Effective Dates: 11/22/2017 - Present Previous | Next

NL 00708.005 Usage Chart for Numbered Paragraphs

A. Claims Paragraphs

  1. 1. 

    AGE

  2. 2. 

    DEPENDENCY REQUIREMENTS

  3. 3. 

    RELATIONSHIP

  4. 4. 

    WAGES, SELF-EMPLOYMENT, MILITARY SERVICE AND RAILROAD EMPLOYMENT

  5. 5. 

    DIB APPLICATION FILED AFTER DEATH OF NUMBER HOLDER

  6. 6. 

    CHILDHOOD DISABILITY

  7. 7. 

    DIB NOT DISABLED

  8. 8. 

    RIB/DIB (RIB or DIB)

  9. 9. 

    DWB WIDOW(ER)

  10. 10. 

    LUMP-SUM DISALLOWANCES

B. Failure to Meet Earnings (or Prescribed Period) Requirement

  Paragraph Fill-ins
DIB-NH Deceased and Not Insured at Alleged Onset or Later 318 2
General Description of Earnings Requirement 320.1 None
Description of 6/12 Test—Disability Before Age 24 320.2 None
Description of Earnings Requirement—Disability Between the Ages 24-31 320.3 None
Description of Earnings Requirement—Disability at Age 31 or Later—Not Due to Statutory Blindness 320.4 None
Description of Fully Insured Test—Disability Due to Statutory Blindness 320.5 None
DWB—Explanation of the Disability Requirement and the Prescribed Period 320.6 None
DIB Denial—Earnings Requirement Not Met—No QC at Any Time 322.2 None
DIB Denial—AOD Before Age 24—6/12 Test Not Met in AQD or Later 322.3 2
DIB Denial—AOD Between Ages 24-31—Earnings Requirement Not Met in AOD or Later 322.4 2
DIB Denial—AOD at Early Age—Earnings Requirement Not Met 322.6 None
DIB Denial—Earnings Requirement Not Met in AOD (AOD 1973 or Later) Disability Due to Statutory Blindness 322.7 2
DWB Denial—Disabled When Alleged or Onset Established Later Than Alleged—Prescribed Period Requirement Not Met 323.1 2
DIB Denial—Disabled in Quarter Alleged or Onset Established Later Than Alleged—Disabled Before Age 24—6/12 Test Not Met 323.2 3
DIB Denial—Disabled in Quarter Alleged or Onset Established Later Than Alleged—Disabled Between Ages 24-31—Earnings Requirement Not Met 323.3 2
DIB Denial—Disabled in Quarter Alleged or Onset Established Later Than Alleged—Disabled Age 31 or Later—Earnings Requirement Not Met—Disability Not Due to Statutory Blindness 323.4 4
DIB Denial—Disabled in Quarter Alleged or Onset Established Later Than Alleged—Disability Due to Statutory Blindness—Earnings Requirement Not Met—EOD 1/73 or Later 323.5 3
DIB—Not Disabled Before Insured Status Expired 324(A) 1

C. Work and Earnings Deduction

  Paragraph Fill-ins
Suspension of Payment to Child(ren)—W/E Employed 600 None
Auxiliary Beneficiary Suspended Because “A” Worked 608 R 2
Work Deduction for the Month Immediately Preceding the Current Month 609 1
Overpayment-Credit Months Involved 633 9
Penalty Determination—Good Cause Not Found—Current Payment Status—Explanation of Late Filing Not Furnished 635(A) R 1
Penalty Determination—Good Cause Not Found—Current Payment Status—Explanation of Late Filing Furnished 635(B) R 1
Penalty Determination—Good Cause Not Found—Conditional Benefit Status—Explanation of Late Filing Not Furnished 636(A) R 1
Penalty Determination—Good Cause Not Found—Conditional Benefit Status—Explanation of Late Filing Furnished 636(B) R 1
Late Filing of Report—Beneficiary Not Previously Notified of Good Cause and Penalty—Foreign Work Deduction 660 R 2
To Working Beneficiary—Temporary Deductions—Deferred Resumption Based on Age 70 683 3
“A” Receiving “B” or “B1” Benefit in Combined Check—“B” or “B1” Benefits Suspended Because Spouse is Working 686 1
To Working Beneficiary—Yearly Earnings Assumed 721 R 2
To Working Beneficiary—Work Month Assumed 722 R 3
Reminded to File an Annual Report 778 R 1
Payment Based on Age 70 Attainment 779 R None

