TN 1 (06-07)

DI 60090.025 BOPD Notices-Exhibits

A. Exhibit of Modified SSA-L1013 - No previous cessation and Disability continues

Social Security Administration

Retirement, Survivors and Disability Insurance

Date:

Claim Number:

Name and address

We recently reviewed the evidence in your Social Security disability claim and find that your disability is continuing. Here is some important information about your claim. We have also enclosed information about working that explains some of the terms we use.

Option 1: Use if TWP not yet completed. You have worked in some months of the trial work period. We counted the following as your trial work months:

F1: mm/yy; mm/yy through mm/yy;

We have scheduled your claim for review in <F2> since it appears your 9th month of trial work will end at that time, according to the information reported to us. Please save your pay stubs. We will ask to see them when we start the review.

F2: mm/yy

Option 2: Use if TWP is completed You have completed your trial work period. We counted the following as your trial work months:

F1: mm/yy; mm/yy through mm/yy;

Although you are now working (or have recently worked and stopped), we find that the work you have been doing does not show that you can do substantial gainful work.

Things To Remember

You must promptly report any changes that may affect your benefits. Failure to do so could mean you may have to repay any benefits not due. Let us know if:

  • You went to work since your last report or you return to work in the future; or

  • You already reported your work, but your duties or pay changed. (Remember to keep records of your work and earnings such as pay statements from your employer.); or

  • Your doctor says your condition has improved (even if you don’t work now); or

  • You apply for, start getting, or have a change in the amount of workers' compensation or another public disability benefit; or

  • You start paying for work expenses related to your disability (for example, you may need special transportation) or the amount paid for these work expenses changes or you no longer pay for such expenses. (Remember to keep records and proof of payment for any work expenses.)

We will use this information to decide if your health problems still meet our rules or if we must change your payment amount.

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 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 if you wait 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.

Please read the enclosed pamphlet, "Your Right to Question the Decision Made on Your Social Security Claim." It contains more information about the appeal.

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 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 questions, please contact your benefits counselor at <F3>, or <F4> at <F5>.

F3: #800 number for state

OPTIONAL F4: DE name

OPTIONAL F5: DE phone number

Carolyn Simmons

Associate Commissioner for

Central Operations

Do you want to work but worry about losing your payments or Medicare before you can support yourself? If so the following information highlights how going back to work may be easier.

Explanation of Trial Work Period

In most cases, you can work and earn any amount of money for up to 9 months. (The months do not have to be in a row.) During this time, called a trial work period, you can still get your disability payments. The following information shows how we count the 9 months of the trial work period.

If you are an employee, we only count months you:

  • earn over $640 beginning in January of 2007

  • earn over $620 before January 2006, or

  • earn over $590 before January 2005, or

  • earn over $580 before January 2004, or

  • earn over $570 before January 2003, or

  • earn over $560 before January 2003.

If you are self-employed, we only count months you:

  • earn over $640 or work more than 80 hours beginning January 2007

  • earn over $620 or work more than 80 hours before January 2006, or   

  • earn over $590 or  work more than 80 hours before January 2005, or

  • earn over $580 or work more than 80 hours before January 2004, or

  • earn over $570 or work more than 80 hours before January 2003, or

  • earn over $560 or work more than 40 hours before January 2003.

Beginning in January 1992, the trial work period is not over until 9 trial work months are completed in a period of 60 months in a row.

Before 1992, you could only have a trial work period the first time you qualified for disability payments. If you qualified for disability payments a second time, usually you could not have a trial work period. Effective January 1992, you can now have a trial work period each time you qualify for disability payments.

What Happens After the Trial Work Period if You are Participating in the Benefits Offset Demonstration

After the trial work period, several things happen.

Your disability ends if your work activity shows you are able to do substantial gainful work. See “What is Substantial Gainful Work?” We will pay you benefits for the month disability ends and the following two months no matter how much you earn. We call these three months the grace period.

