TN 37 (09-22)
DI 23570.100 Age 18 Notice of Disability Redetermination — CDR to Disability Redetermination —
Social Security Administration
Supplemental Security Income
[Case number or BNC #]
John Payee for
Jane G. Beneficiary
101 Main Street
My City, ST 00001
This letter is about your SSI. You do not need to call us.
Earlier we wrote to tell you that we would review your Supplemental Security Income
(SSI) disability case to decide if you were still disabled. We are writing now to
tell you that because you are over age 18, we will use the same disability rules we
use for adults who file new claims to decide your case. However, we will not apply
the rule that says we must deny your claim if you are working.
We Will Let You Know What We Decide
Doctors and other trained staff will decide if you are disabled under the disability
rules for adults.
We may decide that you are not disabled under the disability rules for adults and
your SSI payments could stop. The disability rules for adults are different than the
disability rules for children we used when we last looked at your case. So we may
find you are not disabled now even though we found you disabled before.
When we decide we will let you know our decision. Our letter will explain your right
to appeal the decision. If you appeal the decision you can also choose to have us
continue to make payments until we decide the appeal.
See Next Page
Page 2 of 2
[Case number or BNC #]
Information About Work
If you work or want to work but are concerned about losing your SSI or medical assistance,
your local Social Security office can tell you more about work incentives and how
work and earnings can affect your SSI.
Need More Help?
1. Visit www.ssa.gov for fast, simple, and secure online service.
2. Call us at 1-800-772-1213, weekdays from 8:00 am to 7:00 pm. If you are deaf or
hard of hearing, call TTY 1-800-325-0778. Please mention this letter when you call.
3. You may also call your local office at *F1 (Field Office General Inquiry Line phone
*F2 (Office name)
How Are We Doing? Go to www.ssa.gov/feedback to tell us.
F1- FO Phone contact info
C1 – Business Number from DOORS (Preferred choice when present)
C2 – T2 Number from DOORS for T2 Notices (Use only when Business Number is not present)
C3 – T16 Number from DOORS for SSI Notices (Use only when Business Number is not present)
F2 – Line 1 of FO Address in DOORS
F3 – Line 2 of FO Address in DOORS
F4 – Line 3 of FO Address in DOORS
F5 – Line 4 of FO Address in DOORS
F6 – Line 5 of FO Address in DOORS
F7 – Line 6 of FO Address in DOORS
C1 - Line 6 of FO Address in DOORS
C2 – Null (use when address is less than 6 lines)