D. Awards

  Paragraph Fill-ins
Proceeds of Check for Month of Death or Later and Overpayment Accrued Prior to Death Withheld From Lump Sum 59(B) 4
To Applicant—Part of Lump Sum Authorized to be Paid to Funeral Home, Part Paid to Applicant 67 1
Primary Benefits Based on Transitionally Insured Status 73 1
Underpayment Award in Addition to Other Award (Benefit to Wife Included With Payment) 407(A) None
Increase in Rate—Benefits Payable at Both Rates 430 2
Decrease in Rate—Benefits Payable at Both Rates 432 2
Check to Deceased Beneficiary Outstanding—Amount Withheld From Lump Sum and /or Underpayment Award (Modify Where More Than One Check) 685 R 5
Lump Sum Payment Widow—Lump Sum Death Payment Being Made as a PMA Check While the Initial “D” Award Will be Made as a CMA Payment 687 1
Combined “AB” Check for Month of Death Negotiated by Surviving Spouse Under “Superendorsement” Process 691 None
Lead-In Paragraph for Award Notices 950 1
Former Representative Payee Notified Student Benefits Will be Paid Directly to Student 958 R None

E. Suspension/Offset

  Paragraph Fill-ins
To Former Wife—No Child in Her Care—Payment Suspended 18(a) None
Currently Suspended With Some Benefits Payable 44 1
Wife Under 62 and Widow Under 60 With Payee—Child No Longer Entitled 52(C) 2
SSI Offset overpayment—Offset Period is Same as Retroactive (PMS) Period 80 4
SSI Offset Overpayment—Offset Period Less Than Retroactive (PMA) Period 81 5
Additional Information Regarding the Student's Benefits 733 R None

F. Reinstatement

  Paragraph Fill-ins
Completion of Form SSA-21 (or SSA-22-F4) by Beneficiary (or Payee of Beneficiary) Who Has Moved to Foreign Country 684 None

G. Adjustment

  Paragraph Fill-ins
E or D Conversion Affecting Other Survivors 10 None
Benefits Now Payable With Some Months Suspended 44(A) 3
Previous Action Revised Upon Reconsideration (For Residents Other Than U.S., Guam, American Samoa, Philippines, Canada, Mexico, Western Samoa and British Virgin Islands) 136(D) F None
Previous Action Revised Upon Reconsideration After Implied Request (For Residents Other Than U.S., Guam, American Samoa, Philippines, Canada, Mexico, Western Samoa and British Virgin Islands) 136(E) F None
Program Service Center Reconsiders Case Remanded Prior to a Hearing 137 None
Hearing Paragraph for Reconsidered Disability Cases Hearing Paragraph Used in Reconsideration Notice 140 None
Where Claim is Denied on the Basis of Res Judicata 140(A) None
Increase in Rate—Benefits Payable at Both Rates 430 2
Decrease in Rate—Benefits Payable at Both Rates 432 2
Change in Benefit Rate 439 None
Change in Benefit Rate—Increase or Decrease in Benefits for Retroactive Period 439(A) R None
Beneficiary's Benefit Rate Adjusted Due to Termination of Benefits to Another Beneficiary 440 3
Change in One Beneficiary's Rate—Wage Earner's and Spouse's Benefits Combined 441 R None
Form SSA-L562 Change in Rate Reasons 462(A-M) 1
Waiver of Deduction Overpayment—Auxiliary Beneficiaries 624 1
Overpayment—30 Day Adjustment Paragraph 651 R None
Student Entitled—Family Maximum Case—No Adjustment Required 652 1
Late Filing of Report—Beneficiary Not Previously Notified of Good Cause and Penalty—No Child-in-Care Deduction 656A R 2
Auxiliary Beneficiary Living With W/E Also Overpaid—Request for Refund (to be added to W/E's Notice) 662 3
Auxiliary Beneficiary Living With W/E Also Overpaid—Adjustment Possible (to be added to W/E's Notice) 663 7
Combined Check—Check for Month Subsequent to Month of Death Adjusted Against Current Benefits 676 2

