TN 13 (07-09)

RS 01404.260 Denial Notice in "Ensign" Cases

Process the “Ensign” case in MCS but suppress the notice and manually prepare the disallowance notice using the Document Processing System (DPS).

The following denial language should be used when denying a Title II claim for retirement or disability benefits under the caption “Why We Cannot Pay You,” when it is determined that the Ensign Amendment provisions apply:

“You told us that you worked under a Social Security number that was different from your own. Our records show that you were convicted in court for violating the Social Security Act because of that work. The law (Omnibus Appropriations Act of 2009) does not let us give you credit for that work. You do not have enough credits under your own Social Security number. "

An example of a completed denial notice when the Ensign Amendment provisions apply:

Social Security Administration

Retirement, Survivors and Disability Insurance

Notice of Disapproved Claim

FO address

Date:

Claim Number:

CLAIMANT NAME

ADDRESS

CITY ST ZIP

We are writing to tell you that you do not qualify for retirement benefits. DSL038

Why We Cannot Pay You (SGAC07)

You have not worked long enough under Social Security to receive benefits on your own record. We count work under Social Security in credits. Please read the enclosed pamphlet, “How You Earn Social Security Credits.” The pamphlet explains how you earn credits and how many a person needs to receive benefits.

You told us that you worked under a Social Security number that was different from your own. Our records show that you were convicted in court for violating the Social Security Act because of that work. The law (Omnibus Appropriations Act of 2009) does not let us give you credit for that work. You do not have enough credits under your own Social Security number.

(NEW UTI)

Other Social Security Benefits (CLOC01)

You are not entitled to any other Social Security benefits based on the application you filed. In the future, if you think you may be entitled to benefits you will need to apply again. (CLO001)

Do You Disagree With the Decision? (ALSC02)

If you disagree with this decision you have the right to appeal. We will review your case and consider any new facts you have. A person who did not make the first decision will decide your case. We will correct any mistakes. We will review those parts of the decision which you believe are wrong and will look at any new facts you have. We may also review those parts which you believe are correct and may make them unfavorable or less favorable to you.

  • You have 60 days to ask for an appeal.

  • The 60 days start the day after you get this letter. We assume you got this letter 5 days after the date on it unless you show us that you did not get it within the 5-day period.

  • You must have a good reason for waiting more than 60 days to ask for an appeal.

  • You have to ask for an appeal in writing. We will ask you to sign a Form SSA-561-U2 called “Request for Reconsideration”. Contact one of our offices if you want help.

(ALS120)

Please read the enclosed pamphlet, “Your Right to Question the Decision Made on Your Social Security Claim.” It contains more information about the appeal. (ALS006V01)

New Application (APPC01)

You have the right to file a new application at any time, but filing a new application is not the same thing as appealing this decision. If you disagree with this decision and you file a new application instead of appealing:

  • you might lose some benefits, or not qualify for any benefits, and

  • we could deny the new application using this decision, if the facts and issues are the same.

So, if you disagree with this decision, you should file an appeal within 60 days. (APP001)

If You Want Help With Your Appeal (REPC01)

You can have a friend, representative, or someone else help you. There are groups that can help you find a representative or give you free legal services if you qualify. There also are representatives 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. And if you hire a representative who is eligible for direct pay, we will withhold up to 25 percent of any past due benefits to pay toward the fee. REP001

If You Have Any Questions (REFC01)

We invite you to visit our website at