NL 00705.000 Disability Sample Guide Letters

Subchapter Table of Contents
Section Latest
Transmittal
Disability Insurance Benefits (DIB)
NL 00705.010Model Letter “K” - Statutory Blindness Freeze Allowance - DIB Denial - Claimant Age 55 or Over 
NL 00705.015Model Letter “L” - Freeze Allowance 
NL 00705.020Model Letter “M” - Forwarding Notice Of Determination to Person Having Custody 
NL 00705.025Model Letter “N” - Forwarding Notice of Determination To Claimant 
NL 00705.030Model Letter “O”- Closed Period Of Disability Established 
NL 00705.050Model Letter “S” - Statutorily Blind -Established Onset Date Before 1973 - No 20/40 Or Fully Insured -Disabled Age 31 or Later 
NL 00705.055Model Letter “T”—Statutorily Blind—Established Onset Date 1973 Or Later—Not Fully Insured At EOD Or Later 
NL 00705.060Model Letter “U”—DIB Denial—Lack Of Severity—AQD 1973 Or Later—Alleged Disability Due To Statutory Blindness And Other Impairment(s) 
NL 00705.065Model Letter “V” — CDB Reentitlement — Alleged Onset Date After End Of 7 Years After Prior Cessation 
NL 00705.070Initial DIB, DWB, or CDB Denial—Does Not Wish To Pursue 
NL 00705.075Notice Of Revision—Title II Allowance To Denial—Claimant Engaged in SGABASIC 11-81
NL 00705.080Model Letter Notifying Claimant Earnings Test Not Met On Or After Date Of OnsetBASIC 11-81
NL 00705.085DWB Denial—Subsequent to Prior Medical Denial That Claimant Not Disabled During Prescribed Period 
NL 00705.110Model Letter “G”—Request For Reconsideration Filed On Denied Application Involving Issues Identical To Previously Denied Application—Same Law Applies 
NL 00705.130Letter To Appellant Advising Of Review Of Previous Determination 
NL 00705.135Letter To Appellant Informing That Request For Hearing Has Been Forwarded To ODAR Since Reconsideration Determination Remains UnchangedBASIC 11-81
NL 00705.145Interim Letter To Claimant—Claim Sent To DDS/ODOBASIC 11-81
NL 00705.165Model Letter — DIB, DWB, or CDB Reconsideration Affirmation — Does Not Wish to Pursue 
NL 00705.170Model Letter — Reconsideration Affirmation of Initial Medicare Coverage Only 
DDS Reopening Notices
NL 00705.201Reopening 1 – Allowance to Denial – Title IITN 13 06-09
NL 00705.206Reopening 2 – Allowance to Denial – Title XVITN 13 06-09
NL 00705.211Reopening 3 – Auxiliary – Title IITN 13 06-09
NL 00705.216Reopening 4 – Allowance to Closed Period – Title IITN 13 06-09
NL 00705.221Reopening 5 – Allowance to Closed Period – Title XVITN 13 06-09
NL 00705.226Reopening 6 - Denial to Partially Favorable Onset (Not AOD) Title IITN 13 06-09
NL 00705.231Reopening 7 - Denial to Partially Favorable Onset (Not AOD) Title XVITN 13 06-09
NL 00705.236Reopening 8 - Denial to Closed Period - Title IITN 13 06-09
NL 00705.241Reopening 9 - Denial to Closed Period - Title XVITN 13 06-09
NL 00705.246Reopening 10 - Fully Favorable or Partially Favorable Onset to a Later Onset – Title IITN 13 06-09
NL 00705.251Reopening 11 – Fully Favorable or Partially Favorable Onset to a Later Onset – Title XVITN 13 06-09
NL 00705.256Reopening 12 – No Change in Basis or End Result - Claimant Aware or Denial of Request to Reopen and Revise – Title II or Title XVITN 13 06-09
NL 00705.261Reopening 13 - Change in Basis – Blind to Disabled – Title IITN 13 06-09
NL 00705.266Reopening 14 - Change in Basis – Blind to Disabled – Title XVITN 13 06-09
Continuing Disability Actions
NL 00705.300Letter No. 1—Freeze Cessation—Work Activity—No DIB Or RIB Application Filed 
NL 00705.305Letter No. 2—Freeze Cessation—Medical—No DIB Or RIB Application Filed 
NL 00705.310Letter No. 3—Freeze Cessation—Work Activity—DIB Denial—No RIB Application Filed 
NL 00705.315Letter No. 4—Freeze Cessation—Medical—DIB Denial—No RIB Application Filed 
NL 00705.320Letter No. 5—Freeze Cessation—Whereabouts Unknown Or Failure to Cooperate—No DIB Or RIB Application Filed 
NL 00705.325Letter No. 6—Freeze Continuance Under Age 65 
NL 00705.330Letter No. 7—Freeze Continuance—DIB Denial (Statutory Blindness)—Claimant Under Age 55 
NL 00705.335Letter No. 8—DIB Continuance—9 Month Trial Work Period -Voluntary Report Of Return To Work After Age 64—No Medical Reexamination Scheduled 
NL 00705.350Continuing Disability Review (CDR) Cover LetterTN 10 05-93
NL 00705.354Continuing Disability Review (CDR) Come-In NoticeTN 11 03-04
NL 00705.355Continuing Disability Review (CDR) Deferral NoticeTN 11 03-04
NL 00705.356Continuing Disability Review (CDR) Continuance Notice (Children Under Age 16)TN 11 03-04
NL 00705.357Continuing Disability Review (CDR) Continuance Notice (Children Ages 16-17)TN 11 03-04
NL 00705.358Continuing Disability Review (CDR) Cessation NoticeTN 11 03-04
Miscellaneous
NL 00705.500Model Letter Of Interim Notice To Claimant Of Delayed Reopening ActionBASIC 11-81
NL 00705.505Model Letter—Undeliverable CorrespondenceBASIC 11-81
Prisoner Model Letters
NL 00705.520Prisoner Model Letter “S”—Felony Related Impairment—DIB, CDB 
NL 00705.525Prisoner Model Letter “T”—Felony Related Impairment—DWB 
NL 00705.530Prisoner Model Letter “U”—Incarceration Related Impairment—DIB Freeze Established 
NL 00705.535Prisoner Model Letter “V”—Incarceration Related Impairment—CDB, DWB 
NL 00705.540Prisoner Model Letter “W”—Felony and Non-Felony Related Impairments—DIB, CDB, DWB 
NL 00705.545Prisoner Model Rider “X”—Incarceration and Non-Incarceration Related Impairment—CDB, DWB 
Medicare Coverage Only
NL 00705.600Model Letter“Q”—Medicare Coverage Only—CDB—Lack Of Severity 
NL 00705.605Model Letter “R”—Medicare Coverage Only—CDB—Not Disabled Within 7 Years After Prior Cessation 
Case Development Correspondence
NL 00705.720Adult Initial Case Development Letter - SampleTN 14 04-11
NL 00705.725Child Initial Case Development Letter - SampleTN 14 04-11
NL 00705.730Cover Letter - Function Report - Adult (Form SSA-3373-BK) - SampleTN 14 04-11
NL 00705.735Claimant Call-in Letter - SampleTN 14 04-11
NL 00705.740Third Party Call-in Letter - SampleTN 16 09-11
NL 00705.745Model Consultative Examination (CE) Appointment Notice and FormsTN 17 12-11
NL 00705.755Notification to the Claimant of Medical Deferment -SampleTN 18 03-12
NL 00705.770Model 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 - 03/05/2012
Batch run: 03/28/2014
Rev:03/05/2012