TN 5 (09-92)
A notice of the DHO's decision (see DI 33095.100- .116) will be prepared and released with the DHO's decision.
Auxiliary notices, as shown in C. below, will be prepared and released to any auxiliary
for whom the number holder is not the payee.
See DI 33010.025 for determining when a Spanish notice is required. See DI 33095.130 for instructions and notice language noting that for foreign claimants, the decision
notice will be prepared locally (a printed notice is not available for foreign cases).
Benefit continuation is not offered
SSA-L1674-U2 (title II primary)
SSA-L1678-U2 (title XVI)
Benefit continuation is offered
SSA-L1675-U2 or SSA-L1677-U2 (title II primary)
SSA-L1656-U2 or SSA-L1658-U2 (auxiliary),
SSA-L1679-U2 or SSA-L1680-U2 (title XVI)
NOTES: The SSA-L1675, SSA-L1656-U2 or the SSA-L1680-U2 is used when benefit continuation
was elected at reconsideration and is being offered again at the administrative law
judge (ALJ)hearing level.
The SSA-L1677-U2, SSA-L1658-U2 or the SSA-L1679-U2 is used when benefit continuation
was not elected at reconsideration and is offered again at the ALJ level.
Word processing equipment is used to prepare DHO decision cover letters
Use the SSA-L951-C2/U2 (title II) or SSA-L8052-C2/U2 (title XVI)
Add the third line heading “Notice of Reconsideration” to the letter.
The DHO affirms the determination under appeal and allows a new claim at the same
Send the SSA-L1674-U2 (title II) or SSA-L1678-U2 (title XVI) with the appropriate
NOTE: Only one notice is needed to cover both DHO decisions.
The DHO affirms the determination under appeal and denies the new claim at the same
Send the correct notice for the determination under appeal.
Make sure the denial of the new claim is explained time in the DHO's decision.
A concurrent title II/XVI case is involved
Prepare a separate decision notice for each title.
Attach the title II notice and the title XVI notice to a photocopy of the decision.
(Both notices may be mailed together in one envelope.)
Case is not involved in quality review
Date stamp the notice indicating when it and the decision were mailed to the claimant.
An English notice is being sent
Enclose SSA Pub. 70-10281, “Appeal Rights under the Social Security Law” (Inventory Control Number 469055).
An Spanish notice is needed
Enclosed SSA Pub. 70-10283 (Inventory Control Number 481755).
Enclose the English and Spanish pamphlets when Spanish notices are sent.
Mailing DHOs' Decisions
Follow NL 00603.105B.2.