You get a 72-month extended period of eligibility that begins right after the trial work period. If you work after the grace period and during the extended period of eligibility, we may reduce your benefits based on your expected earnings. We will reduce your benefits $1.00 for every $2.00 you earn over the substantial gainful work amount as discussed in “What Is Substantial Gainful Work?” Generally, we will considered your estimate earnings for the year and use your average monthly earnings to decide whether and how much to reduce your benefits. We will deduct certain amounts from our earnings to decide how much of your earnings to count.

Optional: Add these sentences if TWP is completed Based on the information we have, your extended period of eligibility began <F5>. If you continue to participate in the benefit offset demonstration, your extended period of eligibility will end <F6>.

F5: mm/yyyy

F6: mm/yyyy

What is Substantial Gainful Work?

Generally, substantial gainful work is physical or mental work a person is paid to do. Work can be substantial and gainful even if it is part-time. To decide if a person's work is substantial and gainful, we consider the nature of the job duties, the skills and experience needed to do the job, and how much the person actually earns.

Usually, we find that work is substantial gainful if earnings average over $900.00 a month in 2007 (or $1500 a month in 2007 for a person who is blind) after we deduct allowable amounts. A person's work may be different than before his/her health problems began. It may not be as hard to do and the pay may be less. However, we may still find that the work is substantial gainful work under our rules.

If a person is self-employed, we consider the kind and value of his/her work, including his/her part in the management of the business, as well as income, to decide if the work is substantial gainful work.

Continuation of Medicare

You can keep your Medicare for at least 93 months after your trial work period ends. Your hospital insurance will be free, but you will still pay for your medical insurance. Beginning in July 1990, you can keep your Medicare after your free hospital insurance coverage ends. But, you must pay a premium for both parts.

B. Exhibit of Modified SSA-L1013 - Cessation previously determined-current ESTIMATE of work is below SGA

Social Security Administration

Retirement, Survivors and Disability Insurance

Date:

Claim Number:

Name and address

DELETE FIRST PARAGRAPH AND REPLACE WITH THIS PARAGRAPH:

As part of your participation in the Benefit Offset Demonstration we considered your estimated earnings for the offset period to decide whether to reduce your benefits by a $1.00 for every $2.00 you earn over the substantial gainful work amount. We may have deducted certain amounts from your gross earnings to determine an estimate of countable earnings. Based on the information we have, your estimate of countable earnings for the offset period is below the substantial gainful work amount. Your benefits will not be reduced based on your current work activity.

The following information was considered:

Estimate of earnings: F1

Estimate of impairment related work expenses: F2

Estimate of Subsidy/Special conditions: F3

F1:#####

F2:######

F3:######

At the end of the year you will be asked to provide proof of wages and any deductions that were used to calculate your countable earnings.

If your work plans change and you will earn more than the current estimate, please notify the benefit counselor so we can make sure we are paying the correct benefit amount.

Optional: Add these sentences if TWP is completed Based on the information we have, your extended period of eligibility began <F5>. If you continue to participate in the benefit offset demonstration, your extended period of eligibility will end <F6> .

F5: mm/yyyy

F6: mm/yyyy

Things To Remember

You must promptly report any changes that may affect your benefits. Failure to do so could mean you may have to repay any benefits not due. Let us know if:

  • You went to work since your last report or you return to work in the future; or

  • You already reported your work, but your duties or pay changed. (Remember to keep records of your work and earnings such as pay statements from your employer.); or

  • Your doctor says your condition has improved (even if you don’t work now); or

  • You apply for, start getting, or have a change in the amount of workers' compensation or another public disability benefit; or

  • You start paying for work expenses related to your disability (for example, you may need special transportation) or the amount paid for these work expenses changes or you no longer pay for such expenses. (Remember to keep records and proof of payment for any work expenses.)

We will use this information to decide if your health problems still meet our rules or if we must change your payment amount.

