TN 25 (09-22)
   
   
   
   
      ALS023 INITIAL RECONSIDERATION (G17)
      
      
      (System Generated)
      
      Caption: Do You Think We Are Wrong
      
      If you do not agree with this decision, you have the right to appeal. We will review
          (1)  case and look at any new facts you have. A person who did not make the first decision
         will decide  (2)  case. We will review the parts of the decision that you think are wrong and correct
         any mistakes. We may also review the parts of our decision that you think are right.
         We will make a decision that may or may not be in  (3)  favor.
      
      
      
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                  You have 60 days to ask for an appeal. 
 
 
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                  The 60 days start the day after you receive this letter. We assume you received this
                     letter 5 days after the date on it unless you show us that you did not receive it
                     within the 5-day period.
                   
 
 
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                  You must have a good reason for waiting more than 60 days to ask for an appeal. 
 
 
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                  You must ask for an appeal in writing. Please use our “Request for Reconsideration”
                     form, SSA-561-U2. You may go to our website at  (4)  to locate the form. You can also contact us to request the form, or if you need help
                     filling out the form.
                   
 
 
      Fill-in values:
         
         Fill-in (1)
            
            
Choice 1: your
            Choice 2: Beneficiary's Name possessive
         Fill-in (2)
            
            
Choice 1: your
            Choice 2: his
            Choice 3: her
         Fill-in (3)
            
            
Choice 1: your
            Choice 2: his
            Choice 3: her
         Fill-in (4)
            
            
https://www.ssa.gov/forms/
          
    
   
      ALS054 REMINDER OF IMPORTANCE TO ATTEND HEARING (G87)
      
      
      (System Generated)
      
      Caption: It Is Important That You Go To The Hearing
      
      It is very important that you go to the hearing. If for any reason you can't go, contact
         the ALJ as soon as possible before the hearing and explain why. The ALJ will reschedule
         the hearing if you have a good reason.
      
      
      If you don't go to the hearing and don't have a good reason for not going, the ALJ
         may dismiss your request for a hearing.
      
      
    
   
      ALS113 FPM CASE-RIGHT TO APPEAL (G82)
      
      
      (System Generated)
      
      Caption: If You Disagree With The Decision
      
      If you disagree with the decisions, 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
         decisions you disagree with and will look at any new facts you have. We may also review
         those parts of the case that you believe are correct and may make them unfavorable
         or less favorable to you.
      
      
    
   
      ALS123 FPM CASE-EXPLANATION THAT HEARING WILL BE PROCESSED FIRST (G85)
      
      
      (System Generated)
      
      Caption: If You Ask For A Reconsideration And A Hearing
      
      If you ask for both a reconsideration and a hearing, we will process the hearing first,
         even if you made the reconsideration request first. When we make our decisions, we
         will send you letters explaining our decisions on both the reconsideration and the
         hearing.
      
      
    
   
      ALS125 FPM CASE-EXPLANATION OF HEARING PROCESS (G86)
      
      
      (System Generated)
      
      Caption: How The Hearing Process Works
      
      After we send your case for a hearing, an Administrative Law Judge (ALJ) will mail
         you a letter at least 20 days before the hearing to tell you its date, time and place.
         The letter will explain the law in your case and tell you what has to be decided.
         Since the ALJ will review all the facts in your case, it is important that you give
         us any new facts as soon as you can.
      
      
      The hearing is your chance to tell the ALJ why you disagree with the decisions in
         your case. You can give the ALJ new evidence and bring people to testify for you.
         The ALJ also can require people to bring important papers to your hearing and give
         facts about your case. You can question these people at your hearing.
      
      
    
   
      ALS170 ALJ OR APPEALS COUNCIL DECISION (C13)
      
      
      (Requested)
      
      Caption: Do You Think We Are Wrong
      
       (1)  entitled to benefits because of a decision made  (2)  .
      
      
      If you disagree with this decision, you have the right to appeal. We will review your
         case and consider any new facts you have. A person who did not make the first decision
         will decide  (3)  case. We will correct any mistakes. We will review those parts of the decision, which
         you believe are wrong and will look at any new facts you have. We may also review
         those parts, which you believe are correct and may make them unfavorable or less favorable
         to  (4)  .
      
      
      
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                  You have 60 days to ask for an appeal. 
 
 
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                  The 60 days start the day after you get this letter. We assume you got this letter
                     5 days after the date on it unless you show us that you did not get it within the
                     5-day period.
                   
 
 
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                  You will have to have a good reason for waiting more than 60 days to ask for an appeal. 
 
 
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                  You have to ask for an appeal in writing. We will ask you to sign a form SSA-561-U2,
                     called “Request for Reconsideration.” Contact one of our offices if you want help.
                   