H. Terminations

  Paragraph Fill-ins
To Former Wife—Child No Longer Entitled 16(A) None
Wife Under 62 and Widow Under 60 (50 if Disabled)With Payee—Child No Longer Entitled 52(C) 2
Child Receiving Direct Payment—Age 18—Terminated 61(A) 1
Child Paid By Employer While Attending School 209(A) None
School Does Not Qualify as an Educational Institution 209(B) 1
Disability Ceases—Payments Terminate 412 Varies
Title II—VR Continued Payments—Termination Paragraph 413 2
Title XVI—VR Continued Payments—Termination Paragraph 414 2
Title II—VR Cessation-Auxiliaries in Separate Households—VR Payments Terminate 415 1
Title II—VR Cessation—Auxiliaries in the Same Household—VR Payments Terminate 417 3
Spouse (B1) (B2), Age 62 When Last Child Terminated 671 None

I. Appellate Process and Attorney Fees

  Paragraph Fill-ins
Court Order Provides for Payment of Attorney Fees 145 2
Notice to Auxiliary Living Apart that Court Order Does Not Provide for Payment of Attorney Fee 146.2 4
Direct Payment of Attorney's Fee at the Time Award is Made to Claimant 147 1
Combined Notice Where Direct Payment of Attorney Fee is Made at the Time Award is Made to Claimant 147.1 1
Separate Notice to Auxiliary Where Attorney Fee Has Not Yet Been Authorized 148.2 1
Title II Offset Cases When a Fee for Representation is Involved (Offset Adjustment Notice) 970 4
Authorized Check Equals Amount of Past-Due Benefits Withheld 980 None
Authorized Check is Less Than Amount of Past-Due Benefits Withheld 980.1 1
Authorized OHA Fee Equals Amount of Past-Due Benefits Withheld 980.4 1
Authorized OHA Fee is Less Than Amount of Past-Due Benefits Withheld 980.5 2
Authorized OHA Fee Exceeds Amount of Past-Due Benefits Withheld 980.6 2
Fee Waiver or Statement That No Fee Will be Charged 981.1 None
Waiver of Right to Direct Payment 981.2 None
Future Month of Entitlement Case—No Past-Due Benefits Available 981.3 None
Fee Petition Incomplete After District Office Contact 982 None
Representative is Not an Attorney 983 None
Fee Waiver (or Statement That No Fee Will Be Charged) Received After Past-Due Benefits Have Been Withheld 985 2
Prior Payment to Attorney—Additional Benefits Available 986 4
Questionable Attorney-Client Relationship 987 1