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 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 if you wait 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.

Please read the enclosed pamphlet, "Your Right to Question the Decision Made on Your Social Security Claim." It contains more information about the appeal.

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 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 questions, please contact your benefits counselor at <F1>, or <F2> at <F3>.

F1: #800 number for state

OPTIONAL F2: DE name

OPTIONAL F3: DE phone number

Carolyn Simmons

Associate Commissioner for

Central Operations

C. Exhibit of Due Process Notice for Cessation Determination

Social Security Administration

Retirement, Survivors and Disability Insurance

Notice of Proposed Decision-Benefit Offset Demonstration

Date:

Claim Number:

Name and address

We have information about your work and earnings that could affect your Social Security disability payments. Based on this information, it appears we will decide that your disability ended because of substantial gainful work <F1>.

F1: mm/yyyy

If we decide that your disability ended, it appears from the information we have that we will also decide <F2>. Under the Benefit Offset Demonstration, we use your estimated earnings to decide whether and how much to reduce your benefits. If your total countable earnings exceed $<F3> ($<F4> monthly x <F5) for <F6, your total benefits will be reduced by $1.00 for every $2.00 that you earn over $<F3>.

F2-1: to reduce your benefits payments based on your expected earnings

OR

F2-2: to stop your benefit payments due to your expected earnings.

F3: #####

F4: ###

F5: ##

F6: yyyy; the period mm/yyyy through mm/yyyy

You told us that you would earn $<F7> in <F6>. Based on this information, <F8>

F8-1: your monthly payments should be $#### beginning mm/yyyy.

F8-2: you will not receive any payments for <F6> due to your expected earnings. The last monthly payment you should receive is for mm/yyyy.

Optional: Use if IRWE/Subsidy or other deductions were involved) You told us that you expect to have $<F9> We considered this amount when we determined the amount of your payments. Please save your receipts for any expenses, and proof of any deductions. We will ask to see them after the year is over.

F9: dictated text—provide total of IRWE, subsidy/special conditions etc…

We are writing this letter to give you a chance to give us more information that you want us to consider. Please review the following information we are using to make our decision. You have 10 days to give us more information before we make our decision final. The 10 days start the day after you receive this letter. We assume that 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. If you need more time, let us know right away.

The Information We Have

We are considering the following reports in evaluating your claim:

<Optional>

  • Your signed statement regarding work and earnings

  • Social Security Administration earnings records

  • Work information reported to us by your employer

We are considering the following work in this decision:

Work Start

Work End

Employer

Job title

    

<Optional>

There was no evidence to indicate that you did not fully earn the salary you were paid.

The possibility of a subsidy from your employer(s) was considered in making this determination.

We considered the value of impairment related work expenses which you had to pay in order to work when we considered whether your work was substantial gainful activity.

Based on the information we have, it appears we will decide that your disability ended because of substantial work as of <F1>. Please read the following information about what will happen to your payments if we make this decision.

What Happens When a Person Goes to Work

Going to work does not affect payments right away. That's because a person is allowed a period of 9 trial work months to test his or her ability to work in spite of health problems.

Beginning January 2007, a trial work month is any month in which a person earns more than:

$640 in gross wages, or

$640 in net self-employment earnings, or works more than 80 hours of work in self-employment.

In 2006, the trial work period monthly earnings amount was $620. The amount was $590 in 2005 , $580 in 2004, $570 in 2003, $560 in 2002 and $530 in 2001.

From January 1990 through December 2000, a trial work month was any month in which a person earned more than:

$200 in gross wages, or

$200 in net self-employment earnings, or worked more than 40 hours of work in self-employment.

Beginning 1992, the 9 months of work must take place in a 60-month period to end the trial work period. However, the 9 months do not have to be in a row.