 
 
      Fill-in values:
         
         Fill-in (1) – System Generated
            
            
Choice 1: You are
            Choice 2: Beneficiary's Name is
         Fill-in (2) - Requested As A One Position Alpha Character
            
            
Choice 1 (A): by the Appeals Council
            Choice 2 (B): by the Administrative Law Judge
            Choice 3 (C): on your hearing request
         Fill-in (3) – System Generated
            
            
Choice 1: Beneficiary's Name
            Choice 2: your
         Fill-in (4) – System Generated
            
            
Choice 1: you
            Choice 2: him
            Choice 3: her
          
    
   
      ALS171 FPM CASE-EXPLANATION OF THE DIFFERENCE BETWEEN A RECONSIDERATION AND A HEARING (G83)
      
      
      (System Generated)
      
      Caption: About The Appeals
      
      If you disagree with the non-medical decisions we made on  (1)  case, the appeal is called a reconsideration. Some examples of non-medical decisions
         are the amount of your payment and the month your payment starts. You will not meet
         the person who decides  (2)  case.
      
      
      If you disagree with the disability (medical) decision made by the state, the appeal
         is called a hearing. Some examples of medical decisions are the date your disability
         started or whether you are still disabled.
      
      
      
      Fill-in values:
         
         Fill-in (1)
            
            
Choice 1: your
            Choice 2: Beneficiary's name possessive
         Fill-in (2)
            
            
Choice 1: your
            Choice 2: his
            Choice 3: her
          
    
   
      ALS172 FPM CASE-EXPLANATION OF 60 DAY APPEAL PERIOD (G84)
      
      
      (System Generated)
      
      Caption: If You Want To Appeal
      
       (1)  60 days to ask for an appeal.
      
      
      
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                  The 60 days start the day after  (2)  this letter. We assume  (3)  got this letter 5 days after the date on it unless  (4)  us that  (5)  did not get it within the 5 day period.
                   
 
 
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                   (6)  must have a good reason if  (7)  more than 60 days to ask for an appeal.
                   
 
 
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                   (8)  to ask for an appeal in writing. We will ask  (9)  to sign a form SSA-561-U2, called “Request for Reconsideration” or a form HA-501,
                     called “Request for Hearing.” Contact one of our local offices if  (10)  help.
                   
 
 
      Fill-in values:
         
         Fill-in (1)
            
            
Choice 1: You have
            Choice 2: Beneficiary name plus has
         Fill-in (2)
            
            
Choice 1: you receive
            Choice 2: he receives
            Choice 3: she receives
         Fill-in (3)
            
            
Choice 1: you
            Choice 2: he
            Choice 3: she
         Fill-in (4)
            
            
Choice 1: you show
            Choice 2: he shows
            Choice 3: she shows
         Fill-in (5)
            
            
Choice 1: you
            Choice 2: he
            Choice 3: she
         Fill-in (6)
            
            
Choice 1: You
            Choice 2: He
            Choice 3: She
         Fill-in (7)
            
            
Choice 1: you want
            Choice 2: he wants
            Choice 3: she wants
         Fill-in (8)
            
            
Choice 1: You have
            Choice 2: He has
            Choice 3: She has
         Fill-in (9)
            
            
Choice 1: you
            Choice 2: him
            Choice 3: her
         Fill-in (10)
            
            
Choice 1: you want
            Choice 2: he wants
            Choice 3: she wants
          
    
   
      ALS185 DECISION REVISED BASED ON RECONSIDERATION (A11)
      
      
      (Requested)
      
      Caption: Do You Think We Are Wrong
      
      As you asked, we have reviewed  (1)  case, and are changing an earlier decision we made. If you think we are wrong, you
         have the right to request a hearing. At the hearing, a person who has not seen your
         case before will look at it. That person is an Administrative Law Judge. In the rest
         of this letter, we will call this person an ALJ. The ALJ will review those parts of
         the decision, which you believe are wrong. The ALJ will look at any new facts you
         have and correct any mistakes. The ALJ may also review those parts, which you believe
         are correct and make them unfavorable or less favorable to  (2)  .
      
      
      
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                  You have 60 days to ask for a hearing. 
 
 
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                  The 60 days start the day after you receive this letter. We assume you received this
                     letter 5 days after the date on it unless you show us that you did not receive it
                     within the 5-day period.
                   
 
 
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                  You must have a good reason if you wait more than 60 days to ask for a hearing. 
 
 
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                  You have to ask for a hearing in writing. If you want to make a request, please contact
                     one of our offices. We can help you complete the required form.
                   
 
 
Please read the enclosed pamphlet, “Your Right To An Administrative Law Judge Hearing
         And Appeals Council Review Of Your Social Security Case”. It contains more information
         about the hearing.
      
      
       
      
       
      
      NOTE: MADCAP suppresses ALS120 if ALS185 is requested. If ALS185 is used in a manual Aurora
         notice, DO NOT include ALS120.
      
      
      
      Fill-in values:
         
         Fill-in (1) Systems Generated:
            
            
Choice 1: your
            Choice 2: Beneficiary's Name possessive
         Fill-in (2) Systems Generated
            
            
Choice 1: you
            Choice 2: him
            Choice 3: her
          
    
   
      ALS186 DECISION REVISED BASED ON RECONSIDERATION - POSTENTITLEMENT LETTERS - FOREIGN (A17)
      
      
      (Requested)
      
      Caption: Do You Think We Are Wrong
      
      We are sending you this letter because we changed an earlier decision we made. We
         made this change because you asked us to review  (1)  case.
      
