We are writing to tell you that we will pay (1) temporary disability benefits. The
first month we can pay (2) is (3).
Why We Will Pay (4)
We sent (5) a letter stating that we are reviewing the disability decision made on
(6) case. We told (7) that we had 110 days after the date of the disability decision
to make a final decision.
We said if we did not make a final decision in the 110 days, we would pay (8) temporary
disability benefits. We are paying (9) temporary disability benefits until we make
a final decision.
What We Will Pay And When
We will pay (10) $ (11). This is the amount of (12) temporary disability benefits
for (13) through (14).
Beginning (15), we will pay (16) $ (17) each month until we make a final decision
on (18) case.
If You Disagree With This Decision
We Will Tell You About The Final Decision
We will send you another letter when we make a final disability decision on (19) claim.
If we find (20) disabled, we will tell you the date (21) for disability benefits and
the total amount (22) due. We will subtract the amount of temporary disability benefits
that we have already paid (23) from this total.
If we find (24) not disabled under our rules, we will explain why we cannot continue
to pay (25), and stop (26) temporary disability benefits.
You will receive another letter about (27) application for Supplemental Security Income
If You Have Any Questions