Our records show your trial work period ended <F9> and that your nine months of trial work are<F10>:

F9: mm/yyyy

F10: mm/yyyy; mm/yyyy through mm/yyyy

What Happens After the Trial Work Period if You Are Participating in the Benefit Offset Demonstration

After the trial work period, several things happen.

Your disability ends if your work activity shows you are able to do substantial gainful work. See “What is Substantial Gainful Work?” below. We will pay benefits you for the month disability ends and the following 2 months no matter how much you earn. We call these three months the grace period. Based on the information we have, in your case, this is <F1> through <F1>.

F1: mm/yyyy

You get a 72-month extended period of eligibility that begins right after the trial work period. If you work after the grace period and during the extended period of eligibility, we may reduce your benefits based on your expected earnings. We will reduce your benefits $1.00 for every $2.00 you earn over the substantial gainful work amount as discussed in “What Is Substantial Gainful Work?” Generally, we will considered your estimate earnings for the year and use your average monthly earnings to decide whether and how much to reduce your benefits. We will deduct certain amounts from our earnings to decide how much of your earnings to count. Based on the information we have, it appears that we will decide <F12> as of <F13> due to your expected earnings.

F12-1—to reduce your benefit payments

F12-2 to stop your benefit payments

F13-mm/yyyy

What is Substantial Work?

Generally, substantial work is physical or mental work a person is paid to do. Work can be substantial even if it is part-time. To decide if a person's work is substantial, we consider the nature of the job duties, the skills and experience needed to do the job, and how much the person actually earns.

Usually, we find that work is substantial if gross earnings average over $900.00 a month in 2007 ($860.00 a month in 2006) after we deduct allowable amounts. A person's work may be different than before his/her health problems began. It may not be as hard to do and the pay may be less. However, we may still find that the work is substantial under our rules.

If a person is self-employed, we consider the kind and value of his/her work, including his/her part in the management of the business, as well as income, to decide if the work is substantial.

Information About Medicare

If you have Medicare and your disabling condition continues under our rules, your coverage will continue for at least 93 months after your trial work period.

If We Do Not Hear From You

If we do not hear from you within the next 10 days, we will make our decision based on the information we have now. The 10 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 5-day period. When we make our decision, we will send you another letter.

If You Have Any Questions

If you have questions, please contact your benefits counselor at <F14>, or <F15> at <F16>.

F14: #800 number for state

OPTIONAL F15: DE name

OPTIONAL F16: DE phone number

Carolyn Simmons

Associate Commissioner for

Central Operations

D. Exhibit of Due Process Notice for Offset Applied after Previous SGA Cessation

Social Security Administration

Retirement, Survivors and Disability Insurance

Notice of Proposed Decision-Benefit Offset Demonstration

Date:

Claim Number:

Name and address

We have information about your work and earnings that could affect your Social Security disability payments. Based on this information, it appears we will decide <F1>

F1-1 to reduce your benefit payments based on your expected earnings.

F1-2 to stop your benefit payments due to your expected earnings.

Under the Benefit Offset Demonstration, we use your estimated earnings to decide whether and how much to reduce your benefits. If your total countable earnings exceed $<F2>, ($<F3> monthly x <F4>) for<F5>, your total benefits will be reduced by $1.00 for every $2.00 that you earn over $F2.

F2: #####

F3: ###

F4: ##

F5: yyyy; the period mm/yyyy through mm/yyyy

You told us that you would earn $<F6> in <F5>. Based on this information, <F7>

F6: ####

F5: yyyy, the period mm/yy through mm/yyyy

F7-1: your monthly payments should be $#### beginning mm/yyyy.

F7-2: you should not receive any payment for this year due to your expected earnings. The last monthly payment you should receive is for mm/yyyy.

Optional: Use if IRWE/Subsidy or other deductions were involved) You told us that you expect to have $<F9> We considered this amount when we determined the amount of your payments. Please save your receipts for any expenses, and proof of any deductions. We will ask to see them after the year is over.

