NL 00705.000 Disability Sample Guide Letters

Subchapter Table of Contents
Section   Latest
Transmittal
Disability Insurance Benefits (DIB)
NL 00705.010 Model Letter “K” - Statutory Blindness Freeze Allowance - DIB Denial - Claimant Age 55 or Over
NL 00705.015 Model Letter “L” - Freeze Allowance
NL 00705.020 Model Letter “M” - Forwarding Notice Of Determination to Person Having Custody
NL 00705.025 Model Letter “N” - Forwarding Notice of Determination To Claimant
NL 00705.030 Model Letter “O”- Closed Period Of Disability Established
NL 00705.050 Model Letter “S” - Statutorily Blind -Established Onset Date Before 1973 - No 20/40 Or Fully Insured -Disabled Age 31 or Later
NL 00705.055 Model Letter “T”—Statutorily Blind—Established Onset Date 1973 Or Later—Not Fully Insured At EOD Or Later
NL 00705.060 Model Letter “U”—DIB Denial—Lack Of Severity—AQD 1973 Or Later—Alleged Disability Due To Statutory Blindness And Other Impairment(s)
NL 00705.065 Model Letter “V” — CDB Reentitlement — Alleged Onset Date After End Of 7 Years After Prior Cessation
NL 00705.070 Initial DIB, DWB, or CDB Denial—Does Not Wish To Pursue
NL 00705.075 Notice Of Revision—Title II Allowance To Denial—Claimant Engaged in SGA TN BASIC 11-81
NL 00705.080 Model Letter Notifying Claimant Earnings Test Not Met On Or After Date Of Onset TN BASIC 11-81
NL 00705.085 DWB Denial—Subsequent to Prior Medical Denial That Claimant Not Disabled During Prescribed Period
NL 00705.110 Model Letter “G”—Request For Reconsideration Filed On Denied Application Involving Issues Identical To Previously Denied Application—Same Law Applies
NL 00705.130 Letter To Appellant Advising Of Review Of Previous Determination
NL 00705.135 Letter To Appellant Informing That Request For Hearing Has Been Forwarded To ODAR Since Reconsideration Determination Remains Unchanged TN BASIC 11-81
NL 00705.145 Interim Letter To Claimant—Claim Sent To DDS/ODO TN BASIC 11-81
NL 00705.165 Model Letter — DIB, DWB, or CDB Reconsideration Affirmation — Does Not Wish to Pursue
NL 00705.170 Model Letter — Reconsideration Affirmation of Initial Medicare Coverage Only
DDS Reopening Notices
NL 00705.201 Reopening 1 – Allowance to Denial – Title II TN 13 06-09
NL 00705.206 Reopening 2 – Allowance to Denial – Title XVI TN 13 06-09
NL 00705.211 Reopening 3 – Auxiliary – Title II TN 13 06-09
NL 00705.216 Reopening 4 – Allowance to Closed Period – Title II TN 13 06-09
NL 00705.221 Reopening 5 – Allowance to Closed Period – Title XVI TN 13 06-09
NL 00705.226 Reopening 6 - Denial to Partially Favorable Onset (Not AOD) Title II TN 13 06-09
NL 00705.231 Reopening 7 - Denial to Partially Favorable Onset (Not AOD) Title XVI TN 13 06-09
NL 00705.236 Reopening 8 - Denial to Closed Period - Title II TN 13 06-09
NL 00705.241 Reopening 9 - Denial to Closed Period - Title XVI TN 13 06-09
NL 00705.246 Reopening 10 - Fully Favorable or Partially Favorable Onset to a Later Onset – Title II TN 13 06-09
NL 00705.251 Reopening 11 – Fully Favorable or Partially Favorable Onset to a Later Onset – Title XVI TN 13 06-09
NL 00705.256 Reopening 12 – No Change in Basis or End Result - Claimant Aware or Denial of Request to Reopen and Revise – Title II or Title XVI TN 13 06-09
