NL 00701.255 Form SSA-L795-U2 — Reconsideration — Affirmation of DIB or CDB Cessation

A. Sample form

G-NL_00701.255A

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B. Purpose/Use

This form notice is used to advise a DIB or CDB beneficiary that cessation of benefits was affirmed upon reconsideration.

This notice does not require any fill-ins.

NOTE: Personalized disability notice procedures implemented July 1, 1981, require that Forms SSA-4268-U6/C6 be attached to unfavorable disability form notices. In addition to preparing this form notice according to instructions, the typist must:

  1. Type the personalized and technical rationales on the Form SSA-4268-U6 or SSA-4268-C6.

  2. Prepare appropriate rider (or include paragraphs on form notice if there is room).

  3. Assemble form notice, personalized rationale and the rider stapled together in that order, with envelope for mailing.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900701255
NL 00701.255 - Form SSA-L795-U2 -- Reconsideration -- Affirmation of DIB or CDB Cessation - 06/11/2013
Batch run: 06/11/2013
Rev:06/11/2013