F9: dictated text—provide total of IRWE, subsidy/special conditions etc…

We are writing this letter to give you a chance to give us more information that you want us to consider. Please review the following information we are using to make our decision. You have 10 days to give us more information before we make our decision final. The 10 days start the day after you receive this letter. We assume that 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. If you need more time, let us know right away.

If You Are Participating in the Benefit Offset Demonstration

You get a 72-month extended period of eligibility that begins right after the trial work period. If you work after the grace period and during the extended period of eligibility, we may reduce your benefits based on your expected earnings. We will reduce your benefits $1.00 for every $2.00 you earn over the substantial gainful work amount as discussed in “What Is Substantial Gainful Work?” Generally, we will considered your estimate earnings for the year and use your average monthly earnings to decide whether and how much to reduce your benefits. We will deduct certain amounts from our earnings to decide how much of your earnings to count.

What is Substantial Work?

Generally, substantial gainful work is physical or mental work a person is paid to do. Work can be substantial and gainful even if it is part-time. To decide if a person's work is substantial and gainful, we consider the nature of the job duties, the skills and experience needed to do the job, and how much the person actually earns.

Usually, we find that work is substantial gainful if earnings average over $900.00 a month in 2007 (or $1500 a month in 2007 for a person who is blind) after we deduct allowable amounts. A person's work may be different than before his/her health problems began. It may not be as hard to do and the pay may be less. However, we may still find that the work is substantial gainful work under our rules.

If a person is self-employed, we consider the kind and value of his/her work, including his/her part in the management of the business, as well as income, to decide if the work is substantial gainful work.

Information About Medicare

If you have Medicare and your disabling condition continues under our rules your coverage will continue for at least 93 months after your trial work period.

If We Do Not Hear From You

If we do not hear from you within the next 10 days, we will make our decision based on the information we have now. The 10 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 5-day period. When we make our decision, we will send you another letter.

If You Have Any Questions

If you have questions, please contact your benefits counselor at <F11>, or <F12> at <F13>.

F11: #800 number for state

OPTIONAL F12: DE name

OPTIONAL F13: DE phone number

Carolyn Simmons

Associate Commissioner for

Central Operations

E. Exhibit of Notice of Determination - BOPD

Social Security Administration

Retirement, Survivors and Disability Insurance

Important Information-Benefit Offset Demonstration

Date:

Claim Number:

Name and address

We are writing to give you new information about the disability benefits which you receive on this Social Security record.

Your Benefits

Option 1: Use if cessation determined: After reviewing all the information carefully, we have decided that you are now able to work. You are no longer disabled according to our rules as of <F1>. You are entitled to full benefits for that month and the next two months. We have also decided <F2> due to your expected earnings.

F1: mm/yyyy

F2-1 to reduce your benefits payments

F2-2 to stop your benefit payments as of mm/yyyy due to your expected earnings.

Option 2: Use if cessation previously determined: After reviewing all the information carefully, we have decided that your work is substantial as of <F1>. You are entitled to full benefits for that month and the next two months. We have also decided <F2> due to your expected earnings.

F1: mm/yyyy

F2-1 to reduce your benefits payments

F2-2 to stop your benefit payments as of mm/yyyy due to your expected earnings.

Under the Benefit Offset Demonstration, we use your estimated earnings to decide whether and how much to reduce your benefits. If your total earnings exceed $<F2>, ($<F3> monthly x <F4>) for<F5>, your total benefits will be reduced by $1.00 for every $2.00 that you earn over $F2.

F2: #####

F3: ###

F4: ##

F5: yyyy; the period mm/yyyy through mm/yyyy

You told us that you would earn $<F6> in <F5>. Based on this information, <F7>

F6: #####

F7-1: your monthly payments will be $#### beginning mm/yyyy.

F7-2: you will not receive any payment for this year due to your expected earnings. The last monthly payment you should receive is for mm/yyyy.

