TN 3 (09-89)

GN 03102.450 Form SSA-662, Reconsideration Determination

A. Procedure

Include the following when preparing the SSA-662 or an equivalent:

  • statement of jurisdictional factors — filing of application, date of notice of initial determination, date of request for reconsideration;

  • basis of request for reconsideration;

  • statement of issues;

  • brief nontechnical statement of the applicable provisions of the law and regulation;

  • statement of the facts and evidence as presented;

  • findings of fact;

  • conclusions based on findings of fact and applicable law and regulations.

If the claimant failed to respond to a request for additional evidence, include a statement that the decision was made without the benefit of any additional evidence which might have supported his or her position.

NOTE: To prepare RECON SGA Affirmation notices, see DI 13010.145.

B. Exhibit - SSA-662 (Reconsideration Determination)

To view this form, go to SSA-662.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0203102450
GN 03102.450 - Form SSA-662, Reconsideration Determination - 08/08/2014
Batch run: 08/08/2014
Rev:08/08/2014