TN 23 (12-17)

NL 00725.135 “BEN” UTIs – Benefit Information

BEN030 MBA Chart – Shows Changes to MBA on All DIB Awards and RR Certification Awards

The following chart shows  (1)  benefit amount(s) before any deductions or rounding. The amount  (2)  actually receive(s) may differ from  (3)  full benefit amount. When we figure how much to pay  (4)  , we must deduct certain amounts, such as Medicare premiums. We must also round down to the nearest dollar.

Beginning Date

Benefit Amount

Reason

 (5)   (6) 

 (7) 

 (8) 

 (9)  (10)

(11)

(12)

(13)(14)

(15)

(16)

(17)(18)

(19)

(20)

(21)(22)

(23)

(24)

(25)(26)

(27)

(28)

(29)(30)

(31)

(32)

(33)(34)

(35)

(36)

(37)(38)

(39)

(40)

(41)(42)

(43)

(44)

(45)(46)

(47)

(48)

(49)(50)

(51)

(52)

(53)(54)

(55)

(56)

(57)(58)

(59)

(60)

(61)(62)

(63)

(64)

(65)(66)

(67)

(68)

Fill-ins:

(1) your/beneficiary's given name plus “beneficiary's last name possessive

(2) “you”/“she”/ “he”

(3) “your”/“her”/“his”

(4) “you”/“her”/“him”

(5)

(6) EFD year associated with fill-in 5, in the format YYYY

(7) MBA amount, corresponding to EFD from fill-in 5

(8) Entitlement began/Cost-of-living adjustment/Benefits to another person began or ended/Credit for additional earnings

Fill-ins (9) through (68) follow the logic of fill-ins (5) through (8)

BEN031 DIB Over RIB Entitlement

Since  (1)  now entitled to a higher monthly disability benefit, we are stopping  (2)  retirement benefits.

Fill-ins:

(1) you are/Ms. plus beneficiary's last name plus “is”/Mr. plus beneficiary's last name plus “is”

(2) “your”/“her”/“his”

BEN032 DIB Over RIB Entitlement/Dual Entitlement Involving an Adjustment in Retroactive Benefits

In  (1)   (2)  payment,  (3)  will receive the difference between the benefit