Optional: Use if IRWE/Subsidy or other deductions were involved) You told us that you expect to have $<F9> We considered this amount when we determined the amount of your payments. Please save your receipts for any expenses, and proof of any deductions. We will ask to see them after the year is over.

F9: dictated text—provide total of IRWE, subsidy/special conditions etc…

Option 3: Use if benefits stop If you have Medicare, your coverage will continue after your last monthly payment. If you have supplementary medical insurance (Medicare "Part B"), you will be billed for your medical insurance premiums every 3 months. Please pay the premiums promptly to avoid losing coverage. If you no longer want this coverage, please let us know right away.

Option 4: Use if benefits reduced If you pay Medicare premiums, they will be deducted from your monthly payment amount. Please get in touch with us right away if you get any other notice concerning your Medicare premium payment while you are enrolled in Benefit Offset Demonstration.

When Will the Special Rules for the Benefit Offset Demonstration Project End

The special rules for the demonstration project will no longer apply to you if you withdraw from the project or are no longer eligible for the project. The special rules also will no longer apply to you after your extended period of eligibility ends. You get a 72-month extended period of eligibility as long as you continue to participate in the Benefit Offset Demonstration. If you continue to participate, your extended period of eligibility will end <F9>.

F9: mm/yyyy

What Happens When the Special Rules for the Demonstration Project No Longer Apply

If you are receiving benefit payments, your payments will stop the first month you do substantial gainful work. Unless you voluntarily withdraw from the project or no longer are eligible, your payments will stop with the month you do substantial gainful work after <F9>.

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 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 if you wait 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.

Please read the enclosed pamphlet, "Your Right to Question the Decision Made on Your Social Security Claim." It contains more information about the appeal.

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 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 questions, please contact your benefits counselor at <F10>, or <F11> at <F12>.

F10: #800 number for state

OPTIONAL F11: DE name

OPTIONAL F12: DE phone number

Carolyn Simmons

Associate Commissioner for

Central Operations

F. Exhibit of Notice of Determination – BOPD Project ends

Social Security Administration

Retirement, Survivors and Disability Insurance

Important Information-Benefit Offset Demonstration

Date:

Claim Number:

Name and address

We are writing to give you new information about the disability benefits which you receive on this Social Security record. You have been participating in the benefit offset demonstration project.

The special rules for the demonstration project will no longer apply to you beginning MM/DD/YYYY because <F1>.

F1-1: you requested to be withdrawn from the project. If you are receiving benefit payments, your payments may stop the first month you do substantial gainful work

F1-2: you are no longer eligible for the project. If you are receiving benefit payments, your payments may stop the first month you do substantial gainful work

F1-3 your extended period of eligibility ends mm/yyyy. Payments will end with the month you do substantial gainful work after mm/yyyy

Things To Remember

You must promptly report any changes that may affect your benefits. Failure to do so could mean you may have to repay any benefits not due. Let us know if:

  • You went to work since your last report or you return to work in the future; or

  • You already reported your work, but your duties or pay changed. (Remember to keep records of your work and earnings such as pay statements from your employer.); or

  • Your doctor says your condition has improved (even if you don’t work now); or

  • You apply for, start getting, or have a change in the amount of workers' compensation or another public disability benefit; or

  • You start paying for work expenses related to your disability (for example, you may need special transportation) or the amount paid for these work expenses changes or you no longer pay for such expenses. (Remember to keep records and proof of payment for any work expenses.)

We will use this information to decide if your health problems still meet our rules or if we must change your payment amount.

If You Have Any Questions

If you have questions, please contact your benefits counselor at <F1>, or <F2> at <F3>.

F1: #800 number for state

OPTIONAL F2: DE name

OPTIONAL F3: DE phone number

Carolyn Simmons

Associate Commissioner for

Central Operations


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0460090025
DI 60090.025 - BOPD Notices-Exhibits - 06/18/2007
Batch run: 01/27/2009
Rev:06/18/2007