NL 00705.261 Reopening 13 - Change in Basis – Blind to Disabled – Title II TN 13 06-09
NL 00705.266 Reopening 14 - Change in Basis – Blind to Disabled – Title XVI TN 13 06-09
Continuing Disability Actions
NL 00705.300 Letter No. 1—Freeze Cessation—Work Activity—No DIB Or RIB Application Filed
NL 00705.305 Letter No. 2—Freeze Cessation—Medical—No DIB Or RIB Application Filed
NL 00705.310 Letter No. 3—Freeze Cessation—Work Activity—DIB Denial—No RIB Application Filed
NL 00705.315 Letter No. 4—Freeze Cessation—Medical—DIB Denial—No RIB Application Filed
NL 00705.320 Letter No. 5—Freeze Cessation—Whereabouts Unknown Or Failure to Cooperate—No DIB Or RIB Application Filed
NL 00705.325 Letter No. 6—Freeze Continuance Under Age 65
NL 00705.330 Letter No. 7—Freeze Continuance—DIB Denial (Statutory Blindness)—Claimant Under Age 55
NL 00705.335 Letter No. 8—DIB Continuance—9 Month Trial Work Period -Voluntary Report Of Return To Work After Age 64—No Medical Reexamination Scheduled
NL 00705.350 Continuing Disability Review (CDR) Cover Letter TN 10 05-93
NL 00705.354 Continuing Disability Review (CDR) Come-In Notice TN 11 03-04
NL 00705.355 Continuing Disability Review (CDR) Deferral Notice TN 11 03-04
NL 00705.356 Continuing Disability Review (CDR) Continuance Notice (Children Under Age 16) TN 11 03-04
NL 00705.357 Continuing Disability Review (CDR) Continuance Notice (Children Ages 16-17) TN 11 03-04
NL 00705.358 Continuing Disability Review (CDR) Cessation Notice TN 11 03-04
NL 00705.359 Continuing Disability Review (CDR) Non-Responder TN 19 06-15
Miscellaneous
NL 00705.500 Model Letter Of Interim Notice To Claimant Of Delayed Reopening Action TN BASIC 11-81
NL 00705.505 Model Letter—Undeliverable Correspondence TN BASIC 11-81
Prisoner Model Letters
NL 00705.520 Prisoner Model Letter “S”—Felony Related Impairment—DIB, CDB
NL 00705.525 Prisoner Model Letter “T”—Felony Related Impairment—DWB
NL 00705.530 Prisoner Model Letter “U”—Incarceration Related Impairment—DIB Freeze Established
NL 00705.535 Prisoner Model Letter “V”—Incarceration Related Impairment—CDB, DWB
NL 00705.540 Prisoner Model Letter “W”—Felony and Non-Felony Related Impairments—DIB, CDB, DWB
NL 00705.545 Prisoner Model Rider “X”—Incarceration and Non-Incarceration Related Impairment—CDB, DWB
Medicare Coverage Only
NL 00705.600 Model Letter“Q”—Medicare Coverage Only—CDB—Lack Of Severity
NL 00705.605 Model Letter “R”—Medicare Coverage Only—CDB—Not Disabled Within 7 Years After Prior Cessation
Case Development Correspondence
NL 00705.720 Adult Initial Case Development Letter - Sample TN 14 04-11
NL 00705.725 Child Initial Case Development Letter - Sample TN 14 04-11
NL 00705.730 Cover Letter - Function Report - Adult (Form SSA-3373-BK) - Sample TN 14 04-11
NL 00705.735 Claimant Call-in Letter - Sample TN 14 04-11
NL 00705.740 Third Party Call-in Letter - Sample TN 16 09-11
NL 00705.745 Model Consultative Examination (CE) Appointment Notice and Forms TN 17 12-11
NL 00705.755 Notification to the Claimant of Medical Deferment -Sample TN 18 03-12
NL 00705.770 Model Letter Requesting Medical Evidence of Record (MER) TN 17 12-11

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NL 00705.000 - Disability Sample Guide Letters - Table of Contents - 06/01/2015
Batch run: 06/01/2015
Rev:06/01/2015