BASIC (12-01)

DI 13004.025 Cover Notice Exhibit

Social Security Administration
Retirement, Survivors, and Disability Insurance
Notice of Continuing Disability Review

 Office of Disability Operations
1500 Woodlawn Drive
Baltimore, MD 21241-1500
 DATE:
CLAIM NUMBER:

We must regularly review the cases of people getting disability benefits to make sure they are still disabled under our rules. It is time for us to review your case. This letter explains how we plan to start our review of your case.

What You Should Do

  • Please complete the form enclosed with this letter. Answer all the questions on the form because they are very important. They ask about your health problems and any work you did within the last 2 years.

    We have enclosed an envelope for you to use. If there is no envelope with this letter, please send the signed form to us at the address shown above.

If We Do Not Hear From You

  • You should return the form within 10 days after you receive it. If we do not hear from you in that time, we will contact you again.

    If you don't give us the information we need or tell us why you cannot give us the information, we may stop your benefits. Before we stop your benefits, we will send you another letter to tell you what we plan to do.

When We Receive The Completed Form

See Next Page

  • If we need more information we will call you. If you do not have a telephone, please give a number where we can leave a message for you.

  • The information you give us now will help us decide when we should do a full medical review of your case. We will let you know within 90 days after we receive the completed form whether or not we need to do a full medical review now.

     


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Important Information

If we decide to do a full medical review of your case:

  • You can give us any information which you believe shows that you are still disabled, such as medical reports and letters from your doctors about your health.

  • We will look at all the information in your case, including the new information you give us.

  • We may find that you are no longer disabled under our rules and your payments will stop. If this happens you can appeal our decision. You can also ask us to continue to pay benefits while you appeal.

Things to Remember

  • Do you want to work but worry about losing your payments or Medicare before you can support yourself ? We want to help you go to work when you are ready. But, work and earnings can affect your benefits. Your local Social Security office can tell you more about how work and earnings can affect your benefits.

If You Have Any Questions

  • If you have any questions, you may call us at 1-800-772-1213, or call your Social Security Office at           . We can answer most questions over the phone. You can also write or visit any Social Security office. The office that serves your area is located at:

    If you do call or visit an office, please have this letter with you. It will help us answer your questions. Also, if you plan to visit an office, you should call ahead to make an appointment. This will help us serve you more quickly.

     

 Social Security Administration

 

Enclosures:

SSA-455

Return Envelope


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0413004025
DI 13004.025 - Cover Notice Exhibit - 07/19/2016
Batch run: 07/19/2016