Effective Dates: 6/17/2025 - Present

Identification Number:
NL 00705 TN 30
Intended Audience:See Transmittal Sheet
Originating Office:ORDP ODP
Title:Disability Sample Guide Letters
Type:POMS Full Transmittals
Program:All Programs
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM

Part NL – Notices, Letters and Paragraphs

Chapter 007 – Letters and Paragraphs for Title II, Title XVI, and Title XVIII

Subchapter 05 – Disability Sample Guide Letters

Transmittal No. 30, 06/17/2025

Audience

PSC: CA, CS, DE, ICDS, IES, ISRA, RECONR, SCPS, TSA, TST;
OCO-OEIO: BIES, CC, CCRE, CR, ERE, FDE, PETL, RECONE, RECONR, RECOVR;
OCO-ODO: BET, BTE, CCE, CR, CST, CT, CTE, DE, DEC, DS, DSE, PAS, PETE, PETL, RCOVTA, RECONE, RECOVR;
FO/TSC: CS, CS TII, CSR, DRT, FR, OA, OS, RR, TA, TSC-CSR;
ODD: DDS-ADJ, DHU;

Originating Component

ODP

Effective Date

Upon Receipt

Background

The Office of Disability Policy revised this section to include instructions for the claimant to contact their medical sources to help expedite their claim. In addition, we included information and instructions for child claims, Age 18 Redetermination cases, and Continuing Disability Reviews (CDR) cases, and updated the language throughout for consistency with the Disability Case Processing System (DCPS).

Summary of Changes

NL 00705.720 Adult Initial Case Development Letter - Sample

We changed the title to “Introduction Letter” and made the following revisions:

  • •

    Included canned introductory language for initial and reconsideration claims, Age 18 Redetermination cases, and CDR cases;

  • •

    Added information in the “How We Decide Eligibility For Disability Benefits” section for child claims, and updated the language for adult claims;

  • •

    Added information in the “What We Will Do” section for Age 18 Redetermination and CDR cases;

  • •

    Updated the instructions in the “What You Need To Do” section;

  • •

    Added new section titled, “Contact Your Medical Source(s)”, and provided new instructions to help with expediting the claims process;

  • •

    Added canned language for the “Suspect Social Security Fraud?” and “If You Have Any Questions” sections; and

  • •

    Updated the standard signature block for consistency with DCPS.

NL 00705.720 Introduction Letter

  

AGENCY LETTERHEAD

Date: Fill-in

Case ID: Fill-in

     

Addressee Name

Address Line 1

Address Line 2

City, State, ZIP code

    

INTRODUCTION LETTER

   

If initial or reconsideration claim use:

We are the office that makes disability decisions for the Social Security Administration. We are writing to tell you that we are reviewing your/[claimant's full name]'s disability claim.

If Age 18 Redetermination use:

We are the office that makes disability decisions for the Social Security Administration. Because you/[claimant full name] are/is now age 18 or older, we need to re-evaluate your/his/her case using adult disability rules.

If CDR use:

We are the office that makes disability decisions for the Social Security Administration. Periodically, we must review the cases of people who are receiving disability benefits to make sure they remain disabled under our rules.

 

If initial or reconsideration claim include:

How We Decide Eligibility For Disability Benefits

If child claim use:

To be eligible for disability benefits, you/he/she must have a medical condition(s) that:

  • •

    Causes marked and severe functional limitations, and

  • •

    Has lasted or is expected to last for at least 12 months in a row, or is expected to result in death.

If adult claim use:

To be eligible for disability benefits, you/he/she must have a medical condition(s) that:

  • •

    Keeps you/him/her from doing your/his/her past work or adjusting to other work, and

  • •

    Has lasted or is expected to last for at least 12 months in a row, or is expected to result in death.

 

What We Will Do

If initial or reconsideration claim use:

We will review the medical and other information we have. If we need more information to decide whether you/he/she are/is disabled, we may arrange an exam or test which we will pay for. We may also reimburse some travel expenses to the exam or test site based on a set rate.

If Age 18 Redetermination use:

Doctors and other trained staff will decide if you/he/she are/is disabled. To do this, we may need to request information from your/his/her doctors, hospitals, clinics, and other sources, at no cost to you/him/her. If we need more information to decide whether you/he/she are/is disabled, we may arrange an exam or test. We will pay for the exam or test. When we have finished the review, we will send a letter to let you know what we have decided.

If CDR use:

Doctors and other trained staff will review your/his/her case to see if your/his/her medical condition(s) have changed since the last time we reviewed your/his/her case. To do this, we may need to request information from your/his/her doctors, hospitals, clinics, and other sources, at no cost to you/him/her. If we need more information to decide whether you/he/she are/is still disabled, we may arrange an exam or test. We will pay for the exam or test. When we have finished the review, we will send a letter to let you know what we have decided.

 

What You Need To Do

Please respond quickly to any letters or forms that you receive from us. Let us know right away if any of the following things happen while we [process this claim[1]/re-evaluate this case[2]]:

  • •

    New doctor or hospital visit,

  • •

    Additional tests, therapy, or surgery,

  • •

    Changes in dosage, addition, or discontinuation of medication(s),

  • •

    New conditions develop,

  • •

    Additional current or past medical, educational, or mental health sources not listed on the application.

If adult claim, also include:

  • •

    Begin or return to work.

You must report to SSA right away any changes to your/his/her address, telephone number(s) or any other personal information.

 

Contact Your Medical Source(s)

Obtaining all necessary medical records is critical in reviewing your/his/her disability [claim[3]/case[4]]. If additional medical information is needed, we may request a consultative examination(s). We encourage you to contact your/his/her medical source(s) to:

  • •

    Ensure they submit your/his/her medical records to SSA as soon as possible, and

  • •

    Determine if they are willing to perform a consultative examination if one is necessary.

Contacting your/his/her medical source(s) can help expedite obtaining your/his/her records, avoid delays in processing your/his/her claim, and assist us in making a timely and accurate determination. If your/his/her medical source is available to conduct the consultative examination, please have them contact the DDS at the number or address listed in this letter.

 

Suspect Social Security Fraud?

Please visit https://oig.ssa.gov/report or call the Inspector General's Fraud Hotline at (800) 269-0271. If you are deaf or hard of hearing, call TTY (866) 501-2101.

 

If You Have Any Questions

If you have any questions or wish to provide more information, please call us at the number(s) shown DDS office hours. When you call or leave a message, please provide the Case ID: case ID number, your name, and a call back number.

 

Thank you for your cooperation,

[Name]

[Phone Number]

[Fax Number]

 

Enclosures:

Multi-Language Insert

 


NL 00705 TN 30 - Disability Sample Guide Letters - 6/17/2025