DI 12095.145 Model Language SSI Notice of Decision - Post Eligibility (PE) Review of Noncompliance Finding Treatment for DA&A Not Appropriate and/or Available - Recipient Still Required to Receive Payments Through a Representative Payee

Supplemental Security Income
Notice of Decision

From:

Department of Health and Human Services
Social Security Administration

 
  

Date:
 
Social Security Number:

We are contacting you in connection with your eligibility for payments under the Supplemental Security Income Program.

Under the law, a disabled person who is medically determined to be a drug addict or alcoholic must receive his supplemental security income payments through another person on his behalf. In addition, he must undergo any appropriate treatment for his condition as a drug addict or alcoholic, if such treatment is available, in order to be eligible for payments.

We informed you that the medical evidence in your claim shows that (drug addiction) (alcoholism) 1/ contributes to the finding that you are disabled. Therefore, your payments must be made to another person on your behalf. In addition, you must undergo any appropriate treatment for your condition as a (drug addict) (alcoholic) 1/, if such treatment is available, in order to be eligible for payments. You have failed to comply with the treatment requirement on the basis that you believe treatment is not appropriate and/or available to you.

After further consideration of all the facts in your case, it has been determined that treatment for your condition as a (drug addict) (alcoholic) 1/ is not appropriate and/or available. However, you continue to be subject to the representative payee requirement; therefore, your payments must continue to be made to another person on your behalf.

If you have any questions about this notice, the people in our office will assist you in any way possible. If you phone, please have this notice nearby so that you my refer to it. Please bring it with you if you visit an office.

This information is also being sent to (name of representative payee).

  

1/Use term(s) that applies

NOTE: Send a copy of this notice to the representative payee.

See other side for important information

  

Form SSA-L8165-U2 (9-84)
Prior editions may be used until supply is exhausted

GET IN TOUCH WITH SOCIAL SECURITY IF:

  • You have any questions.

  • You want more information about this case.

Call or write to our office if you have questions or need more information. If you like, come to our office and someone will help you. Please bring this notice with you if you come to a Social Security office.

 Form SSA-L8165-U2 (9-84)

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0412095145