      
      If you still think any of our decisions are wrong, you have the right to appeal. A
         person who has not seen  (2)  case before will look at it. That person will be an Administrative Law Judge. The
         Administrative Law Judge will correct any mistakes and look at any new facts you have
         before deciding  (3)  case. We call this a hearing.
      
      
      
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                  You have 60 days to ask for a hearing. 
 
 
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                  The 60 days start the day after you get this letter. 
 
 
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                  You will have to have a good reason for waiting more than 60 days to ask for a hearing. 
 
 
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                  You can only have a hearing in the United States. You would have to pay any costs
                     for traveling to the United States for the hearing. If you cannot come to the hearing,
                     the Administrative Law Judge will review your case plus any new information you send
                     us. We will send you a letter about the Administrative Law Judge's decision.
                   
 
 
You have to ask for a hearing in writing. Contact us if you want help.
      
      
      Fill-in values:
         
         Fill-in (1) Systems Generated:
            
            
Choice 1: your
            Choice 2: Beneficiary's Name possessive
         Fill-in (2) Systems Generated
            
            
Choice 1: your
            Choice 2: his
            Choice 3: her
         Fill-in (3) Systems Generated
            
            
Choice 1: your
            Choice 2: Beneficiary's Name possessive
          
    
   
      
      
      (System Generated)
      
      Caption: Do You Think We Are Wrong
      
      If you think this information is not correct or you want to report any changes in
          (1)  work plans or earnings, please get in touch with  (2)  benefits counselor at Abt Associates. Please call their toll-free number at 1-877–726–6309
         (877–7BOND09) to report any changes. If you have a hearing or speech impairment, you
         may call their TTY number, 1-877-726-6390 (877-7BOND90).
      
      
      
      Fill-in values:
         
         Fill-in (1) Systems Generated
            
            
Choice 1: your
            Choice 2: Beneficiary's Name possessive
         Fill-in (2) Systems Generated
            
            
Choice 1: your
            Choice 2: his
            Choice 3: her
          
    
   
      ALS193 HEARING PARAGRAPH - FOREIGN-FOR AWARD LETTERS AFTER A FAVORABLE RECONSIDERATION DETERMINATION
         (A15)
      
      
      (Requested)
      
      Caption: Do You Think We Are Wrong
      
       If you think we are wrong, you have the right to request a hearing. At the hearing,
         a person who has not seen your case before will look at it. That person is an Administrative
         Law Judge. In the rest of our letter, we will call this person an ALJ. The ALJ will
         review those parts of the decision which you believe are wrong. The ALJ will look
         at any new facts you have and correct any mistakes. The ALJ may also review those
         parts which you believe are correct and may make them unfavorable or less favorable
         to you.
      
      
      
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                  You have 60 days to ask for a hearing 
 
 
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                  The 60 days start the day after you receive this letter. 
 
 
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               • 
                  You must have a good reason if you wait more than 60 days to ask for a hearing. 
 
 
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                  You can only have a hearing in the United States. You would have to pay any costs
                     for traveling to the United States for the hearing. If you cannot come to the hearing,
                     the Administrative Law Judge will review your case plus any new information you send
                     us. We will send you a letter about the Administrative Law Judge's decision.
                   
 
 
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                  You have to ask for a hearing in writing. Contact us if you want help. 
 
 
 Please read the enclosed pamphlet, "Your Right to an Administrative Law Judge Hearing
         and Appeals Council Review of Your Social Security Case." It contains more information
         about the hearing.
      
      
    
   
      ALS197 HEARING PARAGRAPH FOR AWARD LETTERS AFTER A FAVORABLE RECONSIDERATION DETERMINATION
         — DOMESTIC (A12)
      
      
      (Requested)
      
      Caption: Do You Think We Are Wrong
      
      If you think we are wrong, you have the right to request a hearing. At the hearing,
         a person who has not seen your case before will look at it. That person is an Administrative
         Law Judge. In the rest of our letter, we will call this person an ALJ. The ALJ will
         review those parts of the decision which you believe are wrong. The ALJ will look
         at any new facts you have and correct any mistakes. The ALJ may also review those
         parts which you believe are correct and may make them unfavorable or less favorable
         to you.
      
      
      
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                  You have 60 days to ask for a hearing. 
 
 
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                  The 60 days start the day after you receive this letter. 
 
 
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               • 
                  You must have a good reason if you wait more than 60 days to ask for a hearing. 
 
 
- 
            
               • 
                  You have to ask for a hearing in writing. If you want to make a request, please contact
                     one of our offices. We can help you complete the required form.
                   
 
 
Please read the enclosed pamphlet, “Your Right To An Administrative Law Judge Hearing
         And Appeals Council Review Of Your Social Security Case”. It contains more information
         about the hearing.