J. Medicare

  Paragraph Fill-ins
SMIB Termination Reversal Paragraphs—Computer Generated if Effective Month of Buy-in Precedes Termination Month Shown as “MT” Factor in Item 7 of SSA-101 6K None
Disallowance of Claim for Hospital Insurance—Not Full Retirement Age 265 1
Disallowance of Claim for Hospital and Medical Insurance Coverage—Not 65—Applicant Filed Under Deemed Insured Provision 266 1
Medical Insurance Beneficiary (“M” BIC) Potential Entitlement as Spouse of Premium Payer 267 1
Covered or Potentially Covered Under the Federal Employees Health Benefits Act of 1959—Deemed Insured 272 None
Applied Before Beginning of Initial Enrollment Period 274 None
Not a Resident of One of the 50 States or the District of Columbia 278 1
Special QC's Requirement for Entitlement to HI Under Deemed Insured Provisions—Full Retirement Age In or After 1968 284 2
Chronic Renal Disease Disallowance—Opening Paragraphs 290 1
Disability Established—Health Insurance Coverage Date Begins More Than 2 Months After the Current Operating Month, HI/SMI Begins in Same Month 295 1
Medicare Termination—Revised Date of Entitlement 297 1
to Disability Benefits 297 1
Lead-in Paragraph—Medical Premiums Due 368 2
Suspension of Benefits or Payment Deferred Beyond Current Year—Combined Payments—A and B Beneficiaries Enrolled Under SMI (A Worked) 703R None
Deferred Payment Action—To Recover Overpayment Liable for Premiums 704 None
Deferred Payment Action—To Recover Overpayment Redeferred for Premiums Due 705 None
One-Check-Only Followed by a Suspension-Combined Check Situation (A Worked)—Both A and B Enrolled in SMI 707 1
One-Check—Only Followed by a Deferred Payment Action in Current Year 708 1
To Secondary Beneficiary-Monthly Benefit Payable Less Than $1 709 5
To Secondary Beneficiary—Monthly Benefit Payable is Same as Premium 710 2
To Secondary Beneficiary—Monthly Benefit Payable is Less Than Premium 711 6
Representative Payee for HI and/or SMI Enrollee 716 3
Termination of Monthly Benefits and HI With SMI Entitlement Transferred to New Account 718 None
Explanation of Medicare Premiums and Deductions Under Public Law (P.L.) 97-248, Sec. 278 719 None
Discontinuance of State Buy—In Due to Non-Payment of SSI 728 None
Continuance of State Buy-In When SSI Payments Stopped 729 None
DIB Terminates—HI/SMI Coverage Terminates—No Refunds on Remittance Due 741 1
DIB Terminates—HI/SMI Coverage Terminates—Premium Arrearage Exists—No DIB Overpayment or Underpayment 742 4
DIB Terminates From Suspense—DIB Underpayment HI/SMI Premiums for Month Following Month of Notice to be Deducted From DIB Underpayment—Beneficiary Not Billed for SMI Premiums (to be used in conjunction with paragraph No. 741) 743 3
DIB Terminates From Suspense—DIB Underpayment for Months—HI/SMI Premiums for Month Following Month of Notice to be Deducted From DIB Underpayment—Beneficiary Not Billed for SMI Premiums 743(A) 4
DIB Terminates From Suspense—No DIB Overpayments or Underpayments Beneficiary Billed for SMI Premiums—Premium Arrearage Exists (to be used in conjunction with paragraph No. 741) 744 4
DIB Terminates From Suspense—DIB Underpayment—Beneficiary Billed for SMI Premium—Premium Arrearage Exists Which Will be Deducted From the Next Check (to be used in conjunction with paragraph No. 741) 745 4
