NL 00705.535 Prisoner Model Letter V—Incarceration Related Impairment—CDB, DWB
Prepare on SSA-L951-C2/U2
Social Security Notice
Date:
Claim Number:
You are not entitled to benefits at this time because you do not meet the disability requirements of the
law.
Our records show that your disability claim is based on an impairment connected with
your confinement in a jail, prison, or other penal institution or correctional facility
due to conviction of a felony.
The records also show that you committed the felony after October 19, 1980. In this
situation, the Social Security law allows impairment connected with confinement to
be considered for payment of benefits for any month you are confined. In this situation,
the Social Security law does not allow an impairment(s) connected with confinement
to be considered for payment of benefits for any month you are confined. Where the
jurisdiction does not classify any crime as a felony, we apply these provisions to
confinement for a crime which can be punished by death or by imprisonment for more
than one year.
You may be entitled to benefits when you are released if you meet the disability requirements
of the law. You should get in touch with any Social Security office about filing an
application at that time.
If you believe that this determination is not correct, you may request that your case
be reexamined. If you want this reconsideration, you must request it not later than
60 days from the date you receive this notice. You may make your request through any
Social Security office. If additional evidence is available, you should submit it
with your request. Please read the enclosed leaflet for a full explanation of your
right to question the determination made on your claim.
If you do not request reconsideration of your case within the prescribed time period,
you still have the right to file another application at any time.
If you have questions about your claim, you may get in touch with any Social Security
office. Most questions can be handled by telephone or mail.
Enclosure:
SSA Publication No. 70-10058