TN 7 (10-15)
DI 28075.630 1619 Cessation Notices (Title XVI)
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Paragraph1
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1619(a)
Status
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1619(b)
Status
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1619(a) 301 Status
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1619(b) 301 Status
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1619(b) Blind or Visually Impaired
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Lead In
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4207
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4207
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4207
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4207
|
4207
|
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Attachment 2
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4041
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4041
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4041
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4041
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4041
|
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Payments End
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4213
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----
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4213
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----
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----
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Medicaid Ends
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----
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4229
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----
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4229
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4229
|
|
Information About Medicaid
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4050
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4217
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4050
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4217
|
4217
|
|
Vocational Rehabilitation
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----
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----
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4053
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4227
|
----
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Appeals
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4056
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4056
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4057
|
4057
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4056
|
|
Benefit Continuation
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4061
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4231
|
4061
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4231
|
4231
|
|
Disability Hearing
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4066
|
4066
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4066
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4066
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4067
|
|
If You Need Help
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4069
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4069
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4069
|
4069
|
4069
|
|
Things to Remember
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4073
|
4073
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4073
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4073
|
4077
|
|
DO Referral
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4078
|
4078
|
4078
|
4078
|
4078
|
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Enclosure
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3
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3
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3
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3
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3
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Footnotes:
1 For paragraph language, see NL 00708.100.
2 Delete if personalized explanation is included in the body of the notice.
3 Enclosures:
Explanation of Determination
SSA Pub. No. 05-11008
(NOTE: Delete “Explanation of Determination” if the personalized information is included in the body of the notice.)