We are writing to tell you that we plan to stop _____(1)_____ Special Veterans Benefits (SVB) beginning _____(2 _____. Our records show that _____(3)_____ no longer due payments as of _____(4) _____ because:
[PROMPT REQUESTED SUSPENSION/STOP PAYMENT REASONS]
[Return to the U.S. for More Than a Full Calendar Month]
_____(1)_____ in the United States for more than a full calendar month and no longer _____(2) _____ the foreign residence requirement.
[Return to the U.S. to Reside]
_____(1)_____ returned to the United States to reside and no longer _____(2)_____ the foreign residence requirement.
[Failure to Provide Information Timely]
you have not provided the information we need to decide whether_____(1) _____ should still receive SVB payments.
[Whereabouts Unknown]
we have been unable to get in touch with you to see if _____(1) _____ should still receive benefits. All of our efforts to contact you have failed.
Please contact us as soon as possible. We need your correct address.
[Check returned for Miscellaneous Reasons]
the _____ (1) _____ we sent you for _____(2)_____ _____(3) _____ returned. We will not send any more checks until you get in touch with us.
[Other Benefit Income]
_____(1)_____ other benefit income that is equal to or over $____(2)_____ , which is the maximum SVB payable at this time.
[Deportation]
information we have received from the Attorney General shows that _____(1)_____ removed or deported from the United States. If _____(2) _____ permitted in the future to have a permanent home in the United States, please
contact us again. We will then be able to determine what type of benefit, if any,
is payable at that time.
[Fugitive Felon]
we have received information that shows _____(1) _____ left the United States to avoid _____(2) _____ for a crime or an attempt to commit a crime that is considered a _____(3) _____ under the law.
[Probation/Parole Violation]
we have received information that shows _____(1) _____ violated a condition of probation or parole which was imposed under a U.S.
Federal or State law.
[SSA Restricted Country]
we cannot pay any benefits while _____(1) _____ in _____(2) _____. No agreement has been reached with the government of that country about procedures
for verifying that benefits will be properly paid.
You should let us know if _____(3) _____ again even though we are not paying any benefits now. We need to have a current
address should we be able to pay benefits to residents of _____(4) _____ in the future. We may also be able to pay benefits for the months payments
were withheld if _____(5)_____ in a country where payments are not restricted.
[Treasury Barred Country]
U. S. Treasury Department regulations prohibit sending payments to _____(1)_____ or on _____(2) _____ behalf while _____(3)_____ in _____(4) _____.
If _____(5)_____ a citizen or national of the U.S., you can receive all benefits that were withheld
once _____(6) _____ that country and _____(7)_____ to another country where payments are not restricted, as long as all other requirements
are met. If _____(8) _____ not a citizen or national of the U.S., no payment may be made for the months
that benefits were withheld.
You should let us know if _____(9) _____ again even though we are not paying any benefits now. We need to have a current
address should we be able to pay benefits to residents of _____(10) _____ in the future.
[Optional Paragraph-Delayed Suspension]
This determination replaces all previous determinations for the above periods.
We will send you another letter explaining more about the payments you already received
for _____(1) _____.
[Optional Paragraph to be Requested for All Suspension
Actions]
If you think ___(1)___ may be eligible for Special Veterans Benefits again, please contact us. If you
do not contact us before ___(2)___, you may have to file a new application. If you have to file a new application,
the earliest month for which we can pay ___(3) ___ is the month you file.
If You Disagree With the Decision
If you disagree with our decision, you have the right to appeal. A person who did
not make the first decision will decide your case. We will review those parts of the
decision with which you disagree and will look at any new facts you have. We may also
review those parts with which you agree and may make them unfavorable or less favorable
to you.
-
•
You have 60 days to ask for an appeal.
-
•
You must put the request for an appeal in writing.
-
•
The 60 days start the day after you receive this letter.
-
•
You must have a good reason if you wait more than 60 days to ask for an appeal.
-
•
You may make your request through any U.S. Social Security office, United States Embassy
or consulate, or the U.S. Veterans Affairs Regional Office in Manila. Or, you may
write to us at the address shown at the top of this letter.
Please read the enclosed leaflet, “Your Right
to Question the Decision Made on Your Social Security
Claim.” It contains more information about an appeal.
Appeal In 10 Days To Keep Getting Benefits
If you appeal within 10 days, you will continue to get your benefits until we decide
your case.
-
•
The 10 days start the day after you get this letter.
-
•
If you lose your appeal, you may have to pay back some or all of this money.
