TN 7 (10-15)
DI 28075.630 1619 Cessation Notices (Title XVI)
Paragraph1
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1619(a) Status
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1619(b) Status
|
1619(a) 301 Status
|
1619(b) 301 Status
|
1619(b) Blind or Visually Impaired
|
Lead In
|
4207
|
4207
|
4207
|
4207
|
4207
|
Attachment 2
|
4041
|
4041
|
4041
|
4041
|
4041
|
Payments End
|
4213
|
----
|
4213
|
----
|
----
|
Medicaid Ends
|
----
|
4229
|
----
|
4229
|
4229
|
Information About Medicaid
|
4050
|
4217
|
4050
|
4217
|
4217
|
Vocational Rehabilitation
|
----
|
----
|
4053
|
4227
|
----
|
Appeals
|
4056
|
4056
|
4057
|
4057
|
4056
|
Benefit Continuation
|
4061
|
4231
|
4061
|
4231
|
4231
|
Disability Hearing
|
4066
|
4066
|
4066
|
4066
|
4067
|
If You Need Help
|
4069
|
4069
|
4069
|
4069
|
4069
|
Things to Remember
|
4073
|
4073
|
4073
|
4073
|
4077
|
DO Referral
|
4078
|
4078
|
4078
|
4078
|
4078
|
Enclosure
|
3
|
3
|
3
|
3
|
3
|
Footnotes:
1 For paragraph language, see NL 00708.100.
2 Delete if personalized explanation is included in the body of the notice.
3 Enclosures:
Explanation of Determination
SSA Pub. No. 05-11008
(NOTE: Delete “Explanation of Determination” if the personalized information is included in the body of the notice.)