Basic (11-81)

NL 00701.270 Form SSA-L801-U2 — Reconsideration — Affirmation of DWB Cessation

A. Sample form

B. Purpose/Use

This form notice is used to advise a DWB beneficiary that the cessation of benefits is 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. 1. 

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

  2. 2. 

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

  3. 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/0900701270
NL 00701.270 - Form SSA-L801-U2 — Reconsideration — Affirmation of DWB Cessation - 03/18/1995
Batch run: 03/07/2014
Rev:03/18/1995