TN 3 (09-89)
GN 03102.450 Form SSA-662, Reconsideration Determination
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.