DIB Terminates From Suspense—DIB Underpayment for Multiple Months—Beneficiary Billed for SMI Premiums—Premium Arrearage Exists Which Will be Deducted From the Next Check 745(A) 5
DIB Terminates—HI Coverage Terminates—No SMI Coverage 746 1
SMI Refund Paragraph (to be used in conjunction with paragraph No. 741 when excess premiums will be refunded by SOBER) 747 None
Medicare Ineligibility Paragraph (to be used when beneficiary's DOST and DOCA are prior to the date of entitlement to HI/SMI. It is also to be used when a Future Cessation Date (FCD) equal to or earlier than the date of entitlement to HI/SMI is being established.) 748 None
DIB Terminates—HI/SMI Coverage Terminates—Premium Arrearage Exists Along With DIB Overpayment 749 3
DIB Terminates—HI/SMI Coverage Terminates—Premium Arrearage Exists for One Month Along With DIB Overpayment 749(A) 3
DIB Terminates—HI/SMI Coverage Terminates—Premium Arrearage Exists for Prior Months Along With DIB Overpayments 749(B) 4
DIB Terminated From Suspense—DIB Overpayment Exists—Beneficiary Billed for SMI Premiums—Premium Arrearage Exists (to be used in conjunction with paragraph No. 741) 750 3
DIB Terminated-Excess SMI Premiums Used to Reduce Overpayment 751 4
DIB Terminated From Suspense—DIB Underpayment for One Month—Excess Premiums to be Refunded by SOBER 752 6
DIB Terminated From Suspense—DIB Underpayment for Multiple Months—Excess Premiums to be Refunded by SOBER 752(A) 7
HI and SMI Coverage for RD Beneficiaries (Dialysis) 790 None
Closed Period—Entitlement/Termination (Dialysis) 791 3
HI/SMI Termination Due to RD Cessation (Dialysis) 792 2
Equitable Relief—RD Termination Cases—DOTH is Earlier Than DOTS—Beneficiary Not Notified Timely (Dialysis) 793 4
HI and SMI Coverage for RD Beneficiaries (Transplant) 794 2
HI/SMI Termination Due to RD Cessation (Transplant) 795 2
Equitable Relief-RD Termination Cases—DOTH is Earlier Than DOTS—Beneficiary Not Notified Timely (Transplant) 796 4
NH—Capacity for SGA 850 1
NH—Impairment Not Severe—Medical Consideration Alone 851 None
NH—Impairment Not Severe—Medical Consideration Alone (Date ER Last Met) 852 1
NH or Disabled Child—Impairment Not Expected to Last 12 Months 853 None
NH or Disabled Child—Impairment Did Not Last 12 Months 854 None
Disabled Child—Impairment Not Severe—Medical Consideration Alone or Condition Disabling But Did Not Exist Before Age 22 (Over Age 22) 855 None
Disabled Child—Impairment Not Severe—Medical Consideration Alone or Condition Disabling But Did Not Exist Before Age 22 (Under Age 22) 856 None
Disabled Child—Capacity for SGA—Vocational Consideration (Over Age 22) 857 None
Disabled Child—Capacity for SGA—Vocational Consideration (Under Age 22) 858 None
NH—Not Disabled Before Insured Status Expired 859 2
NH—Not Insured at Alleged Onset Or Later 860 None
Disabled Widow(er)'s Prescribed Period Expired Before Alleged Onset 861 2
NH—Explanation of Disability Requirement 862 None
Disabled Widow(ers)—Explanation of the Disability Requirement and the Prescribed Period 863 None
Expiration of Widow(er)'s Prescribed Period 864 2
Childhood Disability—Law Paragraph—Claimant Age 22 or Over 865 None
