TN 23 (12-17)

NL 00725.115 “AGE” UTIs – Age

AGE004 Disallowance, Age

 (1)   (2)  not qualify for  (3)  benefits now because, based on  (4)   (5)  ,  (6)  ,  (7)  not yet age  (8)  .

Fill-ins:

(1) SN (First letter capitalized)

(2) “do”/“does”

(3) “retirement”

(4) SN/null

(5) “the date of birth that was given to us”/“correct date of birth”/“date of birth”

(6) month/day/year

(7) “you are”/“she is”/“he is”

(8) “62”/“60”/“50”

AGE005 Disallowance, Child (Age)

 (1)  not qualify for child's benefits because  (2)  : over age 18, and not disabled, and not a full-time elementary or secondary level school student.

Fill-ins:

(1) FN

(2) “she is”/“he is”

AGE006 Age Factor - DOB Not Established

 (1)   (2)  not qualify for  (3)  now because we have not received enough evidence to prove that  (4)  reached age  (5)  . If you can furnish additional proof of  (6)  age, please contact any Social Security office promptly.

Fill-ins:

(1) “You”/SN in format “Mr. Jones”

(2) “do”/“does”

(3) Type of benefit

(4) “you have”/“she has”/“he has”

(5) “62”/“60”/“50”

(6) “your”/“her”/“his”

AGE007 Medicare Disallowance, Age

 (1)  must be at least age 65 to qualify for Medicare. Based on  (2)  ,  (3)  ,  (4)  not old enough.

Fill-ins:

(1) “you”/“she”/“he”

(2) “the date of birth that was given to us”/“[2a] or [2b] date of birth”/“[2a] SN possessive birth date”/“[2b] correct birth date”/null

(3) birth date (MM/DD/YYYY)

(4) “you are”/“she is”/ “he is”

AGE008 Established Date of Birth Different from Alleged

Based on the evidence we have, we have decided that  (1)  correct date of birth is  (2)  .

Fill-ins:

(1) FN

(2) Month/day/year

AGER09 Foreign Birth Record Not Readily Available

To pay benefits more quickly, we use  (1)  as  (2)  date of birth. This date is based on the documents  (3)  gave us. We are still waiting for a copy of the foreign birth record. If the foreign birth record does not agree with the date of birth we used, we may need to revise our decision about  (4)  date of birth. A different date of birth could affect your right to benefits or the amount of your payments. Also, if we paid you too much, you may have to pay us back. When we receive the foreign birth record, we will send you another letter to let you know if there will be a change in your payments.

Fill-ins:

(1) alleged date of birth in the format “Month DD, YYYY” *

(2) “your” or beneficiary's full name in the format “Mr. Jack Jones”

(3) “you”/“she”/“he”

(4) “your”/“her”/“his”

(*) indicates that the fill-ins are manual