TN 3 (07-08)

DI 14515.010 Notices for Denial of Section 301 Payments

ODO will prepare notices for denials of Section 301 payments using AURORA paragraphs.

A. Procedure – Denial Notices for Title II and Title XVI

Prepare a title II notice on a form SSA-L951-U2, Social Security Notice Letterhead. Prepare a title XVI notice on a form SSA-L8165-U2, Supplemental Security Income Notice of Decision.

B. List of AURORA Paragraphs for Denial Notice

AURORA paragraph 399 - lead-in:

We are writing to you about your benefits under the Social Security Disability program (or) under the Supplemental Security Income Disability Program.

AURORA paragraph 4043

You are no longer disabled as of (mm/yy). You will get checks for that month and the next two months. Your last check will be for (mm/yy).

AURORA paragraph 412 – reason for Section 301 denial:

We have determined that you are not eligible for continued benefits based on participation in a vocational rehabilitation, employment, training, or educational program. This is because

[1] your program is not:

  • provided under an employment plan by an approved provider; or

  • an “individualized education program” for a student age 18 through age 21.

Or [2] your program will not provide you with the kind of training, work experience, work skills, or education that will make it more likely that you will be able to work if your health worsens.

Or [3] you stopped participating in your program in {mm/yy}.

Or [4] your program ended in {mm/yy}.

AURORA paragraph ALS020:

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.

AURORA paragraph 3215E:

You can have a friend, lawyer or someone else help you. There are groups that can help you find a lawyer or give you free legal services if you qualify. There are also lawyers 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/she can collect it.

AURORA paragraph REF033:

If you have any questions, call us at 1-800-772-1213. We can answer most questions over the phone. If you prefer to visit or call one of our offices, the 800 number service representative can give you the nearest office address and telephone number. Please have this letter with you if you call or visit an office. It will help us answer your questions.

C. Procedure - Reconsideration Affirmation of Denial

Prepare a title II notice on a form SSA-L951-U2, Social Security Notice Letterhead. Prepare a title XVI notice on a form SSA-L8165-U2, Supplemental Security Income Notice of Decision.

Insert the following AURORA paragraphs for both title II and title XVI cases.

D. List of AURORA Paragraphs for Reconsideration Affirmation Denial Notice

AURORA paragraph DSL036:

You asked us to take another look at your claim for benefits. Someone who did not make the first decision reviewed your case, including any new facts we received and found that our first decision was correct.

AURORA paragraph 431:

You reported that you were in a vocational rehabilitation, employment, training, or educational program. However, records show that

[1] your program is not:

  • provided under an employment plan by an approved provider; or

  • an “individualized education program” for a student age 18 through age 21.

Or [2] your program will not provide you with the kind of training, work experience, work skills, or education that will make it more likely that you will be able to work if your health worsens.</