We are writing to tell you that we are reducing the Social Security benefits which
you receive (1) to $ (2) beginning (3) because (4) entitled to a pension from the Department of Veterans Affairs (VA) in that month.
We will reduce the checks beginning with the check you would normally receive around
||Since we could not reduce the checks until (1) , you will have to pay back the money you received for (2) . This overpayment totals $ (3) .
Why We Are Reducing Your Checks
The amount of (6) Social Security checks is partly based on (7) (8) military service in World War II. We cannot use this service to figure benefit amounts
if the VA uses it to pay a pension. Beginning (9) , the VA is using this military service to pay a pension, so we must reduce the Social
If You Disagree With The Decision
3180A - Domestic
3180B - Foreign
If You Want Help With Your Appeal1
Please let us know if any other Federal agency (except the VA) pays a benefit based
on this military service. Any other Federal benefit paid to the family could affect
the amount of the family's Social Security checks.
If You Have Any Questions
3901C - Domestic
3901D - Foreign
1 If the person lives outside the U.S. or has an Attorney, omit this paragraph.