TN 25 (02-95)

NL 00804.135 Requested Information

1100. Situation Where Used:

Used on SSA-L8030's for denials based on claimant's refusal to provide requested information on factors other than blindness/disability.

To be eligible for Supplemental Security Income payments, we asked (you) to provide evidence concerning (your) claim. Since (you) did not give us the information we asked for, we must make our determination based on the information we have. Based on the information in our records, we have determined that (you) are not eligible to receive payments.

2100. Situation Where Used:

Use when we are suspending payment or eligibility due to N20. For example, the payment status changes from C01, E01, or N01 in 1619(b) eligibility, to N20 for failure to furnish requested information on factors other than disability /blindness. Use on an SSA-L8155-U2, Notice of Planned Action, under the caption, “Why [Your/Recipient's Name][Payment /
Eligibility]Changed.” (When you use this paragraph, be sure to also use paragraph 2508 (paragraph SUSM52 for manual notices) in NL 00804.240.)

NOTE: See paragraph SUSM51, which follows, to use in N20 manual notices.

We notified you that to continue (1) you must furnish us with information concerning (your) claim. Since you have not done so, (2) will be suspended beginning (3) .


Choice 1 -

receiving Supplemental Security Income payments


Choice 2 -

to be eligible under the Supplemental Security Income program


Choice 1 -

(your) payments


Choice 2 -

(your) eligibility



SUSM51. Situation Where Used:

Use this language for N20 manual notices. Use it in the same situation as for paragraph 2100 above.

We asked (you) earlier to give us information that we need to (1) . Since (you) have not done this, we will (2) in (3) .

(You) still have time to keep (your) SSI (4) , but we must hear from (you) right away.We will help (you) get any information that we need.

(1)Choice 1 - pay (you) SSI
 Choice 2 - keep (your) SSI case active
(2)Choice 1 - stop (your) SSI
 Choice 2 - close (your) SSI case
(4)Choice 1 - case active
 Choice 2 - null

NOTE: When E01 or 1619(b) eligibility changes to N20, select from fill-in (1), Choice 2 and fill-in (2), Choice 2.

2101. Situation Where Used:

Reinstatement based on receipt of requested information. Status changes from N20 to C01 or E01.

(1) effective (2) since (you) have furnished us with the information we asked for.

(1)Choice 1 - (You) are eligible for supplemental security income payments
 Choice 2 - (You) are eligible under the Supplemental Security Income program


Manual Paragraphs

PMTM01. Situation Where Used:

IC: Use in award situations to explain a nonpayment month(s) for which you are unable to determine eligibility (payment status code N05). Use on an SSA-L8025-U2, Notice of Award, under the caption, “[Your/(Recipient's Name)] Payment Is Based On These Facts.”

(1) cannot get SSI for (2) because you could not give us all of the fact