TN 22 (12-17)

NL 00725.240 “FRZ” UTIs – Freeze

FRZ001 Disability Freeze

 (1)   (2)  for a period of disability beginning  (3)  . Although  (4)  will not receive checks during  (5)  period of disability, we will use the period to protect the amount of any benefit we might pay  (6)  family in the future. Future benefits on  (7)  record will be based on  (8)  average earnings. The period of disability ensures that if  (9)  relatively low earnings while disabled, the low earnings will not affect the average.

Fill-ins:

(1) “You”/FN

(2) “qualify”/“qualifies”

(3) onset date

(4) “you”/“she”/“he”

(5) “your”/“her”/“his”

(6) “your”/“her”/“his”

(7) “your”/“her”/“his”

(8) “your”/“her”/“his”

(9) “you have”/“she has”/“he has”

FRZ002 Disability Freeze – Potential Parent's Benefits

If either or both of  (1)  parents were receiving at least half of their support from  (2)  when  (3)  period of disability began, they may be eligible for benefits in the future. You would need to give us proof of this support within two years of the date the period of disability started.

Fill-ins:

(1) “your”/FN possessive

(2) “you”/“her”/“him”

(3) “your”/“her”/“his”

FRZ003 Statutory Blind Number Holder Allowed a Period of Disability (Freeze) but Denied Disability Benefits

We have reviewed  (1)  Social Security claim and find that  (2)  entitled to a period of disability but  (3)  not entitled to Disability Insurance Benefits. We have established a period of disability for  (4)  beginning  (5)  .

To be eligible for disability benefits a person must be unable to engage in substantial gainful activity. It has been determined from the evidence in  (6)  case that the work  (7)  done while disabled shows  (8)  ability to do some type of substantial gainful work. Thus,  (9)  not entitled to these benefits. Under special provisions of the Social Security law concerning blind persons, however,  (10)  entitled to a period of disability regardless of  (11)  ability to work.

The period of disability now established for  (12)  is important. It protects  (13)  right to insurance benefits and the benefit rights of  (14)  dependents and survivors.

Fill-ins:

(1) “your”/FN

(2) “you are”/“she is”/“he is”

(3) “you are”/“she is”/“he is”

(4) “you”/“her”/“him”

(5) onset date (date freeze begins)

(6) “your”/“her”/“his”

(7) “you have”/“she has”/“he has”

(8) “your”/“her”/ “his”

(9) “you are”/“she is”/“he is”

(10) “you are”/“she is”/“he is”

(11) “your”/“her”/“his”

(12) “you”/”her”/“him”

(13) “your”/“her”/“his”

(14) “your”/“her”/“his”

FRZ005 Statutory Blind Number Holder Allowed Freeze – Reporting Responsibilities

The period of disability established for  (1)