Childhood Disability—Law Paragraph—Claimant Not Yet Age 22 866 None
Widow(ers), Mother, Father or Surviving Divorced Spouse Entitled to Survivors Benefits—Claim Filed for Medicare Coverage—Explanation of Disability Requirement for Medicare Coverage 867 None
Widow(ers) Not Disabled—Lack of Severity 868 None
Widow(ers)—Not Disabled at Any Time Prescribed Period Requirement Met For Deemed Entitlement to Medicare Coverage 869 1
NH—Disabled Widow(ers) or Child—Applicant Does Not Want to Continue Development of Claim 870 None
NH—Disabled Widow(ers) or Child—Failure to Follow Prescribed Treatment 872 None
Widow(ers) Not Disabled—Impairment is Severe at Time of Adjudication But Not Expected to Last 12 Months 874 None
Widow(ers) Not Disabled—Impairment No Longer Severe At Time of Adjudication and Did Not Last 12 Months 875 None
NH—Disabled Widow(ers) or Child—Insufficient Evidence Furnished 876 None
NH—Disabled Widow(ers) or Child Fails or Refuses to Submit to Medical Examination 877 None
NH or Widow(er) Has Demonstrated Ability to Engage in SGA Despite Condition 881 None
NH Demonstrated Ability to Engage in SGA Despite Impairment Within 29 Months Before Attaining Full Retirement Age 883 None
NH—Claim Filed After Death—Not Disabled at Any Time Earnings Requirement Met 884 4
NH—Claim Filed After Death—Not Disabled—Lack of Severity 885 3
NH—Claim Filed After Death—Not Disabled—Impairment is Severe At Time of Death But Would Not Have Been Expected to Last 12 Months 886 2
NH—Claim Filed After Death—Not Disabled—Impairment No Longer Severe At Time of Death and Did Not Last 12 Months 887 3
NH—Claim Filed After Death—Insufficient Evidence 888 1
NH—Claim Filed After Death—Denial—Applicant Does 889 2
Not Want To Continue Development of Claim NH—Claim Filed After Death—Denial—Impairment Was Severe But Claimant Failed to Follow Prescribed Treatment 890 4
NH—Claim Filed After Death—Not Disabled At Any Time Earnings Requirement Met—Medical Consideration Alone 891 4
NH—Claim Filed After Death—Not Disabled—Lack of Severity—Medical Consideration Alone 892 2
DIB or CDB Medical Cessation 893 2
DIB or CDB Cessation—Work Activity (No Trial Work Period) 894 2
DIB or CDB Cessation—Whereabouts Unknown or Failure to Cooperate—Required Information Not Submitted 895 2
DIB or CDB Cessation—Whereabouts Unknown or Failure to Cooperate—Requested Medical Examination Not Taken 896 2
Disability Ends Prior to Beginning of Medicare Coverage 897 None
Disability Ends After Medicare Coverage Begins 898 None
CDB Reentitlement Notice 899 1
Medicare Coverage Termination 901 1
DWB Cessation—Medical Evidence Indicates Ability to Perform SGA 902 2
Medicare Termination—Disability Ends Prior to Medicare Coverage 903 None
Medicare Termination—Disability Ends After Medicare Coverage Begins 904 1
State Agency and M.D. Participation in Decision 914 None
Prior Freeze Not Affected by Current Denial 916 None
Periodic Review Scheduled 917 None
Lead-In Language for Closed Period and Later Onset Date Allowances 918 None
Disability Requirement and 7-Year Period Attachment 919 None
Disability and Earnings Requirement Attachment 920 None
Dual Entitlement—Subsequent Award—Medicare Awarded Previously and Will Continue on First Account 940 None

