You can pick the one you want. If you meet with us
in person, it may help us decide his case.
-
•
Case Review. You have a right to review the facts in his file. You can give us more facts to add
to your file. Then we'll decide his case again. You won't meet with the person who
decides his case.
-
•
Informal Conference. You'll meet with the person who decides his case. You can tell that person why you
think you're right. You can give us more facts to help prove you're right. You can
bring other people to help explain his case.
-
•
Formal Conference. This is a meeting like an informal conference. The difference is we can make people
come to help prove you're right. We can make them bring important papers about your
case, even if they don't want to help you. You can question these people at your meeting.
Page 3
IF YOU WANT HELP WITH YOUR APPEAL
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 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 he or she can collect it.
IF YOU HAVE ANY QUESTIONS
If you have any questions, you may contact the U.S. Embassy or the closest U.S. Consular
Office. Or, you may contact the Social Security Administration, ATTENTION: International
Coordinator, Suite 274, 1262 Vocke Road, Cumberland, MD. 21502-7548.
FO Manager
EXHIBIT 6
SOCIAL SECURITY ADMINISTRATION
Supplemental Security Income
Notice of Planned Action
| |
Office Address: |
| |
Telephone Number: |
| |
Date: August 25, l990 |
| |
Social Security Number: |
| REPRESENTATIVE PAYEE NAME FOR |
|
| RECIPIENT NAME |
|
| Street Address |
|
| City/State/ZIP Code |
|
| |
|
| |
Type of Payment: |
| |
Child—Blind |
We are writing to tell you about changes in (Recipient's Name) supplemental security
income (SSI) payments. The following chart shows how the payments have changed.
(RECIPIENT'S NAME) PAYMENTS WILL BE CHANGED AS FOLLOWS:
| From |
Through |
Amount Due Each Month |
| October 1, 1990 |
Continuing |
$00.00 |
WHY (RECIPIENT'S NAME) PAYMENTS CHANGED
(Recipient's Name) is not eligible for SSI for October 1, 1990 on because you did
not give us all the information we needed about your income.
THINGS TO REMEMBER
Contact your local Social Security office when (Recipient's Name) returns to the United
States.
Page 2
DO YOU DISAGREE WITH THE DECISION?
If you disagree with the decision, you have the right to appeal. We will review his
case and consider any new facts you have.
-
•
You have 60 days to ask for an appeal.
-
•
The 60 days start the day after you get this letter.
-
•
You must have a good reason for waiting more than 60 days to ask for an appeal.
-
•
To appeal, you must fill out a form called “Request for Reconsideration.” The form number is SSA-561. To get this form, contact one of our offices. We can
help you fill out the form.
APPEAL IN 10 DAYS TO KEEP GETTING YOUR SAME CHECK
-
•
We won't change his check if you appeal within 10 days.
-
•
The 10 days start the day after you get this letter.
-
•
If you lose your appeal, you might have to pay back some of all of this money.
HOW TO APPEAL
There are three ways to appeal. You can pick the one you want. If you meet with us
in person, it may help us decide his case.
-
•
Case Review. You have a right to review the facts in his file. You can give us more facts to add
to your file. Then we'll decide his case again. You won't meet with the person who
decides his case.
-
•
Informal Conference. You'll meet with the person who decides his case. You can tell that person why you
think you're right. You can give us more facts to help prove you're right. You can
bring other people to help explain his case.
-
•
Formal Conference. This is a meeting like an informal conference. The difference is we can make people
come to help prove you're right. We can make them bring important papers about your
case, even if they don't want to help you. You can question these people at your meeting.
Page 3
IF YOU WANT HELP WITH YOUR APPEAL
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 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 he or she can collect it.
IF YOU HAVE ANY QUESTIONS
If you have any questions, you may contact the U.S. Embassy or the closest U.S. Consular
Office. Or, you may contact the Social Security Administration, ATTENTION: International
Coordinator, Suite 274, 1262 Vocke Road, Cumberland, MD. 21502-7548.
FO Manager