Social Security Administration
Supplemental Security Income
Claim Number: XXX-XX-XXXX
CITY ST ZIP
Earlier we told you that we would review your case to decide if you are disabled under
the disability rules for adults. We are writing to tell you that you will continue
to receive Supplemental Security Income payments if you still meet all the other eligibility
requirements. This is because you are disabled under the disability rules for adults.
Also, if you are getting medical assistance based on SSI, your coverage should continue.
We Will Review Your Case Again
The doctors and other trained staff who decided that you are still disabled believe
that your health may improve. Therefore, we will review your case again in about 3
years. We will send you a letter before we start your review.
Things To Remember
The decision we made on your case is based on information we have now. If this information
changes, it could affect your SSI. For this reason, it is important that you report
changes right away. Be sure to tell us about any of the following changes:
Your job, pay or work expenses change, if you are working now.
Your doctor says your health is better.
Your income, livings arrangements, or resources change.
If You Disagree With The Decision
If you disagree with the decision, you have the right to appeal. We will review your
case again and consider any new facts you have. A person who did not make the first
decision will decide your case.
You have 60 days to ask for any appeal.
The 60 days start the day after you receive 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
You must have a good reason if you wait more than 60 days to ask for any appeal.
You have to ask for an appeal in writing. We will ask you to sign Form SSA-561-U2,
called “Request for Reconsideration.” Contact one of our offices if you want help.
How the Appeal Works
You have the right to review the facts in your case. You can give us more facts to
add to your file. Then we will decide your case again. You will not meet the person
who will decide your case.
If You Want Help With Your Appeal
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 or she can collect it.
If You Have Any Questions
If you have any questions, you may call us toll-free at 1-800-772-1213, or call your
local Social Security office at XXX-XXX-XXXX. 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:
City, ST ZIP
If you do call or visit an office, please have this letter with you. It will help
us answer your questions.