K. Extended Period of Eligibility

  Paragraph Fill-ins
EPE Case—Cessation—9 Months of Trial Work Complete Beneficiary Performing SGA 905 3
EPE Case—Explanation of 15-Month Reinstatement Period 906 None
EPE Case—Impairment-Related Work Expenses Not Allowed As Claimed 907 None
EPE Case—Impairment-Related Work Expenses Insufficient to Reduce Earnings Below SGA 908 None
EPE Case—9 Months of Trial Work Complete—Medical Review—Disability Continues 909 None
EPE Case—9 Months of Trial Work Complete—Medical Review—Disability Ceases 910 1
EPE Case—Medicare Has Begun Prior to End of TWP 911 None
EPE Case—If 24th Month of Entitlement Has Not Been Reached Prior to End of TWP 912 1
Expiration of Disability Insured Status 913 2

L. General Miscellaneous

  Paragraph Fill-ins
Change of Payee—Former Representative Payee An Individual 35R 1
Change of Payee—Former Representative Payee an Agency or Institution 35(A) R 1
Applicant Not Entitled to Underpayment—Not on Priority List 50(D) 2
Applicant Not Entitled to Underpayment—Another Individual Higher in the Order of Priority Who is Eligible to Receive Underpayment 50(E) 3
No Underpayment Exists—Request for Payment Denied 50(F) None
U.S. Federal Income Tax Withheld from Underpayment Paid to Nonresident Alien 51 2
Award Amended to Exclude Disability Period 70 None
Exclusion of Disability Period Does Not Increase Benefit 71 None
Primary Benefits Based on Transitionally Insured Status 73 1
Address Paragraph for ALJ, ODO, PSC, OHA 160 1
Fee Petition Paragraph for Court Cases 161 None
Applicant Not Entitled to Monthly Benefits—Worker Not Fully Insured 201 2
To Husband or Widower—W/E or S/E Person Not Fully and Currently Insured 202 2
Spouse Not Yet 62 and No Child in Care Age 16 or Under or Disabled 205(B)R None
Child 18 or Over Not Disabled or a Full-Time Student 209 1
Child Paid by Employer While Attending School 209(A) None
School Does Not Qualify As an Educational Institution 209(B) 1
Widow/Widower Under 60—No Child “In-Care” —Child Entitled to Benefits 212 1
If the Widow/Widower May Become Entitled to Benefits at Age 60, Add the Following 212(A) 1
Surviving Divorced Spouse Not Entitled, Child Requirement Not Met 213(A) 1
Disallowance for More Than One Reason but Insufficient Proof in File to Make Decision 240 1
Insured Individual Died After Deportation 244 None
Wife, Child, or Husband Disallowed Because W/E Not Entitled to RIB or DIB 245 None
Denial of Requests for Withdrawal of Claim—Requested Consent Statements Absent 251 None
Denial of Request for Withdrawal—Refund Not Made 252 1
Withdrawal Approved, New Award Made—Notice to Person Whose Entitlement is Nullified 255 4
Withdrawal Approved—Notice to Wife, Husband or Child Whose Entitlement is Nullified 256 4
Insert Paragraph for Form SSA-L250 (SSA-L850)—Withdrawal Approved After Award 257 None
Insert Paragraph for Form SSA-L250 (SSA-L850)—Withdrawal Approved Before Adjudication 258 None
Wife or Widow—Under 72—W/E Transitionally Insured 261 2
Widow Age 72 or Over Disallowed—No Transitional Insured Status—W/E Attained 65 or Died Before 1957 263 3
Request for Change of Address—Claimant Entitled to Hospital Insurance Benefits But Not Monthly Benefits 264 None
Not a Resident of U.S.—Deemed Insured 270 None
Not a U.S. Citizen and Does Not Meet Alien Residency Requirement—Deemed Insured 271 None
Claim Disallowed For Nonmedical Reasons—Disability Determination Unnecessary 288 None
Lead-in Paragraph 306 2
Reconsideration Paragraph 307 2
Hearing Paragraph 308 1
Right to File Subsequent Application 309 1
DIB—Not Qualified Before Full Retirement Age—Substantial Gainful Work313(A) None ​
Disability Denial—General Closeout Paragraph 314 None
Description of Earnings Requirement—Special Insured Status Requirements for Subsequent Period of DIB 320.9 None
Allowance—Subsequent Period of DIB, Special Insured Status—Benefits Payable 5/83, First Possible Month of Entitlement Earlier 321 1
Applicant Mentions Another Disability Program 351 None
Reexamination Scheduled—Beneficiary Hospitalized 354 1
Statutory Blindness—DIB Allowance Under 1972 Amendments—First Month of Entitlement Restricted to 01/73 358 2
Initial Notice—Reference to Follow-up Notice if Title II Underpayment or Overpayment Involved 365 None
Lead-in Paragraph—Underpayment of Title II Benefits Involved 366 2
Lead-in Paragraph—Overpayment of Title II Benefits Involved 367 2
DIB—Rate Increase—Two Rates Payable 372 None
DIB—Rate Increase—Change in Disability Period 374 None
Claimant Insured for RIB—No RIB Claim Filed 378 None
Information Concerning Hospital and Medical Insurance—Claimant Age 63-64 3 /4 379 None
DIB and DWB Applications Filed 380R None
Freeze or DIB Continuance (After Full Retirement Age) 388 None
DWB Cessation—Medical Improvement 396 3
DIB Cessation—Overpayment Involved 397 3
DIB Cessation—Overpayment Involved—SMI Premiums Included in Overpayment 397(A) 4
DIB Cessation—Underpayment Involved for One Month 398 3
DIB Cessation—Underpayment Involved for Multiple Months398(A) 4 ​
Title II “Lead-in” Paragraph 399 None
Request for Refund 399(A) 1
Disability Ceases—Payments Continue 408 2
Personalized Notice Lead-In 409 None
Title II VR Cessation-Auxiliaries in Separate Households—Payments Continue 410 1
Title II-VR Cessation—Auxiliaries in Same Household—Payments Continue 411 1
Combined Check—Primary or Auxiliary Beneficiary Dies—Check for Month Subsequent to Month of Death Outstanding 679R None
SSA-1560-U4 Return Address Paragraph SEPSC 731 None
Reference to Title XVI Claim—Dual Entitlement Case (Title XVI Disclaimer Paragraphs) 842 None
Multiple Claims—Benefits Being Paid on One—Current Claim Being Denied 900 None
Government Pension Total Offset 1000 None
Government Pension Partial Offset 1001 None

