TN 1 (11-00)

DI 32548.060 Notice Instructions - Class Member in Pay Status Based on a Subsequent Award - Hyatt III Review Affirms Prior Denial

A. Background

There will be situations where a subsequent favorable determination has been made prior to the Hyatt III review (DI 32548.020A.2.). If the Hyatt III review results in an affirmation of the prior denial(s), i.e., there is no change in the onset established on the subsequent allowance, the class member must be notified that his/her benefits based on the subsequent application are not affected by the Hyatt III review.

B. Policy - primary and settlement subclass claims

In Primary and Settlement Subclass claims, the claimant, his/her representative, if any, and class counsel must be notified of any determination, which is wholly or partially unfavorable.

Class counsel"s copy of the notice is sent to:

North Carolina Justice and Community Development Center

P. O. Box 28068

224 South Dawson St.

Raleigh, North Carolina 27611-8068

Telephone: 1 (800) 299-8619

C. Procedure

1. Title II only cases

In title II only cases, use an SSA-L951-U2/C2; add the third line heading “IMPORTANT INFORMATION”; and include:

  1. An introductory statement which reads:

    “We have completed the review you requested as a result of the Hyatt III court order. Based on our review, we find that you meet the medical requirements for disability benefits on  (onset date). This review does not change the checks you are getting now based on your later application.”

    Attached to this notice is an explanation of the determination we made on your claim and how we arrived at it.” (Delete last sentence if merged text format is used.)

  2. The optional paragraph in DI 32548.045B.1.b. if the earliest claim within the Hyatt III period is not a Hyatt III eligible claim(s)

  3. Paragraph 4041 - (delete if merged text format is used.)

  4. A discussion of the evidence containing the elements in DI 26530.015B.

  5. Paragraph 4107 in the second sentence substitute “if you still believe” for “if you believe.”

  6. Paragraph REF 003 on LSF

  7. Enclosures

    • Explanation of determination (delete if merged text is used).

    • SSA Pub. No. 70-10281 (Do not send this publication to Settlement Subclass Members. This publication is only sent to individuals whose class claims are reopened.)

2. Title XVI only cases

In title XVI only cases, use an SSA-L8052-U2/SSA-L8052-C2; add the third line heading “IMPORTANT INFORMATION”; and include:

  1. The introductory statement from DI 32548.060C.1.a.

  2. DI