BASIC (11-81)

NL 00701.387 Form SSA-L850 — Approval of Request for Withdrawal (Disability)

A. Sample form

G-NL_00701.387A

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B. Preparation of form

If the disability examiner or claims authorizer requests this notice, use Form SSA-L250. The source of information for completing the fill-ins for this notice is Form SSA-559, Transmittal Slip for Claims Folder.

Fill-ins:

  1. “Type of Benefit” shown on Form SSA-559.

  2. month and year.

NOTE: Paragraph 258 will be automatically included on Form SSA-L250 by the typist unless dictated information or paragraph 257 is indicated on Form SSA-559.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900701387
NL 00701.387 - Form SSA-L850 -- Approval of Request for Withdrawal (Disability) - 06/18/2013
Batch run: 06/18/2013
Rev:06/18/2013