However, even if you appeal in 10 days, we may stop your payment as shown on page
1 if both of the following are true:
-
•
Our new decision is the same as the one appealed, and
-
•
We send or give you a letter with our new decision in time to stop your payments.
How To Appeal
There are three ways to appeal. You can choose the one you want. However, conferences
(choices two and three below) are only held in the United States, District of Columbia, and the Northern Mariana Islands.
We will not pay for travel to these places from outside the United States.
-
•
Case Review. You have a right to review the facts in your file. You can give us more facts to
add to your file. Then we'll decide your case again. You won't meet with the person
who decides your case.
-
•
Informal Conference. You'll meet with the person who decides your case. You can tell that person why you
think you're right. You can give us more facts to help prove you're right. You can
bring other people to help explain your case.
-
•
Formal Conference. This is a meeting like an informal conference. The difference is we can make people
come to help prove you're right. We can make them bring important papers about your
case, even if they don't want to help you. You can question these people at your meeting.
[Optional Domestic Paragraph-Domestic Addressee]
If You Have Questions or Need Help
If you have any questions or need help, you may call, write, or visit our office or
any U.S. Social Security office. You may also write to us at the address shown at
the top of this letter. If you call or visit an office, please have this letter with
you. Also, if you plan to visit an office, you may call ahead to make an appointment.
This will help us serve you more quickly when you arrive at the office.
[Optional Foreign Paragraph-Foreign Addressee]
If You Have Questions or Need Help
If you have questions, you should contact one of the offices shown below. You may
also write to us at the address shown at the top of this letter. However, if you call
or visit an office, please have this letter with you.
-
•
If you live in Canada, contact any U.S. Social Security office.
-
•
If you live in Guam, Puerto Rico, American Samoa or the U.S. Virgin Islands, you should
contact the nearest U.S. Social Security office.
-
•
If you live in Mexico, contact any U.S. Social Security office or the nearest United
States Embassy or consulate.
-
•
If you live in the Philippines, please call 523-1001 extension 2516 or 2645 from 8:00
am to 2:00p.m. or write/visit SSA Division, U.S. Department of Veterans Affairs, American
Embassy, 1131 Roxas Boulevard, 0930 Manila.
-
•
If you live in any other country, you should contact the nearest United States Embassy
or consulate.
Fill-ins:
-
(1)
(your) or ([veteran's name])—possessive
-
(2)
([MM/YY])—month and year payment will stop
-
(3)
(you are) or (he is) or (she is)
-
(4)
([MM/YY])—month and year for which suspension is effective
[Return to the U.S. for More Than a Full Calendar Month]
-
(1)
(you have been) or (you were) or (he has been) or (she has been) or (he was) or (she
was)
-
[Return to the U.S. to Reside]
-
-
[Failure to Provide Information Timely]
-
[Whereabouts Unknown]
-
[Check returned for Miscellaneous Reasons]
-
-
(2)
([MM/YY])—month and year, or (MM/YY through MM/YY)—month and year through month and
year
-
[Other Benefit Income]
-
(1)
(you have) or (he has) or (she has)
-
(2)
([current maximum SVB payment])
[Deportation]
-
(1)
(you were) or (he was) or (she was)
-
(2)
(you are) or (he is) or (she is)
[Fugitive Felon]
-
(1)
(you) or ([veteran's name])
-
(2)
(prosecution) or (custody or confinement after conviction)
-
(3)
(felony, or in jurisdictions that do not define crimes as felonies, is punishable
by death or imprisonment for a term exceeding 1 year regardless of the actual sentence
imposed,)
[Probation/Parole Violation]
-
(1)
(you) or ([veteran's name])
[SSA Restricted Country]
-
(1)
(1) (you live) or ([veteran's name] lives)
-
(2)
([name of restricted country])
-
(3)
(you move) or ([veteran's name] moves)
-
(4)
([name of restricted country])
-
(5)
(you later reside) or ([veteran's name] later resides)
[Treasury Barred Country]
-
-
-
(3)
(you reside) or (he resides) or (she resides)
-
(4)
([name of Treasury barred country])
-
(5)
(you are) or ([veteran's name] is)
-
(6)
(you leave) or (he leaves) or (she leaves)
-
-
(8)
(you are) or ([veteran's name] is)
-
(9)
(you move) or ([veteran's name] moves)
-
(10)
([name of Treasury barred country])
[Optional Paragraph-Delayed Suspension/Stop Payment]
-
(1)
([months for which payments were already sent])
[Optional Paragraph to be Requested for All Suspension
Actions]
-
(1)
(you) or ([veteran's name])
-
(2)
([13th month]) or ([month of termination])
-
(3)
(you) or ([veteran's name])