M. Continuing Disability Review Cessations

  Paragraph Fill-ins
Lead In - Medical Improvement Cessation - Title II 4000 None
Lead In - Group I Exception - Title II 4001 None
Lead In - Medicare Only - Current Coverage - Medical Improvement 4002 None
Lead In - Medicare Only - Current Coverage - Group I Exception 4003 None
Lead In - Medicare Only - Future Coverage - Medical Improvement 4004 None
Lead In - Medicare Only - Future Coverage - Group I Exception 4005 None
Lead In - Reopening To Cessation - Medical Improvement - Title II 4006 None
Lead In - Reopening To Cessation - Group I Exception - Title II 4007 None
Lead In - Reopening To Closed Period - Medical Improvement - Title II 4008 None
Lead In - Reopening To Closed Period - Group I Exception - Title II 4009 None
Lead In - Medicare Only - Reopening To Cessation - Current Coverage - Medical Improvement 4010 None
Lead In - Medicare Only - Reopening To Cessation - Current Coverage - Group I Exception 4011 None
Lead In - Medicare Only - Reopening To Cessation - Future Coverage - Medical Improvement 4012 None
Lead In - Medicare Only - Reopening To Cessation - Future Coverage - Group I Exception 4013 None
Lead In - Auxiliary Notice 4014 3
Lead In - Group II Exception - Title II 4022 None
Lead In - Later Cessation - Medical Improvement - Title II 4038 2
Lead In - Basis Change Only 4040 None
Referral To Personalized Attachment 4041 None
Benefits/Payments End 4043 2
Benefits End - Auxiliary 4044 3
Medicare Ends 4048 1
Medicare Ends - Medicare Only 4049 2
No Future Medicare Coverage 4051 2
Vocational Rehabilitation - Title II 4052 None
DDS Decision 4054 None
Right to Reconsideration 4056 None
Right To Reconsideration - Disability Cessation - Section 301 Case 4057 None
Benefit Continuation - Medicare Involved - Primary Beneficiary - Title II 4059 None
Benefit Continuation - Auxiliary 4060 1
Benefit Continuation - Medicare Involved - Later Cessation or Basis Change Only 4063 None
Benefit Continuation - Later Cessation or Basis Change Only - Auxiliary 4064 1
Disability Hearing Information 4066 None
If You Need Help With Your Appeal 4069 None
Things To Remember - Title II 4070 None
Things To Remember - Medicare - Current Coverage 4071 None
Things To Remember - Medicare - Future Coverage 4072 None
DO Referral 4078 None
DIB, DI or CDB Medical Cessation – Title II/XVI” 4080 1
Disability Cessation - Clear Cut - Title II 4081 1
DIB, DWB or CDB Cessation - Whereabouts Unknown or Failure to Cooperate - Required Information Not Submitted - Title II 4082 1
DIB, DWB, CDB Cessation - Whereabouts Unknown or Failure to Cooperate - Requested Medical Examination Not Taken - Title II 4083 1
Medical Cessation - Advances in Medical Therapy or Technology - Title II/ Title XVI 4084 1
Medical Cessation - Advances in Vocational Therapy or Technology - Title II /Title XVI 4085 1
Medical Cessation - New or Improved Diagnostic or 4086 1
Evaluative Techniques - Title II/Title XVICessation - Prior Determination in Error - Title II/Title XVI 4087 1
Cessation - Fraud - Title II/Title XVI 4088 1
Failure to Follow Prescribed Treatment - Title II/Title XVI 4095 1
DWB Medical Cessation - Title II 4096 1
Benefit Continuation Rights - Medicare Not Involved 4097 None
Appeal Rights - Face-to-Face Hearing - Reopening to a Later Onset 4098 None
Appeals Rights - ALJ Hearing - Title II 4104 None
Benefits End - Later Cessation - Title II 4115 2
Lead In - Reopening To Later Cessation - No Medical Improvement - Title II 4116 2
Lead In - Reopening To Cessation - Group II Exception - Title II 4127 None
Right To Reconsideration (Foreign Claim) 4131 None
Right To Reconsideration - Auxiliary (Foreign Claim) 4132 None
Right To Reconsideration - Award Notice - Revision To Later Onset (Foreign Claim) 4133 None
General Closing Paragraph (Foreign Claim) 4134 1
Disability Hearing Information (Foreign Claim) 4135 None
Auxiliary Notice - Lead In - Allowance To Denial 4158 2
Lead In - Allowance to Denial - Title II 4159 None
Right To Reconsideration - Award Notice 4160 None
Lead In - Affirmation of a Denial 4170 None
Lead In - Affirmation of a Later Onset 4171 1
Lead In - Affirmation of a Closed Period 4172 2
Appeal of the Earlier Decision 4173 None
DDS Decision - Foreign Version 4175 None
Appeals Rights - ALJ Hearing Formal Remands 4176 None
How An ALJ Hearing Works 4177 None
How An ALJ Hearing Works - Foreign Version 4178 None
DO Referral - Foreign Version 4179 None
Notice Enclosures - Cessation - Title II 4180 None
Notice Enclosures - Cessation - Title II 4181 None
Notice Enclosures - Basis Change Only 4186 None
Notice Enclosures - Basis Change Only 4187 None
To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900708005
NL 00708.005 - Usage Chart for Numbered Paragraphs - 11/22/2017
Batch run: 11/22/2017
Rev:11/22/2017